Do I need Hepatitis B treatment?

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Hi All,

I am 33 year old male and new to the forum hence will start with Hello!!!!.. I need help/suggestions on the recent visit and discussion I had with my doctor on my test results and treatment he suggested.

I have been diagnosed with hep B in 2008 since then I have been keeping an eye on viral load and ALT.  Below are my recent test results:

1. HBsAg Screen: Positive

2. HBeAG: Negative

3. HBeAB: Positive

4. HBV Load: 3530 IU/mL (Log 3.548)

5. Liver Ultrasound: Normal

6. Liver Biopsy:  Grade 2 out of 4 Stage 1 out of 4

7. ALT (SGPT):  29 IU/L (Normal Range- 0-44)

8. AST (SGOT) : 21 IU/L (Normal Range 0-40)

After looking at the result my doctor is suggesting to start treatment by taking viread (tenofovir tablet 300 mg).

I am little concerned about starting the treatment as it is way costly. I am not sure if treatment is right choice at this moment. Kindly suggest if I shall look for second option before deciding on medication or shall I start the it.

Thanks in advance for all your help..

-Adi

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  • Posted

    Hi, welcome. when i was diagnosed with Hep c a few years back, i had to have vaccines for hep a, which involved 2 shots and for hep b, 3 shots. Luckily my insurance covered it. Then for the hep c, i took harvoni which cured the virus. But some insurance gives a hard time due to the cost. But i had medicaid and medicare and they paid all the cost with no problems. The harvoni cost the most but i only had a co pay of 3.00 which was good considering how much it would have cost out of pocket. But i would get a second opinion if i was you. good luck!
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  • Posted

    I've been taking Viread, now Vemlidy for 3 years. When I started taking medication, my test results were a lot worse than you, for instance, stage 3 out of 4 in liver fibrosis. The medication did got my conditions back to normal within a year but I continued to take it and will continue for a few years longer. Yes, the medication is expensive even my health insurance pays 80% of its cost. It also has some side effects, though subtle. I'm a marathon runner, routinely qualified for Boston before the medication. After medication, my fitness level took a hit and can no longer qualify for Boston but I continue to run, mostly half marathons, with no problem.

    It seems to me you could continue to monitor the liver conditions without medication, but I'm not a doctor and so take it as a grain of salt.  

     

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    • Posted

      Thank you so much guys for the response.. I am thinking to see second opinion before i decide on the treatment.. I always wonder why Liver Biopsy shows Grade 2 out of 4 and Stage 1 out of 4..  I have been monitoring ALT and AST from last 9 years and they always have been in normal range. I am wondering what does that mean by Liver Biopsy is my condition too bad? 
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  • Posted

    Update: I went for second opinion on starting antiviral treatment, Doctor monitored me for 9 months before deciding on treatment. My ALT, AST and rest of liver enzyme were within normal range except viral load went up. Below are the last 9 months results:

    HBV Load: 3530 IU/mL (Nov-2017), 2,580 (Jan-2018), 4,800 (April-2018), 14,500 (June-2018).

    ALT (SGPT):29 IU/L (Nov -2017), 35 (Jan-2018), 29 (May-2018), 42 (June-2018) - (Normal Range 0-44).

    AST (SGOT) :21 IU/L (Nov-2017), 27 (Jan-2018), 23 (May-2018), 32 (June- 2018)- (Normal Range 0-40).

    Looking at the viral load and slight increase in liver enzyme, Dr suggested to start antiviral treatment. I have started taking Enticavir .5 mg daily. Dr is afraid that I will have to live on the treatment for life. Hope medicine would not have any drug resistance. Hoping a brighter future in term of functional cure  [sad]  . Will keep tread updated on progress.

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