Aa
When to treat?
Hello, I am just wondering if I could get some opinions on when people here feel treatment should be initiated. I know there are several different standards which are followed around the world by medical communities, however is there some discussion on which is better to follow and for what conditions.
She is about 40,000 IU/ ml viral DNA. Everything else seems normal, not sure if they are checking everything they should or not.
She has chronic musical and joint pain. Also complains about pain on her right side by lower ribs, low energy always tired.
E antigen (-)
She is about 40,000 IU/ ml viral DNA. Everything else seems normal, not sure if they are checking everything they should or not.
She has chronic musical and joint pain. Also complains about pain on her right side by lower ribs, low energy always tired.
E antigen (-)
Best Answer
I wish Medhelp would fix this problem-test deleted:
ULN ALT for female is 19 iu/l and 30 for male.
2. Treatment should be considered if there is significant fibrosis (> F2) and cirrhosis, regardless of viral load and ALT.
ULN ALT for female is 19 iu/l and 30 for male.
2. Treatment should be considered if there is significant fibrosis (> F2) and cirrhosis, regardless of viral load and ALT.
1 Comments
past and current ALT respectively are 24 30 22 26 35 24 21 u/l with a reference range of 4 - 55.
viral load has fluctuated between 10,000 and 40,000iu/ml
I guess I should probably talk to here doctor about treating.
I guess treating would release a lot of stresses and also add some new ones. Thanks for the advice
viral load has fluctuated between 10,000 and 40,000iu/ml
I guess I should probably talk to here doctor about treating.
I guess treating would release a lot of stresses and also add some new ones. Thanks for the advice
Update,
July 2018
Viral load - 44,600 IU/ml
ALT - no record
Oct 2018
ALT 30 U/L
Viral load - 148,000 IU/ml
ALT - no record
updating for my self but if anyone wants to comment I would be overwhelmed with joy.
July 2018
Viral load - 44,600 IU/ml
ALT - no record
Oct 2018
ALT 30 U/L
Viral load - 148,000 IU/ml
ALT - no record
updating for my self but if anyone wants to comment I would be overwhelmed with joy.
3 Comments
I think in order for people to comment you need to post more test results. Are you hbeag pos or neg etc
Please share as much info as you have. Most importantly we need to know age, duration of infection, HBEAG.
Here are some regular tests you can get done, please see below, this information will help you and your doctors manage your disease.
Preliminary Information:
1. How long you have had HBV? (example, birth, don’t know)
2. Family history of Liver Cancer HCC
3. HBV Genotype
Group1: every 6 months (Virus and Immune activity monitoring)
1. ALT + Liver Panel (Bilirubin, Albumin, etc).
2. HBV DNA
3. HBsAg Quantitative
4. HBeAG – only if previously positive
Group 2: every 6 months (HCC Screening, men over 40, women over 50, and Africans above 20)
1. Ultrasound (Liver contour, Spleen Size, Portal Vein Diameter)
2. AFP
3. DCP des-gamma carboxy prothrombin (optional)
4. AFP-L3% (optional)
Group 3: every year
1. Fibroscan
2. Fibrosure / Fibrospect (optional)
Group 4: (every few years if HBVDNA detectable)
1. Precore/Core Mutations
Here are some regular tests you can get done, please see below, this information will help you and your doctors manage your disease.
Preliminary Information:
1. How long you have had HBV? (example, birth, don’t know)
2. Family history of Liver Cancer HCC
3. HBV Genotype
Group1: every 6 months (Virus and Immune activity monitoring)
1. ALT + Liver Panel (Bilirubin, Albumin, etc).
2. HBV DNA
3. HBsAg Quantitative
4. HBeAG – only if previously positive
Group 2: every 6 months (HCC Screening, men over 40, women over 50, and Africans above 20)
1. Ultrasound (Liver contour, Spleen Size, Portal Vein Diameter)
2. AFP
3. DCP des-gamma carboxy prothrombin (optional)
4. AFP-L3% (optional)
Group 3: every year
1. Fibroscan
2. Fibrosure / Fibrospect (optional)
Group 4: (every few years if HBVDNA detectable)
1. Precore/Core Mutations
HBV since birth
37 years old
Female
Family History of liver cancer HCC unknown, Grandfather on mom's side died from drinking, however current heptatologist said only immediate family is a concern, so mother father siblings.
