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Avatar universal

discrepency between GI dr. and family dr.

I've been seeing the same GI dr. every 6 months for last two decades,  and the GI dr. saw my last 2 blood work reports with hbv surf anti-body, immune to HBV virus, and took me off Viread that I've been taking for the last 8 years.  last week, I went to a family dr. that I've seen first time only, and mentioned about my hbv condition, this family dr. who also have full access to my bloodwork results,  said I should continue my medication, and monitored every 2 to 3 months, saying chronic hbv is a lifelong condition.  of course everyone is entitle to their own opinion, but who is medically correct?
5 Responses
Avatar universal
Just to add to your confusion, I will state my opinions.
1. Chronic hbv is not necessary  lifelong. If you have lost HBsAg with or without treatment, with or without development of HBsAb, you can be considered "cured", you condition will be sustained without further treatment, according to recent literature.
2. Appearance of HBsAb without disappearance of HBsAg is not considered a "cure".
3. Unless cccDNA is completely eliminated from the liver, the "cure" is considered to be functional. The explanation is that the HBV due to residual cccDNA is well controlled by our own immune system, but therefore can be activated by immuno-suppressive treatments for other diseases. So in that sense, chronic HBV is lifelong, but it does not mean you have to take treatment lifelong.
Avatar universal
Hello Bm2016,
If I remember well from one of your previous messages, your anti-hbs was not that much; it was well below the level that is considered protective, i.e. 10 IU/L. Hence it was wise for you to keep on your hbv treatment. You know once the virus is inside our liver, it never gets out, unless we develop a huge amount of antibodies, something which is almost impossible for us chronic carriers, with current medication.
Avatar universal
unfortunately all my lab reports just state HBV Surf AB reactive,  HBV Surf AG nonreactive, no numerical value, so I do not know what is my anti-hbs is,  but blood report did stated individual is considered immune to Hepatitis B Virus, and HBV Quant PCR  HBV DNA not detected,

I have the next blood work prescription paper that I am going to do in June or July,  will only test for HEPATITIS B VIRAL DNA QUANT, Hepatitis B surface Antigen,  and Hepatitis B surface anti-body-QUALITATIVE.

I brought this up as I am concerned about it.
I don't recall if I ever I experience any HBV symptoms in my lifetime.
Avatar universal
Hello Bm2016,
Sorry, I've misquoted you; you  didn't write about anti-hbs quantitative. That was just in my mind, because I'm quite pessimistic regarding chronic hbvers developing large amount of anti-hbs. But, of course, I wish the best of luck for all of us:)
I think in your next test try to ask them for anti-hbs QUANTITATIVE. That would give you a huge rest of mind; especially if it comes to be >10IU.
You are lucky not to expereincce any hbv-related symptoms. In my situation, I've lots of extra-hepatic problems like chronic kidney problem, pains in whole body, in the muscles, joints and bones, weak and painful legs, burning feet, chronic bad breath, etc. I am never bothered about my chronic hbv, or issues directly related with it like cirrhosis and hcc. What bothers me and has destroyed my life is those extra-hepatic problems that I listed above.
By the way, is there anyone here who have experienced or is experiencing the symptoms I listed above?
Avatar universal
I have constant body and muscle ache, but I think it's because of entacavir,didn't have it before I took anti virals. In fact there are few days when I just don't feel like doing anything...high fatigue
Its the nucs not the disease..
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