Worried, pretty high viral load... antiviral treatment?

[cheng302]

Hi guys, just got my viral load results tested last month. They have to send my blood to Toronto, which takes a long time to wait... They didn't test my HBSAG (quantitive). They said they don't care that. Nonetheless, The viral load is pretty high! I am quite worried now. Do I need antiviral treatment right now? Since last October, I began to feel tiredness, especially when I walk upstairs. Also, I lost almost 10 pounds in the last few months. They still want me to see a doctor of internal medicine to make sure these symptoms are not related to other diseases.

2015/01/16
Male, 27
HBV surface Ag:  Reactive
HBV Surface Ab: 0.5 mIU/ml
HBV DNA: 1.1*10^8
ALT U/L [0-54]  197 H
AST U/L [5-45]   94 H
ultrasound: A small amount of free fluid around the liver. The liver parenchyma appears within normal limits otherwise.

I was first diagnosed with hep B in June 2013. The viral load was undetectable that time. HBEAG positive. My parents all have HBV Surface Ab >200 mIU.ml.

[cheng302]

thanks, I will do it today

[cheng302]

That's also what I want to figure out... I have done many blood tests before 2013, and no one told me that I have hep B. Probably I was not infected at birth, I guess.

[cheng302]

I only tested my viral load three times. Twice in 2013, they are both undetectable (<500). Now it rises to 1.1*10^8... which makes me feel a little bit panic.

[flyinsky]

Mine also is in mlions but my alat is toward 50 70
So I did blood test and I am wating for results of

[StephenCastlecrag]

Normally, if you are HbeAg positive with very high viral load and elevated AL:T, then we will suggest that you are in the immune clearance phase. However, your case is complicated by the facts that you twice tested hbvdna "undetectable", presumably with HBeAg positive. HbeAg positive usually indicates highly replicative state (i.e. high hbvdna) and is not compatible with undetectable hbvdna. So. this is a puzzle to me, anyway.

A prolonged immune clearance phase without hbeAg sero-conversion carries great risk of liver damage and fibrosis. Generally, the advice is to wait and observe for 3 to 6 months to see if you achieve e-seroconversion naturally. However, if your liver functions are highly abnormal(you will need a liver specialist to read your liver function test results), and/or you have several fibrosis already (> F2), then treatment should be started.

So, it is best that you consult a Hepatitis B specialist.

[varsa]

Stephan what is the cause of small ammount of free fluid found in chang abfoman.the same thing is happend in 2012 with me also.please explain