need help with HBV with Indian origin ( i am scared )

[needhelp143]

Does anyone know fibroscan in Mumbai or in Newyork and a good hepatisis B doctor. I am a Indian leaving in US and just found out that I have hepatisis b.

Currently my result are as follows.



On July 27my Viral load was 200 millon
My ALT = 754
     AST = 524
     HB e antigen = negative
           s antigen = postive
      hb core antiboby = postive
           core surface antiboby = negative
      ultrasound = normal




ON AUG 20 MY VIAL LOAD WAS 1MILLON
MY ALT = 75
      AST = 45

on Sep 1 test result

MY ALT = 40
      AST = 35
waiting for viral load

not on medication

[needhelp143]

Just got viral load
on Sept 1
alt 40
ast 35
viral load 76454 iu

[4est]

also have a look on http://www.medhelp.org/posts/Hepatitis-B/The-lesser-of-two-evils/show/1586794 - this is a good discussion if you really want to start a treatment

[4est]

to determine exactly in what phase you are is a dificult question and it has no clear answer.

hbsag quantification correlated with HBe Ag, Hbe Ab, and also with fibroscan results and HBV DNA number and ALT/AST  level could give a good indication of the phase, if one of this are missing the prediction can be less accurate.

[stef2011]

hbsag quant

[needhelp143]

what test is needed to identify immune clearence phase.

[stef2011]

tests needed to say, hbsag quant is easily available in india, not in US

you might check labs and just send a blood sample.in italy  it is available everywhere, france and germany should be the same

[needhelp143]

do you think I am in immune clearence phase and is there hbsag quant test in newyork

[needhelp143]

do you think i am in immune clearence phase.

[stef2011]

check this link, i believe mount sinai has one

http://www.medhelp.org/posts/Hepatitis-B/Is-fibroscan-available-in-the-US-/show/1364837

[stef2011]

at this point you need fibroscan, if damage is severe tenofovir or entecavir

if damage s not severe and hbsag quant is about 1500-2000iu/ml (or even within 5000iu/ml) better go with a combo of antivirals, alinia and interferon

[needhelp143]

hbcan igm is negative. Is there a fibroscan in Newyork?
hbeag is negative
hbeab is positive

[stef2011]

fibroscan values:
less than 6 normal liver (optimum 3-4kpa)
6-7kpa irrelevant fibbrosis
7-10kpa relevant therapy needed
10-13kpa severe fibrosis therapy needed
>13kpa cirrhosis

alt flares, bmi>28, fatty liver, inflammed liver can all give false readings, a very good doctor is needed to interpret results in these cases

[stef2011]

my god new york doctors sound like drug sellers and not doctors, they are not even able to check an hbv infection....do not take those antivirals they dont cure hbv they cure liver damage and you cant take them if you dont know if liver damage is present, if possible sue those docotrs for malpractice (dont know in NY but in italy you can do that and we sue doctors all the time so that they are very very scared and do correct things...they double check all tests even those useless)

mumbay is much better for all the tests, US is missing too many main tests, this is what you require:
hbcab igm, if positive you are acute, if negative you are cronic.if this test is not performed those doctors are just pushing drug business and this is very very bad because this may ruin your health

hbvdna is not important, they just did this test to scare you on million copies....but this tests is not helpful if hbcab igm missing and hbsag quant missing

hbsag quant in iu/ml, this may help understand the phase of infection if cronic and drugs that may clear it.it is also useful to check monthly if acute so you see if you are clearing virus fast

fibroscan. you need more than one reading because after a alt flare there is much inflammation so you may read 13-16kpa which is all inflammation and not fibrosis.you can do it every 3 months and see if it goes down, if it is fibrosis it doens t go down a lot in months but only after years of hbvdna und

hbeag and hbeab can be done once we know it is cronic

[4est]

maybe HBs ag quantitative can give some more information about the state (this beside fibroscan).


as regarding HBe ag negative, seroconversion of Hbe ag can ocure natural without any nuc's

[needhelp143]

my one doctor told me it is chronic and he told me to take entecaivr 0.5 mg and other doctor in NY told me he is not sure it can be acute but the result shows chronic and he said no to medication.

I am HBE ANTIGEN NEGATIVE

Is there a fibroscan in Newyork

[4est]

are you sure about the fact that you are chronic ?
behavior that you describe can be also in a acute phase or maybe in a end phase of immune clearance phase.

anyway, a fibroscan is a desired test, especial after this flare.