All My Hep B Results HV DNA , LFT Advice please

[rockla]

Test Principle : Real Time PCR

Target Selected : Highly conserved pre-Core/Core region of the HBV genome across A-G genotypes is selected for amplification & detection.
Equipment : COBAS AmpliPrep and COBAS TaqMan

HBV - Hepatitis B Viral load (Quantitative) 35,935 IU/mL
Log Value                                               4.56


Test Details:
Limit of Detection: 20 IU/ml
Measuring Range: 20 - 170000000 IU/ml
Conversion Factor: 1 IU/ml - 5.82 copies/ml

Antigen Results

HBeAg-Hepatitis B Envelope Antigen
(Serum,CMIA)                          NON REACTIVE(0.41) S/CO Non Reactive: = 1.0
Anti HBe-Ab to Hepatitis B Envelope Ag
(Serum,CMIA)   REACTIVE(0.25) Ratio Non Reactive: > 1  Reactive:  250.00) IU/mL Non Reactive:  250.00) IU/mL Non Reactive: < 0.05

Can you advise how does it looks overall ? I would be going to hepatologist to give further advice as my partner wanted to clear the doubts before marriage.

[rockla]

Hoping someone comes and response

[StephenCastlecrag]

Your are HBeAg negative, yet your viral load (hbvdna) is > 20,000 iu/ml. You should also check your ALT and do a Fibroscan. You may need to consider treatment.

[stef2011]

and also hbsag quantitative in iu/ml

[rockla]

My LFT Results , the ALT is alright

Investigation Observed Value Unit Biological Reference Interval
Proteins
Total Protein
(Serum,Biuret) 7.51 g/dL 6.4-8.3
Albumin
(Serum,Bromocresol green)4.25 g/dL 3.5-5.2
Globulin
(Serum) 3.26 g/dL 1.8-3.6
A/G Ratio
(Serum) 1.3 1.1-2.2
BilirubinTotal, Direct, IndirectSerum
Bilirubin-Total
(Serum,Diazo) 0.53 mg/dL 0.2-1.2
Bilirubin-Direct
(Serum,Diazo) 0.19 mg/dL 0.0-0.5
Bilirubin- Indirect
(Serum,Calculated) 0.34 mg/dL 0.1-1.0
SGOT (AST)
(Serum,Enzymatic) 27 U/L 0-35
SGPT (ALT)
(Serum,Enzymatic) 27 U/L 0-45
Gamma GT (GGTP)
(Serum,Enzymatic) 19 U/L 12-64
Alkaline Phosphatase
(Serum,pNPP) 77 U/L 40-150
LDH-Lactate Dehydrogenase
(Serum,Enzymatic) 274 U/L 125-220
HBsAg Screening
(Serum,CLIA) REACTIVE(> 250.00) IU/mL Non Reactive:  250.00) IU/mL Non Reactive: < 0.05

[rockla]

Just to add i went through Liver Function Test and Liver Sonography and both were said to be good is it too high ? Fibroscan is expensive test just wanted to make sure everything before i go for that test

[rockla]

Please reply is the 35,935 is power of 4.56 ? What is the exact value is my case good ? Easily treated with medicines ? I was treated with Dengue 1 year back would that make any difference would my viral load change due to that ?

[stef2011]

HBsAg Screening
(Serum,CLIA) REACTIVE(> 250.00) IU/mL Non Reactive:  250.00) IU/mL Non Reactive: < 0.05

this is wrong, they must dilute the sample to make hbsag quantity or use the new automated kits

blood samples are not useful to know if liver is ok, you can have cirrhosis and all blood tests normal

[rockla]

So what test would you recommend ?

And please tell me is the Viral Load Result too high/high/moderate ?

My liver sonography was also all good

[rockla]

And well you are scaring me :-) :-) ;-)

Lets just be positive about things if things are going to happen it will happen.

BTW I'm 31

[Royal36]

I think the best test is Fibroscan if n't you have to go for the biopsy i guess.

[stef2011]

My liver sonography was also all good

ultrasound cannot see cirrhosis, fibrosis or liver damage.if you see a damaged liver on US your liver is so advanced cirrhosis to be end stage with nothing to do.also blood tests may see a cirrhosis but like for US when all blood tests are absnormal liver is so damaged to be on end stage with very little possibilities
US is just to detect liver cancer or fatty liver

only fibroscan see a healthy liver and all levels of fibrosis before cirrhosis and then all stages of seveirty within cirrhosis

hbvdna has little meaning as regards liver damage and also little meaning without all other tests.if undetectable for many years liver is probably not damaged but only fibroscan will tell for sure

[stef2011]

you need hbsag to tell if you can easily clear infection by immune modulators like peginterferon, hbvdna can be made und by antivirals anyway but that doesn t mean clearing the infection but just stopping liver damage

[flyinsky]

I think your case is not too bad according to your alat asat .your viral load is some how high I think your doc will put you under check because your alat asat are normal so he will recheck again.i suggest if you can do fibroscan or biopsy do it to be sure of your liver conditions.this is the only way to know if you need treatment
If this test I ok so no need for treatment and you will just be under control each 3or 6monthes or once a year.what is the opinion of your doc?

[rockla]

I'm going to hepatolgist today will update the thread after my visit

[rockla]

Visited my doc and he advised me 3 options :-

1. Do a liver biopsy
2. Start Medication
3. Wait for 3 months and do test again to see load and LFT is all good and try avoid medicines

He said to start medication which would bring down load easily but one disadvantage is once you start the medicines you cannot stop them and it needs to be consumed life long as stopping them would have multiplying effect as we were worried whether the medicines has any side effects he told us since the medicine has been out since 6-7 years nothing has been reported.

Liver Biopsy is also a option which would hep determine liver damage and would help gauge whether you need medication or not but he mentioned it can be done once 5 years and should be avoided and he told me you should do that maybe 5-6 years down the line not really recommended now.

Final case being wait and watch for 3 months but he said its not usual that load will go down easily on its own.

He didnt mentioned the medicines name he said think and decide what approach you want to follow and he also mentioned that medicines are expensive costing around Rs.50 each tablet not sure whats the name of tablet.Can you advise whether taking of medicines lifelong is mandatory ? People who have been taking any side effects or have they stopped taking after a while ?

[rockla]

Also please let me know why Doc would have not advised fibroscan ? is it recommended

[flyinsky]

i think your doc is well done
fibroscan if you are in usa it is defecult to do it not available on all cities.
i sugest , to wait more 3 monthes or do biopsy.by this way you know exactly what s happen in your liver.
and your doc is right avoid treatment as possible

[rockla]

So these medicines cannot be stopped once started?

[flyinsky]

Yes in one case you achieve cure i mean loosing hbsag and have antibodies

[rockla]

I didn't get it would the medicines bring down the load right nothing else right or you saying if I lose hbsag then I can drop medicines and when you say avoid treatment why is it not recommended

[Royal36]

Well if you loose your HBsag to negative it means you are totally cleared the virus and HBV free, then you just take the HBV vaccination & you are done. Good luck!

[Royal36]

What kind of treatment does your doctor adviced you not to take coz most of us here we take vitamins like vit D, blackseed & fish oil?

[flyinsky]

Those are just supplement not treatments they help immune system.for me I have viral loads in millions my alat around 70,and my fibroscan shows no fibrosis or little so my doc has a doubts about the fibroscan results so she ordered me to do biopsy by this way she will take correct decision if or not take meds

[flyinsky]

All treatments have side effects and each one react differently to treatment
The used ones are viread or baraclude they used to lower DNA to undetectable alat asat normal and avoid damage of liver