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Hepatitis B - Biopsy
I am 31 year old Indian born male currently residing in US.
I have been diagnosed with Hepatitis B earlier this year (Feb 2013) by a screening test.
I had taken Hepatitis B vaccine back in 2007 before coming to use (3 shots), hence it looks like i got infected before that.
My results are as follows.
Date : March 4, 2013
HBV DNA - 1130 IU/ml
ALT - 30 ( Lab reference rage - 0 to 60)
AST- 24 ( 0 to 40)
HBeAg -Ve, Anti Hbe Positive
Date : April 8, 2013
AFP - Not detectable
Lever Ultrasound : Liver is unremarkable ( Normal result)
The HBV DNA and ALT, AST repated after 3 months.
Date : 3 June 2013
HBV DNA - 2590 IU
ALT - 41 ( lab Normal range 0 to 65)
AST - 26
I am really freaked out since my DNA is higher and ALT is also higher.
I met the doctor this week since I was concerned about elevated HBVDNA and ALT values. I requested doctor to have a liver biopsy. My doctor told me that he is not too much concerned with increased DNA and ALT values. He thinks to wait for next three months (for next set of HBVDNA and AST/ALT Tests) before biopsy, and told me if it remains persistently elevated, we may do biopsy. We do not have Fibroscan machines.
Can you please advise on waiting for biopsy for three months?
Also, My doctor told me that ALT seems normal, I have doubt on that as well. Any thoughts?
I really appreciate you insight.
Regards
Neil
I have been diagnosed with Hepatitis B earlier this year (Feb 2013) by a screening test.
I had taken Hepatitis B vaccine back in 2007 before coming to use (3 shots), hence it looks like i got infected before that.
My results are as follows.
Date : March 4, 2013
HBV DNA - 1130 IU/ml
ALT - 30 ( Lab reference rage - 0 to 60)
AST- 24 ( 0 to 40)
HBeAg -Ve, Anti Hbe Positive
Date : April 8, 2013
AFP - Not detectable
Lever Ultrasound : Liver is unremarkable ( Normal result)
The HBV DNA and ALT, AST repated after 3 months.
Date : 3 June 2013
HBV DNA - 2590 IU
ALT - 41 ( lab Normal range 0 to 65)
AST - 26
I am really freaked out since my DNA is higher and ALT is also higher.
I met the doctor this week since I was concerned about elevated HBVDNA and ALT values. I requested doctor to have a liver biopsy. My doctor told me that he is not too much concerned with increased DNA and ALT values. He thinks to wait for next three months (for next set of HBVDNA and AST/ALT Tests) before biopsy, and told me if it remains persistently elevated, we may do biopsy. We do not have Fibroscan machines.
Can you please advise on waiting for biopsy for three months?
Also, My doctor told me that ALT seems normal, I have doubt on that as well. Any thoughts?
I really appreciate you insight.
Regards
Neil
all the tests you did are almost useless without hbsag quantity in iu/ml and fibroscan, especially hbvdna is useless off therapy, it can go from und to billions without real meaning without hbsag quant and fibroscan
have hbsag quant checked so you will know if you can clear hbsag by peginterferon
have hbsag quant checked so you will know if you can clear hbsag by peginterferon
12/12/12 was tested
HBV positive
HBe neg / anti HBe pos
ALT/AST Normal range
HBV DNA 150 ul/ml
Fresh vegy including: black radish/no red meat/ just chicken breast/ no shell fish fried food/ just barbequed or steamed food.
2 months lated :
HBV DNA 29 ul/ml
Took it easy and tried some of the forbiden staff mentioned above
2 months later:
HBV DNA 95ul/ml
Still took it easy and kept on taking some of forbiden staff
2 month later:
150 ul/ ml. 879 copies/ ml
2 months later 27th June 2013
200 ul/ml. 1170 copies/ ml
So as you can see Neil we are on the same boat
Now i am trying a restricted diet as in no fried nor red meat no shell food instead bio food and grilled chicken breast or white fish. Black radish / milk thistle supplement my next test is on the 30 august and i will keep you posted on the result.
