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]

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]

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

[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?

[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

[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

[Royal36]

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