developing hbsab with a result of UND VL / I'm confused

[gnely]

What is the chance of developing hbsab with a result of UND VL? Your answers are very much appreciated.. And also, I'm so confused as to whether I'll join the study because I'm afraid of the side effects of the drug (baraclude or hepsera....I'll be assigned to it randomly). I'm afraid it wouldn't work for me, if it would happen, i would stop taking the drug and it would make my disease worse.. if the doctor would recommend another medicine it's not free of charge anymore..and I cannot afford the meds.. please give me advice.. my VL is 16,100 IU/ML (93,702 COPIES/ML)
HBeAg  3.100   C.O.V. 1   Reactive
Anti HBe 0.994 C.O.V. 1    Gray Zone

Thanks in advance..

[stevenNYer]

For chronic HBV, your HBsAg will very very likely stay positive despite UND VL.

Your info is spotty, but based on what you wrote so far, age 23, eAg positive.  You are likely in the immunotolenrant stage, your "normal" ALT 18 also suggest this.  However, you DNA is very very low for this stage, being eAg positive.

If this is the case, I would not treat because you may need to treat for life or at least until a stable eSeroconversion, which could be for another 10 years or so.  And if your doctor is solely relying on Entecavir or (worse if you draw Adefovir), developing resistance is a real concern.  Especially if you are eAg positive and have limited response (DNA not going UND quickly while you take med).

I would monitor ALT and DNA closely.  When you older and see your ALT elevated on a regular basis with fluctuating DNA, then consider treatment to help your immune system during the suspected immuno-clearance stage, which is in fact what I am practicing now for myself.  Then you have a better shot of going off meds if you seroconvert successfully.

Also consider updating your profile with more info so we know who you are.  You get better feedback this way.  Visit our HepB welcome Health Page for additional suggestions.

[cajim]

2007 Guideline:

HBeAg-Positive Patients with High Serum HBV DNA but Normal ALT Levels. These patients should be monitored at 3 to 6 month intervals.  More frequent monitoring should be performed when ALT levels become elevated.  Patients who remain HBeAg positive with HBV DNA levels greater than 20,000 IU/ml after a 3 to 6 month period of elevated ALT levels greater than two times the upper limit of normal should be considered for liver biopsy and antiviral treatment. Liver biopsy and treatment should also be considered in patients with persistent borderline normal or slightly elevated ALT levels particularly if the patient is above the age of 40. Liver biopsy is usually not necessary in young patients (below 30) who are HBeAg-positive and have persistently normal ALT.

HBeAg-negative, anti-HBe Positive Patients with Normal ALT Levels and HBV DNA <2,000IU/ml (Inactive HBsAg Carriers). These patients should be monitored with ALT determination every 3 months during the first year to verify that they are truly in the “inactive carrier state” and then every 6-12 months.  If the ALT level is subsequently found to be elevated, more frequent monitoring is needed.  In addition, an evaluation into the cause of ALT elevation, including HBV DNA tests, should be initiated if it persists or recurs.

[gnely]

is monitoring my condition and not going for treatment a good decision for me to take? I'm still 23. I had my results posted above.. :(

[gnely]

if my doctor would not treat anymore is there a chance that my UND VL would become detectable again? What's the percentage?


with an UND VL would the HBsAG still reactive?


Thanks steven

[stevenNYer]

Still pitifully low at about 1%, maybe 2% for chronic infections.  The goal of treatment should not be to develop hbsag but rather UND VL.  So if you are already UND VL, your doctor will probably not treat.

[gnely]

Thanks for your reply cajim.. How about if it's with treatment with baraclude or hepsera? what's the percentage of developing hbsab with a result of UND VL?

is it ok if i'll just monitor my disease or i'll go for the treatment??

my SGPT- ALT   is   18      Reference Value is 5 - 40    (U/L)

HBeAg positive


Thank you very much for your support..

[cajim]

What is the chance of developing hbsab with a result of UND VL?

Without treatment, spontaneously it is about 1% a year.