I agree with your doctor and stef after my deep research on the net we are in a very early stage for any medicine intake or biopsy . We are called
Chronic Hbv since we passed six months and virus still present but it deosn t mean we can not fall in category of being Acute HBV and virus clear and if the case we will be HBV negative in my case HBC positive since never had vaccination and with god' will if you clear the virus you will be HBV and HBC negative. Also we are called e-antigen negative and this is a good sign when to concider medicine treatment in our case DNA more than 10000 ul/ml
Or ALT 150
I read we can do Alpha - fetoprotein test not clear to me what is it i need to get feedback from my docter probably to see if our liver is devoloping cirrhosis dont know what is the difference to fibrocis need to do research or ask doctor or stef.
Hope this ease your pain. Also i suspect that i got the virus from dentist on march 2012 when i had thoot filling and resulted in an infection.
I am 40 years old by the way.
HBV positive
HBe neg / anti HBe pos
ALT/AST Normal range
HBV DNA 150 ul/ml
Fresh vegy including: black radish/no red meat/ just chicken breast/ no shell fish fried food/ just barbequed or steamed food.
2 months lated :
HBV DNA 29 ul/ml
Took it easy and tried some of the forbiden staff mentioned above
2 months later:
HBV DNA 95ul/ml
Still took it easy and kept on taking some of forbiden staff
2 month later:
150 ul/ ml. 879 copies/ ml
2 months later 27th June 2013
200 ul/ml. 1170 copies/ ml
So as you can see Neil we are on the same boat
Now i am trying a restricted diet as in no fried nor red meat no shell food instead bio food and grilled chicken breast or white fish. Black radish / milk thistle supplement my next test is on the 30 august and i will keep you posted on the result.
I agree with your doctor and stef after my deep research on the net we are in a very early stage for any medicine intake or biopsy . We are called
Chronic Hbv since we passed six months and virus still present but it deosn t mean we can not fall in category of being Acute HBV and virus clear and if the case we will be HBV negative in my case HBC positive since never had vaccination and with god' will if you clear the virus you will be HBV and HBC negative. Also we are called e-antigen negative and this is a good sign when to concider medicine treatment in our case DNA more than 10000 ul/ml
Or ALT 150
I read we can do Alpha - fetoprotein test not clear to me what is it i need to get feedback from my docter probably to see if our liver is devoloping cirrhosis dont know what is the difference to fibrocis need to do research or ask doctor or stef.
Hope this ease your pain. Also i suspect that i got the virus from dentist on march 2012 when i had thoot filling and resulted in an infection.
I am 40 years old by the way.
12/12/12 was tested
HBV positive
HBe neg / anti HBe pos
ALT/AST Normal range
HBV DNA 150 ul/ml
Fresh vegy including: black radish/no red meat/ just chicken breast/ no shell fish fried food/ just barbequed or steamed food.
2 months lated :
HBV DNA 29 ul/ml
Took it easy and tried some of the forbiden staff mentioned above
2 months later:
HBV DNA 95ul/ml
Still took it easy and kept on taking some of forbiden staff
2 month later:
150 ul/ ml. 879 copies/ ml
2 months later 27th June 2013
200 ul/ml. 1170 copies/ ml
So as you can see Neil we are on the same boat
Now i am trying a restricted diet as in no fried nor red meat no shell food instead bio food and grilled chicken breast or white fish. Black radish / milk thistle supplement my next test is on the 30 august and i will keep you posted on the result.
I agree with your doctor and stef after my deep research on the net we are in a very early stage for any medicine intake or biopsy . We are called
Chronic Hbv since we passed six months and virus still present but it deosn t mean we can not fall in category of being Acute HBV and virus clear and if the case we will be HBV negative in my case HBC positive since never had vaccination and with god' will if you clear the virus you will be HBV and HBC negative. Also we are called e-antigen negative and this is a good sign when to concider medicine treatment in our case DNA more than 10000 ul/ml
Or ALT 150
I read we can do Alpha - fetoprotein test not clear to me what is it i need to get feedback from my docter probably to see if our liver is devoloping cirrhosis dont know what is the difference to fibrocis need to do research or ask doctor or stef.