Genotype unknown - Hepatologist won't test for Genotype unless we are considering treatment. have been to 3 specialists in Canada and all say the same. However, Southern Chinese descent gives us some clues.
ALT - 33 L/U
HBV DNA 148,000 IU/ml
HBsAg Quantitative - Unavailable in Canada, Hepatologist wont send blood for testing to foreign labs
HBeAG - is Negative, if previously positive is unknown but likely
Biopsy - 4 years ago, comments, remarkable good condition
Fibroscan - was I think 4.2 so F0-F1 range sounds correct. Was a while ago, haven't had a Hepatologist for awhile and got a new one last July, will be doing fibroscan in June with new doctor. We had a problem with our specialist and also with our family doctor in finding us a new one. Some Ego political bull crap on their part. Lesson, never insult your specialist by questioning them when there are not many many to go to for second opinions in your province.
Our new Hepatologist follows AASLD Guidelines roughly but follows experience closer.
We don't have AFP that I could find but if I find it will post it later if looks abnormal
No precore/mutations testing - Being E antigen (-) and viral fluctuations between <20,000 to 148,000 may suggest mutations ???
I will bring the recommended testing list to the hepatologist in June, may I ask where the recommendations come from. Country ? Study? If Hepatologist thinks it is no necessary I will want to know where the source is to back up my claim.
37 years old
Female
Family History of liver cancer HCC unknown, Grandfather on mom's side died from drinking, however current heptatologist said only immediate family is a concern, so mother father siblings.
Genotype unknown - Hepatologist won't test for Genotype unless we are considering treatment. have been to 3 specialists in Canada and all say the same. However, Southern Chinese descent gives us some clues.
ALT - 33 L/U
HBV DNA 148,000 IU/ml
HBsAg Quantitative - Unavailable in Canada, Hepatologist wont send blood for testing to foreign labs
HBeAG - is Negative, if previously positive is unknown but likely
Biopsy - 4 years ago, comments, remarkable good condition
Fibroscan - was I think 4.2 so F0-F1 range sounds correct. Was a while ago, haven't had a Hepatologist for awhile and got a new one last July, will be doing fibroscan in June with new doctor. We had a problem with our specialist and also with our family doctor in finding us a new one. Some Ego political bull crap on their part. Lesson, never insult your specialist by questioning them when there are not many many to go to for second opinions in your province.
Our new Hepatologist follows AASLD Guidelines roughly but follows experience closer.
We don't have AFP that I could find but if I find it will post it later if looks abnormal
No precore/mutations testing - Being E antigen (-) and viral fluctuations between <20,000 to 148,000 may suggest mutations ???
I will bring the recommended testing list to the hepatologist in June, may I ask where the recommendations come from. Country ? Study? If Hepatologist thinks it is no necessary I will want to know where the source is to back up my claim.
Update, DNA Viral load was up to 121204 IU/ml, alt is still averaging 25u/l. This was in November, not sure how I missed it. is this normal, could it just be a flair up? I no longer trust the doctor we are seeing, her plan is to monitor viral load and liver function and do another biopsy in 4 years. This makes me uneasy, can anyone give me some insight?
Is there maybe a discussion on here that already covers this, I found next to nothing in the search function, maybe I am using the wrong words?
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1. hbvdna (viral load) > 2,000 iu/ml and elevated ALT (< 19 iu/l female, F2) or cirrhosis.
As Tenefovir/Entecavir treatment is long term, and short term treatment like PegIFN has side effects, you must always consult with an experienced HBV specialist to select the most appropriate treatment and management.