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Need Help on HBV Results

Dear Members,

My age 46, Non Diabetic/Un Married
LFT - Normal
HBV Since 2017


Sr.no Date HBV Quantitative Real Time PCR- Viral Load LOG Value
1 24.10.2017 1033 IU/ml
2 04.08.2018 776 IU/ml 2.89
3 10.04.2019 289 IU/ml 2.46
4 07.01.2020 67 IU/ml 1.82
5 07.06.2020 578 IU/ml 2.76
6 04.01.2021 Un Detected
7 21.03.2021 992 IU/ml 2.99
8 07.07.2021 2788 IU/ml 3.44
9 25.11.2021 529 IU/ml 2.72
10 06.08.2022 4459 IU/ml 3.65

First time the viral load increased to 4459 IU/ml
and AFP levels are

Sr.no Date Alpha Feto Protein(AFP) Serum(ECLIA) Ref Range
1 04.07.2021 9.62 IU/ML < 5.5
2 25.11.2021 9.43 IU/ML < 5.5
3 11.03.2022 7.72 IU/ML < 5.5
4 06.08.2022 7.81 IU/ML < 5.5

I am very panic, my stomach is paining and fullness also there.
Request you please advice me any treatment is required? As of now i have not taken any medicines except some natural products.

Request you advice me.

Thanks,
Mano
India
1 Responses
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Avatar universal
I am not a doctor. Your series of data on your viral load and AFP are very good, but they are insufficient to allow readers to comment. At the minimum, you will need to post your ALT, AST, HBeAg status and whether you were on treatment or stopped. Other data like serum HBsAg and fibrosis will also be useful. At one stage, your hbvdna is undetectable, which is good. But your latest hbvdna is > 2,000 iu/ml. As a guess, only a guess, 1) you were on antiviral treatment, then stopped when hbvdna is zero; or 2) you were HBeAg negative, in the immune control phase, and now transit to the immune escape phase which requires treatment.
Helpful - 0
3 Comments
Hi,

Thanks for your quick response, more details as follows.

On 11.08.2022

AST (SGOT)  -  20 U/L
ALT (SGPT)   - 22 U/L

Hbeag ( ELISA) tested on 24.10.2017 &  02.08.2018 - Negative
Anti - Hbeag (ELISA) tested on 24.10.2017,02.08.2018,10.04.2019,25.11.2021 - Positive

Hbsag ( ELISA) again repeated on 25.11.2021 - Positive

Ultra Sound Whole Abdomen Report - Normal Sonogram of Abdomen and Pelvis (11.08.2022)

Vitamin D Total ( ECLIA) - 19.65 ng/mL (11.08.2022)

KFT - Normal

Thyroid Profile - Normal

Fibro Scan by Abbott mini+430 machine on 18.08.2022

CAP - 244 dB/m
Median stiffness - 7.4 kPa
IQR /med - 14%
Valid Measurement - 10
Success Rate : 100%

HbA1c - 5.6 %

Anti HCV (ELISA) - Non Reactive
HIV I& II ( ELISA) - Non Reactive

  ANTI HBc  IgM - (CLIA)- Negative
  ANTI HBc  TOTAL -( CLIA) - Positive


As on date i have not taken any medicines , except siddha / herbal products.
When my viral load increased on 07.07.2021 as 2788 IU/ml 3.44.
Doctor adviced to start Enticavir - 0.5 mg per day for 12 months and some doctors told wait for some period so i have not taken.

Vitamin D3 / Cholecalciferol(60000.0 Iu) - weekly one 1 gram Granules in Sachet i am taking.

Last two weeks i am worrying more taking sleeping tablets.

I lost everything in my life job/marriage etc., my stomach having fullness and right & left side pain is more.

I am in worst condition now.



Sr.no Date HBV  Hbsag- Quantitative Surface Antigen CMIA

1 14.02.2018 8591.08 IU/ml
2 02.11.2019 8570.70 IU/ml
3 08.02.2020 11174.22 IU/ml
4 07.06.2020 6939.36 IU/ml
5 26.09.2020 6704.34 IU/ml
6 02.01.2021 4201.38 IU/ml
7 07.07.2021 4905.19 IU/ml
8 25.11.2021 4264.61 IU/ml



Request you please review my reports and advice what me , in case if you need any additional information required i am ready to share the same.

Once again thanks a lot for response.

Best Wishes.
Mano




Hi Mano,

Thank you very much for providing the very thorough extra data. You obviously are under the care of very good doctors and you are also very meticulous in recording and keeping a close watch on your test results. I am very saddened to hear that you have lost your job/marriage and that you feel unwell now. It makes me angry that in present days there is still discrimination against a chronic illness like HBV. Honestly, the stigma is worse than the illness itself. Hopefully, people will learn and discard their ignorance and prejudice.
I have a feeling that you know more about HBV than I do. Nevertheless, I will be brave and give you my opinion. Your Fibroscan stiffness of 7.4 KPa is good, borderline between F0 and F1. Your CAP score is also good, indicating little liver fat. Your Vitamin D level could be a bit higher, maybe you can discuss it with your doctors and increase your weekly dosage. Your ALT of 22 U/L is certainly very good. As for your herbal products, my only comment is that you should exercise care and caution when taking any herbal supplement for a long time. They do have side effects.
So everything is fine as far as I can see, except for your increasing hbvdna level to above 2,000 iu/ml. But your hbvdna levels do fluctuate, and I don't know why. However, your ALT is normal, below the UNL You are in a grey area as far as guidelines are concerned. So both options of taking Entercavir or wait/re-test are acceptable.
If you take Entecavir, you will most likely have to continue taking it for many years, until you become HBsAg-ve(very rare, 1-2% chance yearly), or a cure comes along( also unlikely in the near future). However, you will get peace of mind as it should prevent the progression of your HBV.
If you wait, you should re-test your hbvdna and ALT within the next six months, and consider your options then.
Finally, I would suggest you consider taking Entecavir. This seems to be the opinion of an increasing number of medical experts.
You are fine, stop worrying and you may feel better.
All the very best.
Hi,

Thank you very much for your valuable inputs.

My Lipid profile always high only but this time i don"t know how it came to be  normal( may be Siddha tablets?) and my life style has changed. No diet Control.

Fibro Scan Results (old values)

08.12.2017
TE SCORE 3.6 kPa suggests NO Fibrosis
CAP score 86 Db/m suggests NO Steatosis

05.04.2019

Median stiffness - 5.9 kPa
IQR - 0.7 kPa
IQR/med -12%
Valid Measurement - 10
Success rate 100%

23.05.2019

Median stiffness- 8.5 kPa
IQR - 0.5 kPa
IQR/med - 6%
Valid Measurement- 10
Success rate 100%
CAP - 185 Db/m

There are lot of change in the values of the machines.


Honestly telling i got a proposal with a girl but i denied due to HBV (because i do not know how to tell her/family) - if the they refuse me. - still i am having this problem.

I am trying to get good job, but my health is very weak and both abdomen are paining and GERD problem also.


Now a days my face is blacking i am worrying something alarming me  i do not know what should i do .

Once gain thanks a lot for your advice.


Best Wishes,

Mano








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