Hepatitis B - Biopsy

[Neil888]

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

[Neil888]

I will try to see if i can get hbsag quant test done somewhere. But based on your response it looks like I might have limited options since i am hbeag-ve with low but detectable hbv dna and normal alt with low liver stiffness.  
Another question: what suppliments do you recommend to make sure that the HB is in check considering my position? I have reduced 11 lbs since i was diagnosed in feb 13. BmI of 23 now. eating lots of fruits and veggies and taking vit c and D as explained above.

[stef2011]

antiviral is useless as long as hbvdna is very low, alt normal and liver with no damage

pegintf is useless on hbeag neg if hbsag is very high like more tna 10.000iu/ml.....

so we do need hbsag quant and genotype to know if you have high chances to respond to pegintf, anyway inactive carriers with hbvdna und and normal alt showed about 30% hbsag clearance so you have a good starting poitn anyway but without hbsag quan *** makes non sense to go for pegintf in such a bad position as yours, i mean you ll have to pay pegintf yourself and only india/vietnam have very low prices

[Neil888]

Stef
Hypothetically, Suppose i somehow get hbsag quant test done and it comes back with higher value suggesting that i am an active career with dormant HBV( low dna, normal alt and normal liver stiffness), what would be my treatment options?
Will it stil be peg or will i need to be on antiviral?

[Neil888]

I started taking 2000 iu/ day of D3 and 1000 iu/ day of vitamin c.
I dont have my vitamin D level checked but am planning to have it checked next month at my next appoinment.

[Neil888]

I know that I wont be cured. But, based on the test data, do you think it will be a correct approach for me now? Should I seek treatment from other country or can I wait for few years by just observing HB?  It is really frustrating to be in US since there is little i can do towards getting rid of my hbv. They dont even have hbsag quant test inUS.
Any suggestions?

[stef2011]

yes that means you wont be cured for hbv