Hi @availlant
Can’t thank you enough for your explanation.
Hi Lily_Lee,
You have got it right. No benefit of the third dose but it will do no harm.
CNN here. To Health experts like @ThomasTu and @availlant not sure I placed this thread correct. My results are out once again:
- V. Load was 121 in Aug 2021, then 390 in April 2022. Now in Nov it’s 264.
2.Segmented Neutrophils low at 40 - Serum direct bilirubin high at 5 while total is within range. Is this normal
- LDL cholesterol 5.01 which is very high to mean greater than 4.92 mmol/l
- HDL cholesterol is 0.98mmol/l
- Total cholesterol is 6.18mmol/l
7.triglycerides at borderline of 1.65 range being 0.3 to 1.7
No much deviation for the rest. Any thoughts are welcome…esp questions I should ask doctor
Last, doc says all other test look good except the cholestral since am not obese.
He has prescribed some pill called Lozavel 20 for cholesterol. Is this necessary or advisable?
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CNN can you remind us of your treatment history for chronic HBV?
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@availlant you responded to below on 3rd Jun this year. Gives a good history. Am not on antivirals yet. Though I have a prescription from a past specialist.
cnn 3 Jun
I am CNN seeking opinions or views.
Am 42 yrs old male. 8 months ago by chance I tested positive for Hepatitis B surface antigen S/CO B value of 4984.21 . I suspect it’s from child hood since I remember someone close who had symptoms similar to acute HBV but still not sure where I got it from. My family know and have been vaccinated. Below are the following additional results same time or 8 months ago:
- Anti HBc IgG positive
- Anti HBs 2.7 mIU/ml
- Hep A negative
4.Hep C negative
- HBV viral load 121 IU/ML
- Anti HBc IgM negative
- S/CO CM value 0.07
- HBe antibody (anti HBe) positive
- HBeAG Hep B e antigen negative
- Hep C antibody HCV 3 at 0.05
- HIV negative
- Alanine Transaminase 25 U/L
- Total bilirubin 16.4 umol/L high range being 20.5
Two days ago or 8 months later .the following are the results
- Alanine Transaminase 29U/L
- Viral load 390 from 120 8 months ago
- No DTV from Doppler test
- High AFP 6.6ng/ml with or using a ref range of 0 to 5.8
- 3.9 kpa on fibroscan meaning absent or mild fibrosis. No mass or nodules seen
- CAP 270 dB/m grade 2 steatosis
Question for @ThomasTu and any anyone else in this good platformQuestion:
A. I Visited two top gastro specialists in Nairobi and one prescribed tenefovir and the other requested for review in three months. Why the difference? Something to worry me? Not sure who to listen to. One said treatment ensures I reduce to almost zero the possibility of progression then wait for drug advances in the next 5 or 10 yrs.
B. Should AFP worry me. What else should worry me? Or should I monitor closer
C. I have shortness of breath and painful legs always. Worse when I exert yet pressure is ok, no diabetes markers, ok reumatoid factor test
D. Any other or additional view based on my results above are welcome
Hi CNN,
Thanks for the refresh (a lot going on in the community these days!)
So to your question A:
One specialist is prescribing TDF therapy understanding that while your HBV DNA is low and liver function is normal, it is better to have complete suppression for the best long term prognosis.
The other specialist is not prescribing TDF therapy because your HBV DNA is SO low (where long germ prognosis is usually very good) you also have some detectable anti-HBs which is a good sign. Have you had your HBsAg tested? In may be that in three months your situation will improve. If not essential, it is better to not take medication.
Your case is really on the edge of taking TDF or not and frankly it is hard to advise you one way or the other. I think that either way there are no issues.
Question B
Your AFP is not concerning but might as well evaluate it at your next visit. It is probably related to your fatty liver (steatosis).
Question C
These symptoms do not appear to be related to your VERY mild chronic HBV infection which is on the edge of being completely under control. Neither related to your steatosis.
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Hi availlant
Quick question about fibrotest +acti test VS fibroscan…
I had fibrotest ordered and it showed no fibrosis (F0-F-1)… with minimal inflammation.
I am planning to get a fibroscan next week with Hep B surface quantification…
what are the probability these test will have similar results?
Also my AFP was high (16) …. And I am not sure what is causing… I will need to check if I have fatty liver because my cholesterol has been high in last few yrs…
I am CHB - Hepeag negative with 6230 HBV viral load… ALT 49… after the fibroscan I plan to start treatment taking TAF.
Thanks
Nass
@availlant I have seen your response and encouragement. Also glad that you now have been able to see the history. I have seen your response. Thank you.
I still have the following areas of concern around my lipid profile (Cholesterol and triglycerides) which have remained high for the last 6 months (no significant change on cholesterol and Trigly levels from the last lab results six months ago and my 1 week old results (outlined below). My BMI is 24 at 42 yrs.
