Some answers needed

[cally44]

Hi

I was wondering if someone could give me a good understanding of my hep b case.  I was diagnosed last year of having chronic HBV. I am sure I got it from birth through my mother who has already cleared the virus.  My ALT And AST were rock normal and my dna was in the 800's iu/ml pcr.  In Sept of last year I did another series of tests and everything was normal except that my alt and ast were a little raised to the 50's and 60's but my dna was undetectable.  I also did an ultrasound and everything looked normal.  MY AFP was also within range of the lab.

My GI specialist told me to check my blood and do another ultrasound after a year.  I thought it was 6 months that one should do these tests.

Now could this be a sign of clearing the virus since my dna was undetectable?  Can your dna be undetectable one day and then jump up to a crazy number the next?

Also, is it safe to say I am not a precore mutant?  I am e antigen negative and e antibody positive.

Thanks for the help

[twoto]

i believe that i have been exposed to hepatitis b and would like to know about the test for it and the treatment... also how long can a person have it without knowing...

[Hepatitis Researcher]

Your info is not complete. Age,weight, Asian? are all important. But from what you said, it seems that you are are an e-Ag neg carrier, with very low disease activity. Precore mutants can present like that, but most of the time it is an e Ag seroconverted status, that holds the virus in check via a T cell response to the core protein, that needs some eAg produced in the hepatocyte to recognize the core epitope.
Your HBV genotype would be of intererst, since Geno A cannot or only very rarely develops the precore mutant, due to genetic restrictions in the virus.

As jboyhk said above there could be other reasons for your ALT to rise slightly above normal. Like being fat, having NAFDL, or medications.

The important aspect here is to keep monitoring regularly, so that you do not miss the point at which you could slide from the "healthy" carrier state to the typical e-Ag neg hepatitis. Because then treatment should be initiated. Typically you would see a rise in the viral load, at least in the 1000s and a constant rise of LFTs above normal.

[jboyhk]

Those virus levels are so close to undetectable you would expect to see swings. Undetectable does not mean zero. It means there may be some but beyond the limit of the test. Each lab has its own 'undetectable' limit.

The rise in ALT/AST can come from other sources such as maybe taking tylenol or any host of other drugs.