That is true, that recent data shows an increase in death. These deaths are occurring in the areas that access to current antivirals are lacking and if available remains extremely expensive.
Access is good in the West but that is not the case in middle-low income countries where HBV prevalence are the highest and the current deaths are occurring. The burden and resources for this virus are not equitable distributed. We cannot only vaccinate our way through this, we need people everywhere to have access and be treated while we wait for improved treatments leading to some forms of a cure. Prices for these antivirals treatments needs to be at a reasonable and an affordable price. If we are able to do both, then we can make some inroads in the fight against HBV. Liver cancer is the number one killer in Africa now. We need to do more.
There is a parallel between this disease and HIV. While HIV is no longer a death sentence in the West, it remains a deadly virus in many middle-low income countries till this day. I hope we can learn from it and don’t repeat these mistakes again. Thanks, Bansah1.
Dear dr @availlant thanks you for always finding the time to answer…
I also, wish I had known about the HBV vaccine, too late now, anyway…
you have been very supportive and helpful since I joined this forum .
back in July 2023 when I got diagnosed with aggressive Acute HBV with very strong symptoms ( joint pain, weight loss, muscle loss etc.) that lasted until last October when I was advised by my doctor to start TDF because of high viral load, liver inflammation high liver enzymes.
Since I started NUC therapy My viral Load has gone down from the millions to 30
last blood work was on May 3rd 2024 still not seroconversion.
I’m going for the six months abdominal Ultrasound and blood work next October 16th.
I’m very nervous and very anxious and somewhat depressed ( every time I get close to check up) about the results.
. Even though the liver enzymes and liver inflammation have gone dow, I have to be honest. I have lost hope about good news after 15 months of hoping…it’s hard to accept that I have chronic HBV.
some days are better than others, but the dark ones are dark.
Thanks you
Gregory
Another important part of the increased death rate (in addition to regional issues) is age related;the diagnosed patient population is continually aging since we started to collect comprehensive epidemiological information). It is also important to note that despite good NUC coverage in the US and EU, HBV related deaths are only dropping very slowly and we still have a significant proportion of liver transplants coming from HBV infection. The reason for this is that delayed initiation of NUC therapy in those diagnosed individuals does not have a substantial impact on the rate of HCC. Indeed we see HCC in patients who do not have cirrhosis.
The challenge is early diagnosis of a disease which is typically asymptomatic for years and by this time, liver integration is well established. This is the primary reason why China has become more aggressive in initiating NUC therapy (not waiting for liver inflammation or liver disease). There is still unfortunately a significant resistance to this evolution of treatment guidelines in Western countries.
So the unfortunate news is that your acute HBV infection is chronic. However the good news is that your doctor has started you on TDF very soon after you got infected. This means you will have the best possible outcome with available treatments; your liver will be protected from developing inflammation and fibrosis and your risk of HCC will be as low as can be currently achieved (much lower than someone with who started NUC therapy later on in their infection).
So aside from having to take a pill every day, there will be no impact of your HBV infection on your life. I strongly advise you to stop worrying about HBsAg loss and enjoy your life! You will see the doctor every 6 months and if some day HBsAg loss occurs then great! You may get to stop taking medication. But even if this does not happen, you will still be healthy and able to do any and all of things you have planned to do with your life.
Your feelings are certainly very understandable but I hope you can appreciate that your HBV infection really has no actual impact on your life at this point. Be happy and healthy!!
Sure, those are great points. But I will rather be in a Western country than in an African country today. If @Kenoti and @Johnpaul_Ezeike were in a western country they probably will still be alive.
Even though coverage, vaccination, treatment and testing are not 100% as you pointed out, they are still better than what is available in middle-low income countries.
I think China and Taiwan are on the right path, as always the West will play catch up while people die. Policymakers tend to cite costs for their lack of action but I think it makes sense economically to treat everyone. If people are treated then they can continue contribute fully while still strong. If we wait and pay for liver transplant, there’s little these people could contribute because they not 100% strong as they were before and prone to infections due to a weakened immune system.
In all, I think vaccination, early testing and treatment for all chronic patients is the best way to go right now as we wait for future cures. We have to take a holistic approach in tackling this issue. Great insights and I am enjoying this dialogue. Bansah1
The recent academic analyses of progress towards HBV elimination by 2030 have been pretty damning and highlight the disconnects between policy and best practice which are resulting in needless deaths.
It’s a shame, the unintended consequences of these policies and practices are leading to deaths. We will continue to fight for what the evidence shows is the best way forward. But, we need to do it now, as the longer we wait the more people will die.
I worry about my siblings back home who are unable to enjoy the health care services I have access to here in the US. It keeps me up at night.
