Is wait and see the best approach?

[Kevin812]

I was diagnosed with Hep B in August of 2012 during a hospitalization for Pancreatitis and Gall Bladder all of which share similar symptoms to Hep B.  During my 10 day stay in the hospital I found out I had Hep B but was told it appeared that I had it for a long time which I did not understand and still don't today.  My partner ironically came down with Acute Hepatitis in May from what we believed was exposure from a dentist office.  It turned into who gave the disease to whom for several weeks... I had my gallbladder removed and the surgeon did a liver biospy at the same time.  My doctor had to search for a surgeon to do the surgery because no one wanted to the work on me because they thought I had an Acute case of Hepatitis and would have placed my at higher risk for infection. My doctor an  Infection Control Specialist again ironically felt my jaundice and other systems was my gallbladder!  Anyway the biopsy came back weeks latter which indicated moderate inflammation and scarring.  The GI specialist I was sent to to do the follow up for Hep wasn't convince I was really Chronic in September!  He thought that the biopsy would have looked the same if I had an Acute episode or a flare of a Chronic condition so I left totally confused with a script for blood work due in November.  Well the blood came back the surface antigens were still present and the DNA was high but my enzymes were good.  So he tells me it looks like its Chronic now and I probably start you on medication after I test you again in March?  The questions I have are if the virus is present multiplying in your liver and its your immune response that is causing the scarring why would you wait? Wouldn't you want to reduce production of the virus ASAP?  I am a 51 year old man and my partner zero converted in September.  I believe I was exposed to the virus in my work via behavioral interventions with developmentally disabled.  This illness has really become a real preoccupation.  I don't know if I should ask for a second opinion?  I hate feeling helpless with this virus.

[Kevin812]

I appreciate your opinion... I go back and forth with my thinking on how I acquired the virus.  At this point I guess if the liver enzymes looked good that's good sign.  I think the liver biopsy concerned me because it said bridging fibrosis and the inflammation I didn't realized that the liver could recover from the damage.  The ALT and AST were in the very low 20's in November blood test even with a very high DNA load.  Hopefully, in March the antibodies will appear, the viral load will be undetected and this will be over with and life will be better.

[StephenCastlecrag]

I think you kind of answer the question yourself. The virus itself does not cause damage, but it is the immune reactions that do. As you say, your ALT (liver enzymes) is good, so that indicates minimal, if any, damage is being done. Antivirals are supposed to inhibit viral replication, therefore reducing viral load (hbvdna), and hence reducing inflammation and immune reactions, thereby normalizing ALT.
American doctors follow guidelines, decisions to treat depend on viral loads and ALT levels. So your results may not demand immediate actions.
I agree with you that you may be infected only recently as you are from a low prevalent area. So a further check in March (end of 6 month window period) may be prudent, despite all the tests and biopsy.

Just my opinion.

[stef2011]

that I had it for a long time which I did not understand and still don't today.

probably you have it since birth as all chronic carriers.hbv makes no damage itself but our immune system failing to clear it can make liver damage by decades of oxidative stress.eating extremly helathy, only fresh organic food, vitamins and antioxidants can prevent liver damage

there are no drugs active on the virus, just antivirals that lower replication and prevent liver damage.sequqntial treatment with tenofovir for 3-5years and then interferon add on clears hbv in 50%, monotherapies are useless to clear the virus

be also aware that hbvdna pcr test is useless too because hbv has an intracellular template called cccdna which is not detected by hbvdna pcr blood test.only hbsag quantitaive test in iu/ml can reflect cccdna in infected cells and clearance of hbv.

hbvdna is only usefull to check if antiviral is working to make it und in blood

liver damage can be monitored by fibroscan only, not blood tests, not Ultrasound, not biopsy

we report all this because most doctors are ignorant and others just sells antivirals without any care for the patients or cure the infection