how bad is my hepatitis b situation

[soa923]

iam hep b positive,i did not known when infected, age 32,hbeag +ve,hbv-22 million copies,after treatment with lamivudine for 8 weeks  hbeag +ve,hbv dna 680,765 copies.how bad is this situation? what are my chances of survival? and for how long i'm going to live.

[soa923]

Stefano pls need ur advice on what to do next my recent lab test are alt 119 u/l,ast 65 u/l,hbv dna 150 million copies/ml,hbeag +ve 16.96,anti hbe'reactive 0.465,feto protein 0.5.Iam very worried on what to do next .can hbv dna get undected with trtment?how bad is it now?still feel very strong.pls need ur advice.

[FakharMohiuddin]

hi

check your liver enzymes how mch they are elevated
hbe ang postive shows initial stages of chronic liver diseae... shows virus is replicating and causing injury to liver
continue treatment but dnt use lamuvidine for long term bcz it can cause virus mutation

[stef2011]

also what are your alt/ast before and after lam? just to be sure you are not in immune tollerant phase

[stef2011]

just check liver by ultrasound and fibroscan and even if you have compensated cirrhosis you don't have nothing to worry about if you switch to entecavir or tenofovir, if hbvdna doesn't get und in 6 month consider combination of both

since you have been exposed to lam tenofovir is better becuase if you had a mutation in these 8 weeks, very difficult but possible, also entecavir is not safe any more

[stef2011]

stop lamivudine immediately, lam is out of 2010 guidelines, only entecavir and tenofovir can be used safely as monotherapy.also change doctor right away

switch to another antiviral as soon as possible and slowly in about one month stop lam, with your very high hbvdna you just get virus mutation and resistance with lam and get a worst situation than before therapy.