HepB treatment interpretation...

[insanefighter]

Hi, I am 25 yrs old/Male and was diagnosed with chronic HepB on July 2009. My 2009 report is given below-

Anti HB Core : Reactive
Anti HB Core IgM:  Non Reactive
HBeAG: Non Reactive
HBsAG: Reactive
Quant HepB DNA Load: 5020 IU/ml

What does the above mean??

I have been on Tenofovir since then. I used to drink alcohol occassionally (once in couple of months) which I stopped immediately after diagnosis. I am a non smoker. The viral load reduced to 14 IU/ml after 6 months of treatment on Dec 2009 and to less than 6 IU/ml (below detectable range of the assay)since July 2010. It has been below 6 IU/ml in the last four reports (latest being June 2012).  

My doctor has prescribed the following tests before I go for my routine 6 monthly checkup in November 2012-

1. Fibroscan
2. Qualitative HBV DNA
3.  Something like Creatine AFP ( cant read his handwriting)

My last FibroScan was 3 kPa (Dec 2011). My questions are-

1. What is the interpretation of my initial diagnostic report?
2. What are the above stated tests meant to establish? And what is "below detectable range of the assay"?
3. I have been reading the forums and came across a term called "seroconversion"  What does it mean? Is it applicable to me? What are the implications of being "seroconverted" and non converted"??

And Lastly WHAT NEXT??

Kindly provide answers to my questions.

[stef2011]

i agree no difference from 3 to 4.8kpa, both normal range.this said 3kpa is of course better and it is the result of being good bmi/normal weight

bmi and liver are coonected but this is important only for those with cirrhosis or fibrosis

if you like to be super healthy and prevent all diseases connected with sedentary life few changes in diet can make a perfect bmi, also check liver by ultrasound every 6 months just to be sure not to develop any fatty liver which can make the same damage as hbv to both liver and all body metabolism

in case of fatty liver check my post by research box "update on my fatty liver" and the diet i followed, i found diet can do so much more than exsercise, at least for me.fresh food is a must for us hbvers, fresh vegetables, fresh fruit, no red meat, few white meat from trusted sources with animals in the wild and not fed by ormons and antibiotics

same danger from milk, cheese and poultry because animals are fed by ormons and antibiotics that we get eating them

cancer is probably generated from this food mainly and from chemicals in food (aspartame is one the most scarry thing in food)

all this is well known in italy but maybe it is easier here since our food culture and production is based on these thing: fresh, no chemicals, animals in the wild with controlled food/no drugs

[StephenCastlecrag]

I am not an expert with Fibroscan score, maybe stef2011 will give you a better answer.  Obesity and inflammation(high ALT) can elevate Fibroscan score. I don't think 4.8 kPa is significantly dofferent to 3 kPa.

I think you are in very good shape with your undetectable viral load which should be supported by normal ALT reading.

[insanefighter]

Today I went for routine 6 monthly check up and got the above mentioned tests done. While results of the DNA tests will be available after a week, I have the Fibroscan report. It shows 4.8 kPa. I could not get an appointment today because DNA test results are still awaited. I have gained weight, from 62kg (in 2010) to 69kg today since my last Fibroscan (Dec 2010). I apologise for the error above where I mentioned that my last Fibroscan was taken on Dec 2011.

I need some pointers as to what could have led to an increase in the number (3 kPa in 2010 to 4.8 kPa today) in Fibroscan report? I have been on Tenofovir as mentioned above, do not drink, but I do lead a sedentary lifestyle as a college lecturer. Is the increase due to weight? Or is this number within the range of "normal" reading??

Thanks in advance...

[StephenCastlecrag]

In my opinion, your doctor is ordering a lot of tests. I don't see the purpose of another Fibroscan. Creatinine is test of  kidney function (a very cautious test because you are on Tenofovir). AFP is a test for potential indicator of cancer. The HBsAg-Q could be a quantitative assay of a surface agent (good to know). Your hbvdna is below the detectable range, that means your viral load is undetectable by your lab's testing technology.
There are two types of seroconversion:
1. from eAg positive to eAg negative;
2. from sAg positive to sAg negative (a cure).

Most likely you were infected at birth. Had a big flare in 2009 (resulting in jaundice) during immune clearance and was prescribed treatment. You have responded to treatment, lost your eAg (the first seroconversion). Yout HbsAg-Q test may tell you whether you are on your way to your second seroconversion.

These are of course just  my opinions and I am not your doctor.

[insanefighter]

PS: I cannot read his writing but there is another suggested test, something like "HBAG-Q" along with above three tests.... Any pointers...??

[insanefighter]

P.S. (additional Info)---  Before being diagnosed with HepB I contracted jaundice twice- once in 2004 (bilrubin around 4-5)  and then agian in 2008 (bilirubin around 9-10). It was this second time when, my doctor suggested me to go for Hepatitis tests... Also my mother is an inactive carrier. She never had jaundice.

----BITAN