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Avatar universal

Undecided and confused

I discovered just by accident that I was chronic hep B +ve 3 years ago and I am now over 55yrs.
Not sure when I contacted it, but it could have been from childhood.
I am HBSag +ve  HBe Antigen negative, my ALT has always been very constant at 45, I have antibodies to hep A and D.
I am having regular follw up with ultrasound and blood tests for hep B DNA and AFP.
My viral load fluctuates between 3100iu & 8300iu/ml over the last few years follow up
I am Hep B genotype E (There is very little research or studies done about this type's natural history & response to treatment)..
My AFP has been within normal range and I have normal liver fibroscan that is negative for fibrosis and my liver biopsy shows only mild inflammation but no fibrosis.
My desire for total seroclearance and I have been given options for treatment with interferon & Tenofovir, but my Dr is not keen to give me interferon (15-20% success) as I may not tolerate the treatment & it could affect my work (I am very busy and sole bread winner for my family), but he wont say no.
Also I dont want to takeTenofovir as it is for life & once stopped the virus could surge back. He mentioned real prospect of new more effective drugs coming up close to end of trials and approval to be on market in next 3-5years.
Am not sure whether to wait or what to do. My levels are over the 2000iu/ml cutt-off for treatment, but I am afraid of side effects of both drugs since I am well with no fibrosis, but very terrified of the risk of Liver cancer because of my age at over 55yrs and not sure how long I have been going about with it.
What are my risks of liver cancer and could I still clear the virus without treatment over time.
Please advice!!!!!  
Worried and confused B777.
6 Responses
Avatar universal
Normal Alt is now considered up to 30 for males.
If you didn't clear it by now chances are bad you'll be clearing on your own as your hbsag is likely not low based on your results. In your case treatment is recommended by British/Nice, Canadian, Japanese guidelines. On your place I would go for either entecavir or tenofovir. If your kidneys are not 100% normal go for entecavir
Avatar universal
Many people with hepatitis live in denial.
Some don't monitor the disease at all...others looking for a reason to not go under treatment or delaying it despite the fact that guidelines (written by the most knowledgeable people in the world about it) say they should do otherwise.

Same with the guy from another topic who has F3 fibrosis yes still wants to wait.

One day if HCC knocks on the door it will be too late...

Avatar universal
Like I stated, go seek doctors advice.  I think you are more giving medical advice to him without seeing any of his blood lab works.  I don't give medical advice, but just my option.  

My hepatologist is very good, and came highly recommended.  Of the past month, I seen two hepatologist and the hepatologist I did stick with, recommended by my GP, i have seen him twice, and also seen my GP twice in the past month, and they been schooling me on hep b.  I am not saying I am a expert but am aware of what should expect and what might or might not become.  

I am sure his doctor for the last three years has a better hand on his hep b then you do from a page long post.  

Dude, like I said, go to your doctor to ask more questions or seek a second option, because it does hurt to have another doctor to look at you and give you their professional medical advice or treatment.
Avatar universal
get to treatment as soon as possible after 50yo you can t stay and monitor, hcc risk is highest after 40-50yo and no treatment is suiciadal.

if no liver damage before 40yo it could be ok but at your age the risk is too high

what is fibroscan in kpa and genotype?with C or D risk is even higher
Avatar universal
By your age also precore and bcp mutations are probably positive, check that too because hcc risk is increased even more by this and can be decreased by treatment of course
Avatar universal
you have to be careful of some doctors. some only want to push pills while others like the wait and see approach. i went to 2 diff hepatologist and they both gave different opinions on whether to start treatment or not. in the end i started treatment because of mutations and family history of hcc. the doc that pushed me to start treatment was more well known in the hep b and c community and the other was just a reg hepatologist. point is in my situation i came on the forums and evaluated what my doctors have recommended and got different opinions from forum members. some forum members are on clinical trials and we have medical researchers looking for cures in our community. we should be lucky that in our forum we have so many different members from different backgrounds. this is just my opinion but i feel most doctors besides surgeons are just the faces of big pharma. it is the researcher that goes on in the background that cures diseases and the doctors are just the sales people for them.
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