Viral Load from Billions to Millions in 6 months

[iamalice1]

I have had Hep B since birthday. During the last 6 months, my ALT has been staying high, generally around the 400s. I noticed my last blood test showed that my Viral Load went from 1.1 Billion to 6 Million in just 6 months. Is this due to the high ALT? My doctor mentioned that this is a big drop. I am just wondering if my ALT stay up around 400s for another 6 months, is it possible that it will drop even more? How damage will my liver be if ALT stay up so high for so long? I am currently not on treatment, because I am 4 months pregnant. Any information and personal experience you can share in regards to big Viral Load drop will be appreciated. Thank you!!!

[iamalice1]

Thank you, Stef2011 and Enolia for giving me some information. It is much appreciated support for me.

[enolia]

Oh I see. I guess the best course of action is to see another doctor, you need a second opinion and you absolutely need tenofovir because this pregnancy is risky for both of you. Please refer to steff's comment above.

[stef2011]

she is not immune tollerant, alt in the 400

active hbv infection is a risk for the mother too with such high alt

[iamalice1]

Now I am really worried. The liver specialist I am seening at the moment is actually one of the most senior ones here in the city I am in and he is very well respected by all the other doctors. I don't really want to offend him by seening another specialist for a second opinion. Or should I?

I don't quite understand which phase I am in, would you be able to tell me based on the information given to you below?

I had hep b since birth and my ALT has stayed normal until about 2 years ago. (I am 32 years old now.) Since 6 months ago, my ALT suddenly went up from 100s to 400s and stayed around 400s for the past months and my ALT dropped dramatically from 9 logs to 6 logs in just 6 months.

I don't want my baby to have what I have. The doctor seem to think that my baby has 90% of not getting it as long as the baby gets an extra shot of something staight after birth.  

[enolia]

Oh my god but this is risky for your baby... I believe doctors don't like to treat when HBV is in the immune tolerant phase? Not quite sure about this one. Could you ask another good specialist for a second opinion?

[stef2011]

My doctor doesn't want to treat me unless my viral load stays above 8 logs.....

this doesnt sound like a liver specialist, 7log is already very high above 8logs antivirals might not work and years are needed for hbvdna und on combos.so he has no experince over 8 logs you cant be treated successfully, 1log or 8 logs makes no difference too only undetactable makes a difference and hbeag neg.

look for a new liver specialist an expert one

[iamalice1]

Thank you so much for responding to my question, Enolia and Stef2011. I am new to this and I hope you will see this message.

My doctor doesn't want to treat me unless my viral load stays above 8 logs, at the moment it has dropped to 6 logs, so unless it goes up again at 30 weeks I don't think he wants to treat me. Should I ask for Tenofovir anyway?

[enolia]

Hello

Please check my thread 'Pregnancy and breastfeeding while on Tenofovir (Viread)', I went through the exact same thing even though I am HbeNeg. I believe HbePos is even more infectious. The best course of action is Tenofovir for pregnant woman, you got to see a doctor now to get the prescription. Your baby will be fine, my baby is 8 months old, is doing well and has no hepatitis, check the thread mentioned in the forum list for all the details. Good luck.

[stef2011]

bad thing you are moving from immune tollerant to cronic hepatitis, tenofovir would be a good treatment to prevent the baby to get cronic hbv since vaccine can fail on high hbvdna and hbeag pos

Is this due to the high ALT?
of course, your immune system has started killing infected cells, this will lower hbv but will make liver damage too.being immune tollerant was better because virus makes no damage it is immune system to make the damage

you should start tenofovir now as prescribed by guidelines...treating during the transition from immune tollerant to cronic is good, check both hbcab igm quant and hbsag quant to know chances to clear hbv

after the baby is born and finished brestfeeding a combo interferon+tenofovir may be good to clear hbv