Hopefully, we can all come together and save lives. All your points are well noted. Thanks, Bansah1
Your situation is very similar to mine. I was diagnosed in December 2020 and have been consumed with depression, anxiety and shame ever since. I honestly wish I had never found out. This is why I am actually sort of opposed to testing people without symptoms (unlike you, I had no symptoms when I tested positive). Having said all that, it looks like you’re doing well and I think you will be okay. Best of luck with your tests on Wednesday! My next appointment with my doctor is on 22 October.
Indeed very similar, I was going to send you a message but you anticipated me.
nice to meet you.
Thanks you, Im doing better physically.
I’m 57 never had flu, never been to the hospital, very healthy and strong immune system.
my life went completely upside down on June 29 2023 when I was told my diagnosis. It has changed me 360 degree. As you well know, I entered a tunnel of despair, shame, anger and deep depression.
scared of the future, feeling alone and disconnected, and worst is the guilt ( of being responsible for it)
After the initial shock and reality sinks in its even worst, the magic of life has gone, replaced by doctors appointments and never-ending blood tests and waiting month after month with always hope… hope… I wish I was told about the existence of HBV vaccine…
I started to go to a psychologist and it has been somewhat helpful in returning some color in my all of sadden black and white life.
I have great friends and family that love and support me, and yet doesn’t seem enough.
Thanks god I found this INCREDIBLE hepbcommunity forum. has been AMAZING with great informations and wonderful health experts and patients sharing their struggles.
Although it’s impossible to relax and be serene, like doctors suggest. (Only when you carry a cross like this you can understand.) it does get better with time.
It’s amazing how one life priority shifts once you are diagnosed with a life threatening virus.
I’m in the process of puzzling together a new way of life, new me…a new person.
it’s not easy but I have no choice.
I wish you good luck with your tests on October 22nd
keep in touch
best
Gregory
I recognise myself in everything you say. I honestly don’t think doctors realise what they are doing to us when they give us this diagnosis. I disagree with you though when you say that hepatitis B is a life-threatening virus. In most cases, it isn’t, especially not when you’re taking medication to suppress the viral load.
Thank you both for sharing such personal and honest perspectives. There are a lot of people going through the same thing that now feel that much less lonely because of your words. The hope you bring in showing that it gets better over time will change lives.
I hope you both continue to get the support you need to manage your conditions and please keep us all up to date with how you’re going.
Dear dr @ThomasTu dr @availlant@Bansah1
Hello I’m a very nervous this morning I went in for Ultrasound I just received the results it says a Slightly increased echogenicity ( I googled it and says it could be fatty liver , steatosis)
My doctor hasn’t seen it yet , can you please advice? I’m freaking out.
all the blood tests are all good, just waiting for the HBV DNA
Thanks you
Gregory
Dear Dr. @availlant
Thanks you, especially for your kind patience… being ignorant about it I get very anxious when I read a medical word I don’t understand and ( google search) therefore I panic…
my doctor didn’t t even mention it after he reviewed all the tests, he said it all looks good and be back in 6 months. is HBV Viral load 10 low?
I attached the latest test please I really trust your expertise and review
Thanks you so much.
Gregory @Bansah1@ThomasTu
First I suggest that in the future do not consult Google but directly come here to get the correct information. Without knowing where to look and what to look at, you can get the wrong information and or impresion.
Second your virology and biochemistry results are excellent. Liver function is normal and your HBV DNA has been reduced to such low levels that the very sensitive test used to detect it can no longer quantify the amount present (<10 IU/mL). Your HBV infection is under excellent control!
Hope you are doing well. Some days are better some days I feel devastated about my diagnosis. My doctor also said that my live function results are fine but when I google I freak out. Please see the below results and advise if this is okay.
Your feelings are normal and many others feel the same as you do. However, one of the reasons why this community is here is to get the message across that HBV diagnosis, while unfortunate, should really be treated as an annoyance: you have to take a daily pill and see the doctor every 6 months. Other than this, existing medication does an excellent jog of controlling the infection in your liver and preventing the development of liver disease. It is important that you keep this in your mind! There is no reason to despair.
Your doctor is absolutely right, your liver results are fine. The results that are indicated in red (an unfortunate choice of color) not because they are alarming but just that they are technically above the average value observed in healthy adults. The minor elevations in ALT and AST you have above their “normal ranges” are so small that they don’t mean anything medically.
Thank you so much for clarifying this for me. I am on truvada. My first appointment appointment is next year January since I started the treatment and to check my viral load if it has decreased because it was in millions when I was diagnosed in May 2024. I saw 2 people who confirmed it reduced to less than 10 UI after 6 months of starting treatment. I really wish the same for me or even find that it was acute . My partner is taking vaccine as he is not infected
I am confident that as long as you maintain your daily pill regimen, your viral load will have declined substantially at your next visit. Truada contains tenofovir disoproxil fumarate, which is a highly potent suppressive drug against both HIV and HBV.
Hope you are doing well. Such articles are the one stressing me and make me panic.my viral load was 5mil . According to this article does it mean I am at risk of getting liver cancer? I am currently on treatment though
My partner is taking vaccine as he is not infected