For us to make detailed comments, we need more information, such as HbeAg/HBeAb, HBcAb (igg and igm, to exclude acute infection) status. Fibroscan should provide a number in Kpa, not just "clear". It is important to know this number.
In terms of treatment, if needed, it will be either Entecavir/Tenofovir, a daily pill taken orally, or Peg Interferon, a course of 48 weekly injections, or a combination of the two.
Doc said mine is Chronic. I have not done any full health checkup in the past, so I cant tell when I got it.
Doc mentioned Barraclude as one of the options if I hv to start treatment. Is that effective?
Also, liver functions test normal... Was told since virus is not causing any damage yet (as well as from fibroscan and ultrasound), hence just monitor. Thought this is at least something positive in a negative situation. But reading this forum, I seem to get the idea having something like ALT flareups may be a better thing. Am I wrong to think that way?
I am not a doctor, I will give you my opinions.
It does seem from your Fibroscan that you do not have severe fibrosis. This could be due to the fact that you may not have been chronic for long. Elevated ALT used to be an important criterium in deciding treatment, however because of uncertainty about the normal range of ALT and the fact that many patients still have disease progression even though their ALT is persistently normal. Now, hbvdna, viral load, is considered to be important in deciding treatment. Your viral load is considered to be on the high side. Finally, you are over 40, so treatment is a safety net. Having said all that, HBV is a slow moving disease and if you have not been chronic for long, there is no rush to treatment.
ALT flares occur when our immune system reacts against the virus. If the reaction is decisive and clears the virus, then of course it is good. But all too often, the reaction is not fully successful, the battle is lost and we incur damage to the liver. Over the years, many battles are fought and lost, that is why we have disease progression from fibrosis to cirrhosis.
With regards to your last para, do you mean the disease progression without treatment, or even with treatment? I know of a carrier who has been treated for almost 20y, and has had no liver impairment despite a certain degree of fibrosis when he was diagnosed (ie the fibrosis was somehow reversed). So an older lady (abt 70y old) who has also been treated for a long time ], having a certain degree of cirrhosis.
Reading the posts in this forum, I have the impression that current therapies have been most effectively in arresting the progression, for most patients.
You are right, my discussion about many battles refers to those without treatment. Treatment by oral NAs inhibits viral replication, leading to undetectable virus in the blood - no virus in the blood means generally no immune reaction, thereby no inflammation and no damage to the liver. With peace, the liver can heal and fibrosis can be reversed.
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