Hope this ease your pain. Also i suspect that i got the virus from dentist on march 2012 when i had thoot filling and resulted in an infection.
I am 40 years old by the way.
HBV positive
HBe neg / anti HBe pos
ALT/AST Normal range
HBV DNA 150 ul/ml
Fresh vegy including: black radish/no red meat/ just chicken breast/ no shell fish fried food/ just barbequed or steamed food.
2 months lated :
HBV DNA 29 ul/ml
Took it easy and tried some of the forbiden staff mentioned above
2 months later:
HBV DNA 95ul/ml
Still took it easy and kept on taking some of forbiden staff
2 month later:
150 ul/ ml. 879 copies/ ml
2 months later 27th June 2013
200 ul/ml. 1170 copies/ ml
So as you can see Neil we are on the same boat
Now i am trying a restricted diet as in no fried nor red meat no shell food instead bio food and grilled chicken breast or white fish. Black radish / milk thistle supplement my next test is on the 30 august and i will keep you posted on the result.
I agree with your doctor and stef after my deep research on the net we are in a very early stage for any medicine intake or biopsy . We are called
Chronic Hbv since we passed six months and virus still present but it deosn t mean we can not fall in category of being Acute HBV and virus clear and if the case we will be HBV negative in my case HBC positive since never had vaccination and with god' will if you clear the virus you will be HBV and HBC negative. Also we are called e-antigen negative and this is a good sign when to concider medicine treatment in our case DNA more than 10000 ul/ml
Or ALT 150
I read we can do Alpha - fetoprotein test not clear to me what is it i need to get feedback from my docter probably to see if our liver is devoloping cirrhosis dont know what is the difference to fibrocis need to do research or ask doctor or stef.
Hope this ease your pain. Also i suspect that i got the virus from dentist on march 2012 when i had thoot filling and resulted in an infection.
I am 40 years old by the way.
wow and I was thinking our public care is crap.
you need hbsag quant to have a full picture and then make a decision.
contact a faculty that does clinical trials and they will hook you up for that test and maybe some trial where you get IFN for free (like i did).
heres a link to my trial with locations:
clinicaltrials.gov/ct2/show/study/NCT01277601?term=GS-US-174-0149&rank=1&show_locs=Y#locn
if hbsag is low + your other results it might be worth a try IFN to full cure despite statistical odds regarding response.
you need hbsag quant to have a full picture and then make a decision.
contact a faculty that does clinical trials and they will hook you up for that test and maybe some trial where you get IFN for free (like i did).
heres a link to my trial with locations:
clinicaltrials.gov/ct2/show/study/NCT01277601?term=GS-US-174-0149&rank=1&show_locs=Y#locn
if hbsag is low + your other results it might be worth a try IFN to full cure despite statistical odds regarding response.
The problem is, hbsag quant lab test is not available in US. My doctor thinks that i am not a good candidate for either antiviral or peg treatment as my hbvdna is not superhigh, alt is in normal range and liver stiffness is in normal range( see above posts) Doctor is following AASLD guideline for hepb. He will keep testing me for every 3 months for first year and if everything is normal he will designate me as inactive career. I consulted another doctor and he is also saying prettymuch the same thing. Peg cost $25000+ here and insurance wont pay in full evenif doc is prescribing it. in my case doc is not considering me for peg.
Neil, stef can sometimes be a bit confusing with his lapidary replies but hes telling you the right things. I suggest you read a few threads here and you will have a good picture on why is HBsAg so important in regards to treatment strategy.
PS. Why is interferon not refunded for you in US ?
PS. Why is interferon not refunded for you in US ?
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