Precore mutation

[Kazfiz]

Can anyone please tell me more about hepatitis b Mutation.
My husband is a carrier genotype c2 hbeag neg
His viral load was quite high. So we think he has precore mutation. Trying hard to understand everything but it's so complicated. If anyone can shed some light on this.
He has been on Viread for about 6 months.

[Bravesoul]

Normally, after losing the 'e' antigen and gaining the 'e' antibody, majority of people enter the inactive Carrier state characterised by low or undetectable hbv DNA levels and normal ALT. However overtime, some people develop mutations in the precore or basal core of the virus that allows it to escape the effect of e antibodies and liver damage begins. This phase needs treatment. Did your husband  get viral levels under control while on viread or not? If he did, there's not much to worry about.

[Kazfiz]

Hi we have an appointment with his hep Dr next month, I am going to ask him for a copy of all his blood results,
My husband gets very ill with his stomach,  roughly every two months he starts vomiting uncontrollably, usually ends up getting admitted to hospital for dehydration, Doctors couldn't find anything wrong with him, then all off a sudden hep b started to show up in his blood tests, which was really strange as his doctor has said he has probably had it since early childhood.
Strange thing is I never got infected from him or had evidence of past infection. I'm vaccination now, how can that be possible?
Hep Dr said he is low risk of transmitting to others as long as he is careful with blood etc...
I'm struggling to understand everything (sorry for rambling)
Anyway from what I can remember the doc saying before he started meds his viral DNA was 3,2x10^5
Hbeg neg
Hbeab pos
Alt fluctuation between 40-50
Genotype C2.
He had fibro test which was 12kpa
But had ate before test so may not have been accurate.
Had liver biopsy doctor said he was boarder line to start treatment.
So he's been on Viread for about 9months now.
Could his illness every 6weeks be flares?
Sorry about all questions.

[Kazfiz]

I try my best not to make him panic, I think this is effecting me mentally more them him, I am so paranoid, whenever he gets poorly I think its his hep b kicking off and his liver is getting more and more damaged.
Can i just ask for people he comes into contact with who hasn't been vaccinated how much of a risk is this (I know I sound like such an *** asking that) cos I know how it's transmitted and he is very careful with blood etc, I'm just worried when he has a flare up is he more infectious to other through sweat, saliva etc...

[Bravesoul]

Yes, 3.2x10^5 is a standard notation for 320000. It is high for someone with a negative HBeAg serostatus, and coupled with elevated ALT, warrants initiation of treatment. Since your husband is already on treatment, there is nothing else your husband can do right now. Viread will hopefully bring down  his viral levels down to undetectable within a year. You shouldn't try to promote feelings of panic inside your husband. As long as he takes his pills everyday, he is safe and can expect a normal lifespan.  

[Kazfiz]

Thank you for answering my questions, appreciate it.

[Kazfiz]

One last question... does DNA 3.2 x 10^5 mean his VL is 320,000?
Is this extremely high? I read somewhere viral DNA doesn't mean much but surely have 320000 per ml of blood is a huge amount, correct me if I'm wrong.
Will Viread really lower this or will it take years and years of Meds to reach undetectable levels.
I'm very worried, my husband doesn't seem to understand how serious this is and he refuses to read up on his condition. He has just put all his faith and trust in his hepatologist and says what will be will be,

[Bravesoul]

The frequent stomach upsets, vomiting and a high fibroscan score suggests your husband has suffered significant liver damage. However, if your husband achieves an undetectable viral load and normalisation of AlT while on viread, then his liver will have a chance to heal.
Your husband is HBeAg negative, which makes him less infectious. Your not contracting hep B from him is likely a combination of his HBeAg status and luck.