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11313481 tn?1417129031

Hep B and Liver Cirrhosis

Hello there

I have a question regarding my mom who has Hep B for the last few years. She did ultrasound 5 months ago after blood test shows some change comparing to the past and I recieved the call from Health Professional from the Hospital telling me first that her Liver is okay but later that she has a lot of scars on her liver and that the doctor wants to do biopsy in order to determine the condition of my mom's liver. We didn't go back but we actually turned to a healthy food and mom started taking one therapy with natural teas which we bought back home from one doc of natural medicine who is very well known in Balkan area for curing liver diseases.

My mom did blood test about 10 days ago and it came back as very  normal and with very good results. Her family doctor said the results are very good and so far the best. However, I took my mom to the same Hospital where she did liver ultrasound and we talked with this lady, NP, who told us that we need another ultrasound in a month ( bc of health insurance covering every 6 mo ) and to see what's going on. But, she shocked me when she said my mom's liver has cirrhossis according to the last ultrasound test that she did 5 months ago. I asked for the copy of ultrasound and I showed it to two doctors who said they can NOT see any signs of scars tissue or cirrhossis whatsoever. Mom is feeling great, normal and all good although she had some kind of depression and stress a few months ago when she was about to do ultrasound test but for the past few months, without stress or anything she has no major or even minor problem with health.  Now, my question is: How can they say a lot of scars on her liver and this NP even said cirrhossis when on the copy of ultrasound said this:

"Liver: The Liver is normal in size and echogenicity. The echotexture is smooth. No focal intraphetic mass is identified. There is no intraphetic biliary ductal dilatation. There is hepatopetal flow in the main portal vein. The surface of the liver is smooth. ARFI measurements were acquired: 1. 21, 2.17, 2.25, 2.8, 2.95, 3.42, 3.7, 4.17. Resultant ARFI median is 2.9 m/s."

I am afraid that they actually think there is cirrhossis or scars tissue according to this ARFI measuremtns as her median is 2.9 m/s. Can someone explain to me, please ?

"ABDOMINAL AORTA AND IVC: The visalized portions in the upper abdomen are unremarkable."
PANCREAS: The visualized portions of the pancreas are unremarkable.
SPLEEN: The spleen is normal in size.
KIDNEY: Survey sagittal images of both kidneys show no hydronephrosis. There is a smple cortical cyst measuring 0.9 x 0.9 x 0.9 cm in the posterior cortex of the right kidney."
OTHER: There is no fluid in the uppear abdomen.

IMPRESSION: Unremarkable ultrsound of the liver. ARFI measuremtns as above. "  - That's it about ultrasound.

This ultrasound was performed in June this year/last summer. Now I am posting blood test that she did 10 days ago:

BLOOD SUGAR 89 / range: 65-110 mg/dl  
UREA NITROGEN BLOOD ( BUN ) 17 / range 6-24
CREATININE, BLOOD 0.73 / range 06-1.4
BUN/CREAT 23.3 / range 5-26,
SODIUM 140 / range 135-148,
POTASSIUM 4.4 / rangr 3.5-5.5,
CHLORIDER 105 / range 98-108,
ALK PHOSPHATASE 44 range 35-115,
CARBON DIOXIDE 28.6 / Range 21-31
CALCIUM 9.5 / range  8.3 - 11.0,
SGOT/AST 19 / range 7-48,
TOTAL PROTEIN 7.1  / range 6.0-8.5,
ALBUMIN 4.5 / range 3.3-5.2,
TOTAL BILIRUBIN 0.65 / range  0.2 - 1.2

CBC WITH DIFF

WBC 5.8 / range 4.0 - 10. 0,
RBC 4.43 /  range 4.1 - 5.4,
HEMOGLOBIN 14.5  / range 12.1 - 15.4,
HEMATOCRIT  43.5  / range 37.0 - 47.0,
MCV 98.1  range 82.0-99.0,
MCH 32.7  range 27.0-33,
MCHC 33.3  range 32.0-36.0,
RDW 12.3  range 11.5-14.5,
MPV  10.6  range 7.4 - 10.4,
PLATELET COUNT  161  range 130 - 400,
POLYS 41.8  range 40 - 75,
EOSINOPHIL 1.3 range 0.0 - 6.0,
BASOPHIL 0.2  range 0.0 - 5.0,
LYMPHOCYTE  51.1  range 18.0 - 47.0,
MONOCYTE 5.6  range 0.0 - 12.0,
ABSOLUTE NEUTROPHIL COUNT 2.4  range 1.8 - 7.7

Hepatitis B DNA IU/ML 912  

HEPATITIS B DNA COPIES/ML  5308

Comment: Reference range: Target Not Detected or <20 IU/ml ( Dynamic range: 20 - 170.000.000 IU/ML ) ( 116 - 989. 400.000 copies/ML )
This assay was performed using Rosche Taqman Polymerase Chain Reaction ( PCR ) Assay.

HEPATITIS B DNA LOG IU/ML  3.0  

HEPATITIS B DNA LOG COPIES/ML 3.7

That would be all I have for right now.

Can anyone help me on this, please ?

Thank you

Al
Best Answer
Avatar universal
While this is the Hep C forum. I totally agree with your doctor and not the NP. Thers is nothing in her Ultrasound that suggests cirrhosis and her blood test looks great. Happy Thanksgiving.
55 Responses
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11313481 tn?1417129031
Hey Dan.

I am sorry, for the last two days I am typing from my phone as I do not use pc,laptops etc when I am off from work. I'll hit you later today when I get to work. I didn't forget your question, don't worry. We are here to help each other.
Helpful - 0
Avatar universal
Thank you very much!
Helpful - 0
11313481 tn?1417129031
I talked with NP yesterday and she told me that they THINK it MIGHT be cirrhosis ACCORDINGLY to measurements that are showing on ultrasound. We have 2.9 m/s measurements and she said everything over 2.0 m/s they considered as a cirrhosis liver. But she also said it might be because mom is overweight ( 240lbs and about 5'10" ) and it's hard to measure the liver. I asked if they know liver cirrhosis is for sure, she said "we don't know if it's cirrhosis for sure and that's why doc has feeling to do biopsy."

Also NP said the last blood test is very cert interesting and looks very good beside that is hep b antig still reactive which they expected to be.

I was checking online and it seems like it could be healing from inflammation of the liver and proceed of going back to normal.
Helpful - 0
Avatar universal
it doesn t change anything, if cirrhosis antiviral (tdf) must be continued irrisepective of alt, hbvdna. hbsag negativity, for at least one year since hbsag turned negative and hbvdna und
Helpful - 0
11313481 tn?1417129031
Its a little bit confusing, I think I'll have her do the blood test again to clarify this...
Helpful - 0
11313481 tn?1417129031
What do you think about being:


Hep Bs antigen   -    A Reactive ( that's mean positive )

Hep B antibody   -      Reactive ( the same, positive )

Hep Bs Ab          -     Individual is considered immune to HBV infection.


That's my mom latest blood test. Got the call from the hospital today and the faxed it to me.
Helpful - 0

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