Chronic Hepatitis Carrier

[Dantri]

Hi,
Today I receive my blood test result as:

1. Hbsag: + at 3599.55 S/CO
2. Hbeag: - at 0.285 S/CO
3. Hbv - Dna: 7.28x10^2 IU/ml or 4.23x10^3 cp/ml.
4. Ast: 21 U/L
5. Alt: 19 U/L

Doctor told me that I was an inactive carrier and now the virus is becoming active again. I am recommended to see a specialist for treatment. Can anyone please help? I never knew that I had Hepatitis before. Do I understand correctly that despite carrying the virus, my liver is still not harmed yet?

Thanks,
Duc

[Dantri]

Hi,

Sorry to be lengthy. The specialist doctor also told me that even if they had collected my data in the past, it would still be very difficult to ascertain if the virus was getting reactive or not.

The reason is that HBV DNA normally fluctuates. He said also some patients fluctuate between undetected level to low level (as low as mine) so even if mine past HBN DNA data was undetectable, it is not possible to tell that the virus is "waking up". Is that true?

Thanks,
Duc

[StephenCastlecrag]

Sorry to get your gender wrong. You are chronic because you are HbsAg positive for more than 6 months . Generally HBeAg negative indicates a low virus replication phase, but it is not necessary true in all cases.

Yes, most hbvers have inactive disease and may never require treatment. But it is necessary to keep monitoring as disease can become active again, usually without symptoms until it is serious. So treatment when it is necessary is important.

[Dantri]

Hi Stephen,

Thank you for your kind help.
I saw a specialist today and she asked me not to worry and come back to see her in 6 months. We did also a quick untrasound that showed no fat liver.

I'm confused and dont know what to do. If I carry on living healthily, does it mean my immune system will be capable of keepin viral load lower than the level that requires treatment?

I am also amazed that doctor were able to tell my hepatitis was chronic but not acute. Doea Hbeag negative always means chronic infection?

Thanks,
Duc (I am male btw)

[StephenCastlecrag]

I think it is a bit early to say that you will need treatment now. Since we have no comparison with your previous data, we cannot say that your virus is becoming active again. Your ALT is normal for a female and your hbvdna is 728 iu/ml, well below the 2,000 iu/ml that is usually recommended for consideration for treatment.
Whether your liver is harmed yet depends on your history and it is difficult to tell with a Fibroscan or biopsy.

I do agree with your doctor that you should see a specialist (not necessary for treatment) as most doctors are not experienced with Hepatitis B.

Just my opinion.