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HepB Doctor says i can seroconvert - Thoughts!!!

Hi Stef,
Diagnosed with HepB back in 2013 and have been seen a well renowned Hepatologist since then here in Florida, USA who just informed me that there’s a high chance (not 100%) for me to seroconvert and develop HBsAB.
As you know here in the US we previously didn’t have the hbsag quant test until recently and, my doctor attitude toward my results had always been to keep screening twice a year. After seeing my HBSag Quant result, we had discuss the possibility to put me on Tenofovir 300 MG tablet (Generic Viread) and expects that I might clear the surface antigen within 2 years.
I'm 43 and was born in West Africa. I exercise regularly and take several other natural supplements as well as VitD thanks to you and this forum. I'm worry about getting on med. Genotype testing is scheduled for this week  
Your thoughts!  

7/12/17 - FibroScan - 4.4
6/6/17  - Complete abdomen US Normal
4/15/16 - MRI - Normal
10/02/15 - FibroScan 4.9
8/27/15 - Biopsy - Grade 2,STAGE 1


                2/9/18 6/23/17         12/19/16 6/18/16 10/26/15
HepB DNA 82 iu/ml 112 iu/ml       69 iu/ml und iu/ml 118 iu/ml
HBSAG         2772 IU/ml
HBSEG         Neg Neg
ALT(SGPT) 25 28 27 27 27
AST(SGOT) 18 19 22 22 38
VitD, 25-OH 58 72 37 37
AFP         5.5 4.9 5.2
4 Responses
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Avatar universal
I don't know how and why Ur doctor predicted 2years coz I am not able to see any logical reason behind this. Anyways best of luck
Helpful - 0
2 Comments
Thanks for the reply Jatashankar!  To be honest, I’m not sure why but he’s if not the top Hepatologist in US. He and his father wrote most of the Liver testing guidelines that exist here in the US today (since the 60’s) and one of the top University Liver disease Center here in the US is named after them. Most new drugs and trials are performed in this center.

However, he’s not making any promises but he is saying HCC is a risk factor associated with HepB and his goal is to decrease that risk level and hope that based on my numbers my immune system could produce the antibody to HepB once the HBSag Quant start trending downward.
I’m not expert, but I know you guys have wealth of knowledge in this area thru research. Is Tenofovir the right med? What are the side effects? I travel a lot here in the US and was wondering what will be the impact on my work. Has anyone achieve a full remission based on these numbers and Tenofovir?  
Tenofovir is the only best medicine for hbv today and taking it is a wise idea to prevent any further complications. Once u on meds other risks like HCC and cirrhosis reduces to a significant levels however nothing is for sure. Still take the med lifetime and live peacefully. Learn to live with hbv and accept it's presence. There are few people who have lost hbsag completely but that is very unpredictable thing. Taking tenofovir also clears hbsag on very long term but still very low chances. All hbvers are just in hope of some wonder drug to come but that is way way ahead.
Avatar universal
You are right to be worried about getting on the treatment; in most cases, treatment goes on forever and nobody knows what the outcome would be - which is why I find it strange that your doctor is predicting and even putting a duration on it. You also appear to be HbeAg negative patient, they are more vulnerable to flares and complications after treatment, compared to their HbeAg positive counterparts. Read this journal All i can wish you and myself is - good luck!

