Sharing experience

[confuseguy]

Steve, Cajim, Zelly,

How are you guys doing? Just want to drop a note on my progress:

I saw my specialist a month ago. Here's a recap:

1. HBV +, e -, eab +, HBVDNA ~48,000 copies/ml.
2. AST, ALT (33, 27) normal value
3. Ultrasound: normal
4. CBC: normal

After talking to him for 45 min: Here are the major points he told me:
1) No treatment recommended. There is no benefit to gain with current condition but will consider if liver tests indicate otherwise. He never treat until it is serious because of resistance problems.

2) Will follow-up with liver panel, CBC, and AFP marker tests every 6 months

3) Ultrasound every 6 months when I reach 40 years old. I'm 27 y.o. now.  Do not recommend ultrasound for the next 13 years. I thought this was a surprise?

4) Do not want to run genotyping even though I requested it.

5) No biopsy or CT recommended until future routine tests show otherwise.

6) Stated that maybe mutant strain is responsible for current DNA even though  e antigen negative but not unsual to have detectable DNA even in Wild type.

7) Stated that my DNA level is not anything to worry about, not sufficient to likely lead to clinical problems but can certainly fluctuate depending on strength of immune system.

8) Recommended healthy lifestyle.

[confuseguy]

Thanks Steve. I'll request it from him to do yearly US. If he refuse, then I'll ask my primary.

[stevenNYer]

US is a screening tool for HCC, although not common (thank goodness) HCC could occur in the absence of cirrohsis of us B heppers.  Do it once a year to be safe.  And why not, it's simple and non-intrusive.

If you find a mutation, you monitor more closely since that increase your chance of disease reactivation / active flares of hepatitis.  Why is having infomation bad???

"he ordered a AFP cancer marker work every 6 months. Is this routine?"
Yes, it's routine.

[confuseguy]

Yes, he said no US until age 40 unless blood work every 6 months showed elevated abnormal liver enzymes. Can I push him to do an ultrasound every year? There is no harm with US right?

I was adamant about the genotyping but his answer was and I paraphrase, "even if we found a mutation, what can we do? Mutation or not, we still treat in the same manner."

Also, he ordered a AFP cancer marker work every 6 months. Is this routine?

[stevenNYer]

No US for the next 13 years???  That is a surprise.  My MD said every year, which is the standard recommendation.

I would ask for genotyping again.  Just to have the info in case it becomes useful in the near future.  Remember, once and if you treat and go UND of DNA, you can't do genotyping at that time.