Suggest a good doctor for Hepatitis B

[Nopatronas]

I recently got all my blood examinations done and my liver functions test, ultrasound scan are all normal. My CBC count is normal too.

My Vitamin D levels Were 16 about 6 months ago and I take calcirol every once a month.

I was diagnosed of being a HbsAg carrier when I was expecting my baby. Since then I got my antigens regularly & two doctors gave me different versions, one said I don't need any treatment as my virus is dormant, whereas the other put me on Lamavir and said I need it.

But after almost 13 years I had a bout of stomach infection and the gastroenterologist recommended me that I get an HBV DNA to see how is the virus progressing.

My reports shows my HBV DNA as 41,500 IU/mL

I am 40 years of age and looking for a balanced view on exactly what's should be the course of treatment and who is the best doctor in New-Delhi for this kind of a disease. Any suggestion? I would be very grateful for it. Also I don't want to undergo any liver biopsy, so is there an alternative to it too?

[brij116]

Its very difficult to get a doctor who will give you a personalised as well as an expert guidance. You must share all your reports on this forum. People here will give you the best help. People like Stef are most knowledgeable and extermemly helpful.

Stef,
Her vit d3 was low one year back (count 16 only unit???), that time she took only 5,000 iu/week for 6 weeks. This dose is of no help and I am sure it must have deteriorated over the year.

I believe a high dose of vit d3 like 8,000 - 10,000 iu/day can help her bring down the DNA count, Fibroscan reading and may be HBSAG count also (like me). May be she should try this first, nothing to loose.

[stef2011]

we all had it since birth, hbv is cronic only that way.adults can get it cronic only if immune system is damaged when they get infected, this happens with drug addicts, patients taking immune suppressive drugs and so on.the percentage of adults getting it cronic is thought to be around 5% but it is probably much less

most hbv infected have no damage at all from the virus only about 5% gets damage, cirrhosis, liver cancer and this happens after a life time around the age of 50yo

it is also possible to be infected and keep liver healthy by healthy life styles, antioxidants, proper diet.hepatitistechnologies protocol made of vitamins and antioxidants food extracted (not synthetic made in labs like most vitamins sold) can keep the liver healthy dispite infections, a patient o it since more than 6 years could regress a cirrhosis despite being infected by hbv and hcv active

interferon are immune modulators and antivirals like entecavir and tenofovir lower replication and lower liver damage, antivirals have no effect on virus infection and its clearance

by the way both you and your mother, like for most of us, are cronic infected, both need to check liver damage by fibroscan every 6 months, being hbvdna und and alt less than 30men and 19 women cant prevent liver cancer or liver damage 100% so monitoring of damage is mandatory anyway

no antivirals make no kidneys damage on hbv patients, only those with already damaged kidneys may have problems with tenofovir and no problems with entecavir.hbv virus itself make kidneys damage and using antivirals improves kidneys function.be aware that there are no sensitive tests for kidneys damage so you may have damage but normal tests, the tests get abnormal only when 50% of the kidneys function is already gone and not while the kidneys are being damaged

if there is vaccine and protective antibody hbsab present in blood there is no way to get cronically infected, hbv is harmless for vaccinated, boost vaccine may be necessary every 10 years

[Nopatronas]

What are interferons? I am sorry I am really new to these terminologies so may sound ignorant.

The doctor when saw me the first day said that if I've it since birth then the virus hasn't done any substantial damage to me in 40 years. Now since my mother is Hep B positive it is more or less established my source of virus. Does this have any role in my treatment?

Second is the doctor and the place I am going to is of concern to me. The doctor I visited is an authority in his field, but he's way too much into research & trials. The place he sits is a Government run hospital, so kind of chaotic, I am actually looking for a doctor who can give some personal attention to me and I should not be a mere statistic to him.

Another question I've is do anti-virals harm kidneys? I don't know I am really worried and it almost feels like a trappedsituation right now.......I am extremely stressed.

The doctor also put my 13 year old in the radar in spite of us giving her immune globulin and vaccines immediately after birth. She has tested negative soone after birth and then I had to repeat her tests at the age of 7 then also she tested negative. Can someone become positive all of a sudden? Few of the questions are nerve wrecking presently.

Thank you so much & regards.

[stef2011]

liver has no relevant damage, hbsag is too high to clear hbv on interferon so you may wait for better drugs or start tenofovir and see if hbsag goes down at least less than 10.000iu/ml in 3years so that interferon add on may have chances to clear hbv

you are also almost 40yo, it is not safe to keep high hbvdna in the range of years close to 50yo since both hcc and cirrhosis develop more around this age

[Nopatronas]

Hi I saw the doctor and he got my tests and felt that I've the virus since birth, probably contracted it from my mom. My mother got screened and is a carrier, but she has normal liver tests as well as her Anti HBS is Non-reactive. Titter<10 mIU/ml.

My tests however are as follow

LFT all within normal range. A/G Ratio1.31

HbsAg Quantifification 22665 iU/ml.

SerumAlfaFeto Protein2.06 ng/ml (normal range: 0-8.5)

Anti HBe reactive

HBeAG non-reactive

HBV DNA 1.18/(multiply) 10^5 IU/ml.

Fibroscan result

Median 6.6

IQR* 0.7

IQR*/med 11%

Success rate100%

My HbsAg genotype is awaited & have to get a CT scan.

Kindly tell me your view.

The doctor I a, seeing is. Great doctor, but he's too much into clinical research & I feel I am like a statistic to him not an individual patient. Also if Incase there's an emergency I doubt he would be available. So I am very confused whom to see.

[Nopatronas]

Thanks a ton for your valuable suggestion. Have fixed up an appointment with the doctor on Tuesday and another one on Wednesday, will update you on what they say.

Have a fabulous weekend.