Read this journal when you have time https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161793/
Helpful - 0
8 Comments
To  Ollamail1982
Thanks for the journal. I read it in the past including several other publication and that's the reason why i'm still concern about starting any Med. However, my Hbsag is a bit high and should be somewhere below 100 IU/ml to avoid any liver damage and lower the HCC risk. Also, I just turn 43 this year.
Are you currently on any med and which one?  How long have you been on it and is your Hbsag level trending down?  are the side effects manageable?
The doctor said the virus is tricky and we have to be smart as to how we attack it.
i doubt any doctor is willing to put in writing stating that any patient will clear hbsag at a definite time.  i took viread for almost decade and my dr. verbally told me i have about two percent chance of going through hbsag seroconversion as well when went thought hbeag seroconversion on the 5th year.  i am in similar age as you are now.    there is a myth, as your age goes up, higher chance your own immune system able to clear hbsag and develop hbsab, around 50 or 60 years old.   hbv infection is always fluctuating, in long term, it may cause scar on liver when repeatedly inflammation and healing,  the goal of medicine is to reduce change of cirrhosis, which can advance to end stage hcc.  what you also have to consider is viral medicine like viread 300mg, once started, it will be taken lifelong, until hbsag seroconverted, the chance of virus relapse is extremely if medication is stopped.
Thanks for the explanation Bm2016... So would recommend I get on med as my doctor suggested? I've already made up my mind that if I do start, it will be for long term  if not for life. what made you decide to go on med 10 years ago? Any general side effects associated with this med? any improvement in your labs?
I truly appreciate you guys feedback as we're all in the same boat and hopefully there will be a cure soon:)
there is always hope, every year roughly 2 to 5% of the hbv patients went through hbsag seroconversion, naturally or by medicine.
my dr started my viral treatment around age 30 when my viral load spike exponentially to millions, took 5 years to lose hbeag, and physically i was able to see my body and immune system gradually increase in strength, another 5 years to lose hbsag, then dr. continued my anti-viral treatment for another 12 months after i've developed hbsab just to make sure i have developed enough hbsab, then stopped the medication, and monitored another 6 months, and finally my dr sent me home for good, ending the decade long treatment.  I have not taken any pill for almost 2 years now.  
oh, by the way, there is no cure for hbv at the moment, the best we can do now is functional cured, this hbv is very complicated dna virus, once it enters the body, it is here to stay until death,   i still have remnant of hbv virus inside me hidden deep inside liver cells, due to cccDNA keeps replication going forever, my hbcab is reactive for ever, what i got is my own immune system able to generate my own hep b surface anti-body to stop the hbv going into the blood stream.  if someday my immune system is being suppress by steroid, chemo, or weaken as ages goes up, i will be at risk of hbv virus relapse as well.
God bless!!! Glad to hear you're able to develop hbsab and functionally cured which is the best outcome for us HepB patient.
As my doctor explained it to me, if you have to be put on chemo for any reason in the future, there are ways to counter act that so you don't reactivate.
He said since my hbsag is around 2770, we can lower it and give my immune system the chance to generate hbsab like you maybe not in 2 years but long-term, and my wish is to do just that.
Did you have to be on any specific diet? I've tried different diets in the past but now I've eliminated if not lower meat consumption. I stop drinking alcohol almost 3 years ago and only drink water, natural ginger/green drinks and that could explain the reason why Fibroscan went down to 4.4 from 4.6 (not a big difference).
I'm really considering the treatment option as my doctor and 2 others physicians in his office told me that I've nothing to loose as it's hard to predict who will develop HCC ( lower than 3%) with the absence of cirrhosis and based on the fact that I'm 43 and surface antigen keeps replicating, I should start med as a preventative measure.
What do you think you did beside taking Meds that had helped you with your recovery?
My last ultrasound 7 months ago was normal and I'm scheduled for a new one tomorrow, and hopefully there's no change. AST-18 ALT-25 & AFP 5.5 couple of weeks ago but i'm extremely stressed for the ultrasound outcome.
Please advise  
@Brohim_2122 how are you now? did you take the med as suggested by the doctor? what is your hbsag level now?
Hi There,
Hope everyone is doing well...I did started treatment almost 2 years ago with tenofovir and since, I've had several blood works and Ultrasound done and so far, things appear fairly normal.
I presume I eat healthy (a lot of plant-based diet and occasionally indulge myself with white meat and seafood mostly salmon). I consistently juice various plants and mostly berries fruit every morning, exercise occasionally and take Vit D which was recommended by Steff in other posts. I drink a lot of water and have not consumed any alcoholic or sugary beverage in the past 5 years.
hbsag went up to 3100 and from 2700 and down to 2200 per my most recent lab. Bi-annual Ultrasound throughout the years have been normal as well as my metabolic panel - ALT/AST with latest values respectively 26/17. My creatinine fluctuates with latest – 1.01.  Latest AFP is 5.7.  
Although I’ve had low platelets/WBC in the past pre-treatment, I did notice my platelets level has been trending downward since 2019 and MPV upward - 139, 137 & 131. We plan to do a fibroscan in the next few weeks for precautionary measure. Last fibroscan was 4.4kpa back in 2017, but my doctor said she does not expect to see much change.
Due to chronically low WBC level (since 2006), a full blood chemistry analysis back in 2017 by my hematologist didn’t reveal anything malignant except that this was attributed to my ethnical background of black African-American. I have a history of Gastritis (occasional stomach pain and right side pain that goes away after I eat) since 2002 and have learned to live with it and occasionally take PPI if not rarely (try to stay away from Meds) and see my GI every 6 month.
I wanted to ask this panel here if this should be cause for concern and if there’s any advise you can give me.
Please advise
Thanks and stay well everyone :)
Avatar universal
Im not sure if it is a doctor thing but my doctor keeps telling that I will be on meds (entecavir for the past 3 years)  until I seroconvert. I keep asking him "isn't the chances of that happening very slow?" and he says ...."it happens.."
It sounds that he doesn't know what he is talking about but he is very respected and credited doctor in Israel. He has been involved in the creation of one of the main HBV vaccines and very much involved in testing new drugs. ....Maybe he is just trying to keep me positive.
fyi...where i live they dont test hbsag quantity also.... so know idea what my is.

Helpful - 0
Avatar universal
Hi There,
Hope everyone is doing well...I did started treatment almost 2 years ago with tenofovir and since, I've had several blood works and Ultrasound done and so far, things appear fairly normal.
I presume I eat healthy (a lot of plant-based diet and occasionally indulge myself with white meat and seafood mostly salmon). I consistently juice various plants and mostly berries fruit every morning, exercise occasionally and take Vit D which was recommended by Steff in other posts. I drink a lot of water and have not consumed any alcoholic or sugary beverage in the past 5 years.
hbsag went up to 3100 and from 2700 and down to 2200 per my most recent lab. Bi-annual Ultrasound throughout the years have been normal as well as my metabolic panel - ALT/AST with latest values respectively 26/17. My creatinine fluctuates with latest – 1.01.  Latest AFP is 5.7.  
Although I’ve had low platelets/WBC in the past pre-treatment, I did notice my platelets level has been trending downward since 2019 and MPV upward - 139, 137 & 131. We plan to do a fibroscan in the next few weeks for precautionary measure. Last fibroscan was 4.4kpa back in 2017, but my doctor said she does not expect to see much change.
Due to chronically low WBC level (since 2006), a full blood chemistry analysis back in 2017 by my hematologist didn’t reveal anything malignant except that this was attributed to my ethnical background of black African-American. I have a history of Gastritis (occasional stomach pain and right side pain that goes away after I eat) since 2002 and have learned to live with it and occasionally take PPI if not rarely (try to stay away from Meds) and see my GI every 6 month.
I wanted to ask this panel here if this should be cause for concern and if there’s any advise you can give me.
Please advise
Thanks and stay well everyone :)
Helpful - 0
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