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Chronic Hepatitis B

Posted , 17 users are following.

muhammad66851
muhammad66851

Hi, I am 36 years old. My LFT levels are normal but HBV DNA Viral Load is 6200 IU/mL. HBe Antigen is negative and HBe antibody is positive. Can you please explain what all these mean and how likely is the sever damage to liver in this state? What do I need to do to reduce or finish the Viral load and how much time is it likely to take?

Thanks

2 likes, 29 replies

29 Replies

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  • Bollyarchive
    Bollyarchive muhammad66851

    Posted

    As someone with chronic Hepatitis B for 30+ years I present the opposite view to Ivan.

    I was diagnosed with Hepatitis B in 1976.

    My GP said my liver function was fine and the viral load was low.

    The highest viral load we measured over the years was 183iu compared to Muhammads 6,000.

    I remained untreated.....

    ....until I was diagnosed with HCC primary liver cancer and subsequently cirrhosis.

    Unless you are having your ALT and other liver functions measured every week you will miss brief elevations of the enzymes. Every elevation causes just that little bit more inflammation and damage. 

    Primary liver cancer has a poor outcome with only a 50% survival rate of 5 years post diagnosis.

    You may stay well.  You may never develop cancer. But knowing that you have a virus that has a high risk of developing into liver cancer, will you risk it?

    Its your choice Muhammad. 

     

    • muhammad66851
      muhammad66851 Bollyarchive

      Posted

      You are right. I have the appointment tomorrow and will see if the Hepatologist suggests medication, I will go for it. The only thing which worries me is the Side effects as I heard people saying that it is accompanied by weight loss, hair loss etc etc. And then the other thing that you have to stay on medication all your life. I mean can't we do away with medication once the viral load is reduced to a minimum?
  • Bollyarchive
    Bollyarchive muhammad66851

    Posted

    I know, side effect worry everyone. I think you may be confusing anti virals which you will take with chemotherapy which is no longer used as a treatment for viral hepatitis.

     I'm on Tenofovir and have no hair loss, no weight loss and take a daily calcium and Vitamin D supplement in case of calcium loss. 

    List the risks of the side effects against the benefits of no liver damage. Your liver performs around 500 functions for you, you only have one liver, once it's gone it's gone. 

    List the risks of no treatment (progressive liver damage and ill health) against the benefits of treatment.

    If you have a decent and experienced Hepatologist they are in the best position to advise you. We don't know enough about your medical history and we are not doctors. 

  • Bollyarchive
    Bollyarchive muhammad66851

    Posted

    And yes you do stay on meds for life. If you stop the virus comes back resistant to the antiviral medication.
    • cabin4
      cabin4 Bollyarchive

      Posted

      Hi Bolly, I've been reading this thread but from what I heard from hepa doctor is that Tenofovir has no known resistance and plus people aren't on it for life. Only until body developed antibodies

  • muhammad66851
    muhammad66851

    Posted

    I met the Hepatologist few days back. He did the Liver scan as well and I told him that I was diagnosed with HBsAg in 2009 and since then the status is the same. He said that three factors are considered for deciding medication: LFTs, Liver scans to check about any Scarring and the Viral load. In my case, LFTs and liver scan are perfectly fine. The only thing is Viral load which he said that I should keep monitoring periodically. He advised me not to start medication at this stage and make another appointment to recheck the results after three months. If things remain same, he says that I should keep a check of LFTs every six months. According to the Hepatologist, I am an Inactive carrier and I don't need to worry a lot
    • ivan3388
      ivan3388 muhammad66851

      Posted

      Sounds like the rigth thing to do. No reasons to start any medicaitons at this stage smile

      Try to maintain a normal ALT and AST level and you would be fine for life.

      (Diet, living habbit, use fo supplements etc. might help with ALT and AST)

    • muhammad66851
      muhammad66851 ivan3388

      Posted

      Can you elaborate a bit about the Healthy diet and Life style particularly in this situation please? I mean what not to eat and what not to do etc?
    • Bollyarchive
      Bollyarchive muhammad66851

      Posted

      If you are happy with decision as the patient, then that's good.

      I hope your hepatologist is up to date with all recent developments, such as these published just last year..

      Minerva Gastroenterol Dietol. 2015 Oct 8..."The unique replication strategy employed by HBV enables its persistence within the infected hepatocytes [that means Hep B viral cells will always be in the liver tissue cells and have a sneaky way of replicating or increasing]...The persistence of the HBV genome, as well as the inability of the immune system to resolve chronic HBV infection are believed to be key mechanisms of HBV chronicity...."  [in other words, your viral load can go up (or down) without affecting your ALT level and without you knowing unless you have a HBV DNA very frequently.  My ALT can change from 28 to 99 in a week]

       

      Curr Opin Virol. 2015 Oct;..."Hepatitis B virus (HBV) infection is a major cause of chronic liver disease, including liver cirrhosis, liver failure and hepatocellular carcinoma (HCC)-the second leading and fastest rising cause of cancer death world-wide. While de novo infection can be efficiently prevented by vaccination, chronic infection can be controlled using antivirals targeting the viral polymerase"

      He is not really following the current European Association For The Study of The Liver (EASL) clinical practice guidelines: "Management of chronic hepatitis Bvirus infection, 2014". where liver specialist from all over Europe have got together and decided on a prudent treatment plan, and say:  Patients should be considered for treatment when HBV DNA levels are above 2000 IU/ml

    • cabin4
      cabin4 ivan3388

      Posted

      Hi Ivan, how long have you been on antivirals and which one? Any side effects?
  • LightSeek
    LightSeek muhammad66851

    Posted

    Hi, I'm in a similar state with about 5000 IU/ml (21000 copies) with all other indicators in normal limts (CRP, SGOT, SGPT, PHOS ALCALINES, ALBUMIN; etc) except 24 mic mol/l bilirubin (may be genetic?). I'm HAV immune(IgG positive).

    The specialiste didn't recommend any medications in my case. However, I'm thinking of Interferons therapy as it is short terme and doesnt developpe a viral resistence (mutation).

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