Dear stef2011 and others, require you urgent attention, thanks in advance

[jhakas]

Dear Stef ( with Dues respect to others at the same time)

THis is for my brother.

Indian age 30 .. was diagnosed almost 10 yrs back ..when had jaundice.  HIs weight stands at 110 Kg... height 5'9''
HbeAg : Negative
HbeAb : Positive
Smoking = Yes
Drinkings = used to be a regular drinker
family history : Father had Hep B and Canccer ( though cancer in liver was not primary, it spread to liver)


Feb 2009 :
1. HBsAg, serum by CMIA/MEIA Positive (>250)      
ALT  :10
AST : 8
Else normal

July 2009:
ALT : 52
AST : 37
HBV DNA : 1194 IU /ml


Oct 2009 :
ALT : 51
AST :24
HBV DNA : 4949 IU /ml


Jan 2010:
ALT : 88
AST  : 39
HBV DNA : 28304 IU /ml
Feb 2010 :
HBVGenotyping by PCR : Genotype D

There was a big gap in the next report below and the count is very high please please suggest
Jul 2011 :
ALT : 75
AST :  55
HBV DNA : 2015555 IU /ml


After this he simply didnt do any test nor medication and only ater 5 yrs he did :

Jul 2016
ALT : 68   15- 37 (iu/lt)
AST : 40   upto 65 U/LT
Gamma GT (GGTP) Serum by Carboxy substrate-kinetic  30   Male  13 to 86 U/Lt
Vitamin B 12  163    187-883 pg/ml
Viral Load : 5 million + Iu/ML
Liver ultra sound : Fatty liver

Pleaese comment on where I stand in the whole pic ...
>How serious it this ?
>What phase does he belong to ?
> Does a high HBV DNA indicates that liver cirohhis exits ?
WHat should be his next logical step ? I have asked him to get Fibroscan done

What if :
Fibroscan is > 2
OR Fibroscan <2

[Aduiski]

If he doesn't believe in allopathy then he is neither intelligent nor logical.
On his place, with such consistently bad DNA and ALT, I myself would start the treatment right away irrespective of Fibroscan, in order to reduce future chances of HCC.

[stef2011]

you need to check his fibroscan, hbsag quantity in iu/ml and if not over 7kpa he can:
keep monitoring but he must change food quality, take vit d3 10.000iu daily, take vit E 800iu daily and exercise to clear fatty liver

start pegintf or tenofovir, much better tenofovir

[jhakas]

Thanks for quick response :
1. How serious is this condition ?
2. what if Fibroscan is greater than say 8 kpa ?
2. Does the high viral load has direct correlation with Cirohiss or HCC ?
3. Embarrasing for me to say this but he doesnt believe in allopathy medicine and wants to practice Own Urine therepy. He is intelligent and logical, just not a fan of allopathy, how do I convince him ?

Sorry for repeat question.. but answers to all wil help.

[jhakas]

Thanks, you did not mention anything on high HBV DNA?

Also does higher HBVDNA count is a clear indicator of HCC or cirrhosis

[jhakas]

Also once he starts meds, does he have to take it life long ?

[flyinsky]

I see his dma and alat still rising during 5years wich Is So long.i had a flare wich at max during one year and my hepato was very careful about tho and if I start a treatment or not.i did blood tests sometimes each 15days then each 3monthes in addition ultrasound biopsy and fibro scan to evaluate ththe damage to liver and start treatment in appropriate time.thanks god I passed without treatment and no damage but five years without fibroscan or biopsy and rising alat.i think treatment is needed immediately because his body is doing nothing towards this replication.......