HEP B

[hepbvictim]

I was first diagnosed with HBSAg + in 2003 tested HBV DNA which was undetectable (in 2005). didn't take it too serious for 4 years or lets say didn't know what to do with this??. Now in a routine medical exam, found HBSAg still +, ALT are raised to 120 rest of LFT are normal, HBeAG is negative but then Viral load is 11000 (not sure copies or IU, i know it makes a difference if these are copies or IU). some say should be on treatment other saying not. My doctor want me to undergo a Liver Biosy and I am not ready for this as have no problems or sysmptoms and only came to know about this through routine medical exam. Liver biopsy is scary and side affects and risks, what would you suggest guys??

[stef2011]

if you have normal alt/ast or never more than 200 fibroscan is more accurate then biopsy because biopsy is limited to the piece of liver they take but not all the liver (you can have different damage in different parts of the liver).So biopsy is not required so often as once.
i suggest no tx if you have no liver damage (fibroscan 7-10kpa), also ultrasound is a good exam to check liver damage.
be very carefull do not wait for synthoms, you can have no synthoms and have cirrohosis or liver cancer which is an advanced state of the disease, you check carefully by blood tests and fibroscan for cirrhosis and ultrasound for cirrhosis/liver cancer.checking for liver cancer is important because we have a higher chance of liver cancer especially with high hbvdna (not your case)

the best first line tx is peginterferon at the moment but it can have many sides, when trials of antivirals combo (tenofovir+entecavir) will be finished and if toxicity is low over the years this will be a very good tx choice (almost no sides)

[hepbvictim]

Thansk for your comments. Is Fibroscan paibless unlike Biopsy?
Its really very difficult to convince your ownself just on the basis of Blood Test Results when in reality you are not facing any sorts of problems or symptoms and living a healthy life- apparently.
if started treatments how bad are the side affects ike nuisea, vomiting, headache etc etc. if they are 11000 copies , then it is just over 2000IU, am i right? so its just the threshold for the treatment.

[bberry]

ask for a liver fibroscan ( if available)
fibroscan is available in a small number of hospital in the US. i think it would have to be a cancer and liver disease center of some sort.
as for liver biopbsy it may not be needed at this time but i think overall isnt something you want to do often... i would wait and may even have a second opinion with a different doctor.
even at 11000 copies which is less than IU by miles , you are still considered a candidate for treatment. know this though, starting treatment while hbeag negative is an endless treatment course ( i,e.. for life ) with no end in sight unless somehow you resolve hbv alltogether ( 1-2% chance every year ) or a cure is found ( nothing in sight for the near future ) so your chances are almost slim to none of resolving this problem.

i would run more tests and may wait  for like 3 sets of tests over a span of 9-12 months. if the results remain unchanged from the current result then maybe treatment is needed and a biopsy should take place.. biopsys shouldnt be repeated a lot.. maybe one or two times in your life time but remember one thing, the only organ in your body that regenerates is your liver so the tiny piece they are gonna take out of your liver will regenerate and go back to normal...

good luck