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Diagnosed w/ Chronic Hep B

At 29, I never knew I have hep B until I got jaundiced and had dark urine.

I immediately went to the doctor and they ran hep B tests. I tested positive for Hep B and diagnosed as chronic.

During peak of symptoms, ALT was 2000 (very high!!) but after 1 week, it was down to 500. HBV DNA was 200,000+ at that time.

Doctor said I had a flare up but did not run any tests except for ultrasound (liver kidney spleen gallbladder are normal)

I dont understand what caused the flare up! Is it really possible? Am I really at chronic? Please help. My doctor prescribed tenofovir for a month before my next lab tests but I still did not take it cause I am still in figuring things out.

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Avatar universal
Hello, thank you for providing your insight.

To add, when I had the symptom and had the hep B profile test, my antihbc igg is reactive and igm is negative. Hence, they said I am chronic.  Is this always the case for chronic hep B?
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A positive HBc total antibodies and HBcAb-IGM negative, with HBsAg positive, are consistent with a chronic HBV infection. This should be confirmed with another serology test 6 months later. When you have all the details, such as HBeAg/HBeAb status, hbvdna, and ALT, then you can decide on the course of treatment. A quantitative serum HBsAg and a Fibrosis score(such as from a Fibroscan) will also be very useful.
All the best.
All the best.
Appreciate your insights. I will be considering your inputs and get tested again after 6 months from the onset of my symptoms
Avatar universal
It is possible to have jaundice during acute HBV. The information you provided does not allow us to offer an opinion on whether you are chronic or acute. Anyway, your next checkup should provide you with more details.
All the best.
Helpful - 0
3 Comments
If I may ask again, are the symptoms that I had experienced 3 weeks ago indicates the peak of it as a result of my body fighting Hep B? I am afraid that I will experience the symptoms again
I am sorry I don't know the answer to your question. I am not a doctor. An experienced liver specialist may be able to give you an answer. Let me expand on what I know. Because you are not sure when you are infected,  we need to find out:

1. If your infection is recent is it acute or you are unlucky for it to become chronic?
2. If your infection was recent and you became chronic, then what is your current status: HBeAg negative or positive, hbvdna and ALT levels? If HBeAg is negative, I believe you will not experience the high ALT or jaundice symptoms again.

3. If your infection is old, say at birth, then you may be in the Immune Clearance phase, where ALT and hbvdna will fluctuate? In this phase, your immune system will try to clear the infection, in general, leading to the Immune inactive phase.
4. If your infection is old, then are you in the Immune escape phase, where hbvdna and ALT are on the rise from a very low base?

I am sure you can find a lot of details regarding the natural history of HBV infection on the Internet. The HBV virus itself is harmless, but repeated attempts by our immune system to clear the infection cause damage (cell deaths leading to fibrosis). Antiviral medication, in general, limits the virus replications and reduces the need of your body to fight the viral infection.

These are my opinions.
All the best,

Thank you much! I appreaciate your response. I only had one test of the hep B profile (during peak of symptoms) hbeag is positive (first doctor said virus is actively replicating) then I had ALT test which yielded 2000 (said it is very high) but went down to 500 after a week (doctor said it is good in a span of 1 week alt went down significantly). Ordered Dna test, it was 200,000.

I will come back to the doctor by next week to check ALT again and bilirubin.
And will definitely request for a hep B profile after 6 months since I had the symptoms.

Thank you all for helping me out!
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