Hep B treatment in immunotolerant phase

[usagirl781]

Hi,

I am new in the forum and I would appreciate some help.My brother was diagnosed with hep b 6 months ago. The first doctor told him to start on Viread right away due to high viral load ( 3million), His liver enzymes have been normal in the first and second testing.He refused a liver biopsy, Md ordered an ultrasound with ARFI to detect liver damage.He is having  that done in a couple weeks. THe second doctor ( hepatologist this one) ordered the tests again, did not put him on treatment yet,will see if liver damage.He is in his early 20s, no symptoms. Does this look more like immunotolerant?

[usagirl781]

THat is true, I told my brother. Two doctors from the same practice wanted him on antiviral and based on the research I did, I found this other hepatologist. The first ones were just gastroenterologists. ANyways, the ultrasound that the doc ordered is new and some studies that have been made prove it to be accurace in seeing liver damage. IT is called ultrasound with ARFI. There is no fibroscan in usa unfortunately as you said and I don't like the risks of doing a liver biopsy. If it is necessary he is going to have to do one.
thanks so much

[stef2011]

yes he is immune tollerant and needs no treatment as long as ast/alt normal and fibroscan less than 6kpa.be aware that only fibroscan detects liver damage, not ultra sound machines
hbsag quantity can also confirm with the other tests he is in immune tollerant phase, it is very high in this phase.US and canada dont have hbsag quant machines

treating while on immune tollerant phase is against guidelines and makes the person unhealthy and tied to antivirals which may easily fail without animmune response

be carefull in your choices, there are ingnrant doctors and also drug sellers that has nothing of a doctor.look for the most expert liver specialist in your area and the second is better for sure

also antivirals should not be prescribed to young patients even if not immune tollerant phase if there is no liver damage.

check all community there are many new drugs that cure hbv close.of course antivirl monotherapies are not an hbv cure, they can only block liver damage.
it is also of intrest the sequential combo tdf and then interferon but not in immune tollerant phase