- LDL cholesterol 5.01 which is very high to mean greater than 4.92 mmol/l
- HDL cholesterol is 0.98mmol/l
- Total cholesterol is 6.18mmol/l
- Triglycerides at borderline of 1.65 range being 0.3 to 1.7
- V. Load was 121 in Aug 2021, then 390 in April 2022. Now in Nov it’s 264.
6.Segmented Neutrophils low at 40 - Serum direct bilirubin high at 5 while total is within range. Is this normal
My humble question: Yesterday, doc says all other tests look ok except the cholesterol since am not obese, my diet sounds ok, and there is no decline in 6 months. He has prescribed some pill called Lozavel 20 for cholesterol. Is this necessary or advisable? I understand I still need to decide based on my doctors advice. But I have also learnt how to question things and to read widely…and this community is still my biggest source of encouragement.
Can one stop taking them once started or its for life once you begin taking statins?
I also welcome anyone from this community with a lived or expert experience on taking Lozavel or statins?
Dear Nass,
Fibrotest is a collection of blood tests which are are used in a calculation which estimates your liver disease status.
Fibroscan is a direct measure of your liver stiffness using a technique called ultrasound elastography.
Both to a reasonably good job of assessing your liver disease status.
Given that your HBV DNA is 6230 IU/mL, the HBsAg test will not give you any additional information to guide your decision to start TDF or not. What matters is viral load and liver disease status. Your ALT is still essentially normal.
As I mentioned in other posts, AFP elevation can be caused by fat accumulation in the liver (steatosis).
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Dear CNN,
In your case, there are two issues: mildly elevated LDL (which can be lowered by a statin such as Lozavel) and low HDL. These do not appear in your case to be related to diet.
LDL (and VLDL) are responsible for distributing lipids and cholesterol to the organs of your body and are associated with elevated risk of stroke and coronary heart disease (bad cholesterol).
HDL is responsible for scavenging lipids from your body and returning these to your liver for processing (good cholesterol).
You can increase your HDL with regular moderately strenuous exercise.
It is the ratio of LDL:HDL which is important, you want this to be as low as possible.
Statins can be an effective remedy for those who are genetically predisposed to having a poor LDL:HDL ratio.
If you can raise your HDL with lifestyle changes, you many not need to take a statin.
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Thanks!! Appreciated your time and feedback… Thanks!!
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Thanks Dr Thomas for your help. I really appreciate it. Looking at my liver function test, what do you suggest? Because the doctor said my liver is normal and the virus didn’t cause any effects on the liver. Thank you
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My result was identical 2 years ago and my latest HBV DNA (Nov-'22) was 4100 IU/ml. My GI doc said it is low and too low for any treatment since my UScan was ok.
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The most appropriate thing to do is get regular blood tests and monitoring to make sure your liver stays healthy.
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Hi,
I recently did my HBsAg test which turns out to be positive , i contacted my doctor who suggested to test for HBeAG and HBV DNA. Below are the results
HBsAG : Positive
HBeAG : Negative
HBV DNA : Target Not detected.
Doctor suggested there is no need for treatment , I am bit worried and need help of below queries.
- What does this test result exactly means? Is it possible HBV DNA can be detected after some time or virus is clean on own.
- Should i go for Hepatitis B vaccination at this stage? Will that be helpful.
- Should i go for treatment or any other tests to confirm
Thankyou for help
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Dear Deep,
The production of HBsAg is independent from the production of virus. As such, it is technically possible (but unusual) for someone to be HBsAg positive but HBV DNA negative. You do have good immune control over your viral infection but there elements of the virus which integrate into your chomosomes (this happens in everyone who is infected) which is still making HBsAg but not virus. These cells are still present in your liver. The potential for reactivation is greater in the presence of HBsAg than with HBsAg loss. But your doctor is right in advising you that there is no need for treatment.
There is no point in getting vaccinated while you are HBsAg positive.
You should have regular checkups with your doctor to monitor your infection.
Best regards,
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Dear @availlant
Thankyou so much for response.
Is there any other test should I do to confirm I am in which stage , last year my HBSag test was negative. I am also worried because my wife is pregnant but her HBSag test is negative , doctor also gave her first dose of Hepatitis B vaccine , do I need to worry about my wife and child, also should I take any precaution to make sure I don’t spread it
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Dear @Deep,
If your HBV DNA level is undetectable, then your risk of transmission to other people is negligible. It is a good idea for everyone to be vaccinated against HBV though, so it sounds like everything is being done appropriately.
Thomas
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Thankyou so much @ThomasTu , Could you please suggest should I go for any other test? Is it possible my HBSag will come negative after some time or is there any risk for me in future.
Thanks a lot for your time.
If you are HBsAg positive, it is recommended that you have 6-monthly tests to monitor your health. This should include liver function tests and Hep B tests. It may also include fibroscan to see if your liver is remaining healthy.
Some people do become HBsAg-negative after some time but it is rare; this happens to about 1% of people per year.
Thomas
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