Pls help with this findings Hepatitis B positive

[paulice]

Pls help me to understand the below findings:
I was diagnosed Hepatitis B positive 7 months ago and no medication has been given since i was pregnant that time.

Test: Hepatitis Profile
HBsAg -                            reactive - 3.373
Anti- HBs -                        Non reactive - 0.015
HBe Ag -                            Non reactive - 0.052
Anti- HBe -                         Non reactive -3.166
Anti-HBC IgG-                    Reactive - 0.012
Anti-HBc Igm                   - Non- reactive  - 0.100

Please help me to understand the result.

Thank you.
Pau

[stef2011]

go with the guidelines, especially the US ones, and very easily end up with advanced cirrhosis while they monitor according to those guidelines....in US you have double risk since they have no fibroscans so it is impossible to monitor liver damage (biopsy can be made every 5 year and some cases might develop cirrhosis as early as 1 year!)

[stef2011]

thoose are the guidelines are talked about made for the ignorants....treatment must be personalized according to tests results, this is why i got to cirrhosis level because of these extremely "STUPID" guidelines which are wrong for many although they might fit for the most

and this is why researchers in pisa said "going to a normal hospital is just like going to a fast food" while here you have a single chef cooking just for you

[4est]

AASLD • Consider treatment:
(Lok 2007; 2009)
• HBeAg(+): HBV DNA >20,000 IU/ml + ALT ≤2x ULN + biopsy shows moderate/severe inflammation or significant fibrosis.
• HBeAg(+): HBV DNA >20,000 IU/ml + ALT >2x ULN Observe for 3-6
months and treat if no spontaneous HBeAg loss.
• HBeAg(-): HBV DNA >20,000 IU/ml + ALT >2x ULN
• Consider biopsy:
• HBeAg(+): HBV DNA >20,000 IU/ml + ALT >2x ULN + compensated
• HBeAg(+): HBV DNA >20,000 IU/ml + ALT 1-2x ULN + age >40 years or family history of HCC
• HBeAg(-): HBV DNA >2,000-20,000 IU/ml + ALT 1-2x ULN

APASL • Consider treatment:
(Liaw 2008)
• All patients: HBV DNA detectable + advanced fibrosis/cirrhosis
• HBeAg(+): HBV DNA >20,000 IU/ml + ALT >2x ULN + impending/overt
decompensation
• HBeAg(-): HBV DNA > 2,000 + ALT >2x ULN + impending/overt
decompensation
EASL • Consider treatment:
• HBV DNA >20,000 IU/ml + ALT >2x ULN + moderate to severe
necroinflammation

Belgian • Consider treatment:
(Colle 2007) • HBeAg(+): HBV DNA >20,000 IU/ml + ALT >2x ULN (or moderate/severe
hepatitis on biopsy)
• HBeAg(-): HBV DNA ≥2,000 IU/ml and elevated ALT
• Consider biopsy:
• Fluctuating or minimally elevated ALT (especially in those older
than 35-40 years)

Dutch • Consider treatment:
(Janssen 2008)
• HBeAg(+) and HBeAg(-): HBV DNA ≥20,000 IU/ml and ALT ≥2x ULN
or active necrotic inflammation
• HBeAg(-): HBV DNA ≥2,000–20,000 IU/ml and ALT ≥2x ULN (and absence
of any other cause of hepatitis)

German • Consider treatment:
(Cornberg 2007)
• HBV DNA >2,000 IU/ml + minimal inflammation/low fibrosis or ALT ≥2x ULN

Italian • Consider treatment:
(Carosi 2008)
• HBeAg(+): HBV DNA >20,000 IU/ml + ALT >2x ULN
• HBeAg(-): HBV DNA >2,000 IU/ml + abnormal ALT and or fibrosis (Ishak ≥S2)
• Consider biopsy:
• HBeAg(-): HBV DNA >2,000 IU/ml + borderline ALT, or if DNA 2,000–20,000 IU/ml + high ALT

Polish • Consider treatment:
(Juszczyk 2008)
• HBeAg(+): HBV DNA ≥20,000 IU/ml + raised ALT; biopsy not required
• HBeAg(-): HBV DNA ≥2,000 IU/ml + raised ALT; biopsy not required
• Biopsy required:
• Normal ALT

Turkish VHSD • Consider treatment:
(Balik 2008)
• HBeAg(+): HBV DNA >20,000 IU/ml + ALT >ULN or age >40 years
(ALT 1-2x ULN) + histological indication
• HBeAg(-): HBV DNA >2,000 IU/ml + histological indication

Turkish TASL • Consider treatment:
(Akarca 2007)
• HBV DNA >2,000 IU/ml + histological fibrosis >2
• HBV DNA >20,000 IU/ml + any histological finding + ALT >2x ULN

[4est]

"The general book of ingnorance about hbv" - I've read this and I can say that teh conclusion from thsi book is apply in europe. and in this book (presentation) I've not see a indication to use the hbvag quantitative to determine the virus acivity, but I've see that hbvdna pcr is indicated to be used. in the presentation hbvag quanitatiive is presente to be a indicator if a person will respond more or less to interferon.

" hbsag can be used instead of hbvdna pcr or in combo" - I've read a study and the result was that no relation between hbvag quantitative and hbvdna pcr was found, so in this case we can not use hbvag quantitative instead of hbvdna pcr, maybe we can used it only in combo.

as far as I know HBV DNA carries the genetic blueprint of the virus - how many HBV DNA “copies” are found in your blood indicates how rapidly the virus is reproducing in your liver.

I had a look on the clinical guide line from europe and I don't found any country that use hbvag quantitative for tratament indication, all country use ALT / AST levels, fibrose level and hvbdna level.

so for me is still unclear what is hvbag quantitative and what is stand for.

[paulice]

what do i need to do now if the ultrasound that was requested by my doctor is not that much effective to detect liver damage? Also, what can u say about my alt result? THis is the latest findings.. pls explain.


Test: Hepatitis Profile
HBsAg -                            reactive - 3.373
Anti- HBs -                        Non reactive - 0.015
HBe Ag -                            Non reactive - 0.052
Anti- HBe -                         Non reactive -3.166
Anti-HBC IgG-                    Reactive - 0.012
Anti-HBc Igm                   - Non- reactive  - 0.100

UTZ: the liver is normal in size with a span of 11.7cm. Parenchyma is homogeneous with no evident mass nor abnormal calcification. Intraphetic ducts are dilated.

Impression: Normal sonogram of the liver.

ALT: 34.1 IU/L..

What's all about now? any other test do i need to do?
What do u mean about early cirrhosis ?
What test to i need to do to detect the liver damage?

I badly need ur comment pls..

To my fellow filipino: any good/specialist doctor that u could recommend?

thanks..

[stef2011]

hbsag quant and fibroscan are used since 2005 in advanced countries with good healthcare and good doctors...that is germany, italy, france, belgium, holland, norway