Hi @Selfseen,
It is normal for HBV DNA to fluctuate like this in the timeframe you have presented. Your viremia is not extremely high but still above the threshold (< 2000 IU/mL) where starting therapy makes sense.
I would not interpret any trend from this but instead say that your viremia is “relatively stable”. With persistent viremia like this for ~6 years, starting therapy makes sense.
Best regards,
Thank you very much for your reply!
I finally get my fibroscan results:
5.7kpa
Cap: 269Db/m
IQR: 0.6
IQR/Med: 11%
My HBsAG quantitative is: 1442
HBV DNA: 6200
Will soon start TAF…but since my cholesterol is high I wonder if TDF is better choice than TAF… My doctor recommends will prescribe me TAF…Will discuss with him…
Also wonder if TAF with Pegylated interforen is recommended because of my HBsAG level (1442)…
Your thoughts is appreciated!!!
Happy new yr!
Nass
HI @Nass,
You can always start TDF / TAF and see how your infection proceeds for year. Functional cure with HBsAg of 1442 IU/mL does not frequently occur with pegIFN.
Best regards,
Thanks. Agreed… Will start TAF and then see where I am next yr…
Any thoughts about my fibro results? Especially the cap score.
Thanks
A post was merged into an existing topic: Deciding when to start treatment
Is fluctuating between positive and negative for hep b surface antigen and hep be ag a good sign? I get my blood work done every 6 months and the Hep B surface antigen was negative, positive, positive, negative (this one was done 12/2022) and hep be antigen negative, negative, positive, negative. I was told that I had a seroconversion when my hep b surface antigen was negative the first time only for it to be positive the next 2 blood work.
A strange one.
I am due to begin CAR-T cell therapy for lymphoma, but this has been delayed for a month due to HBV reactivation. I will likely need antibiotics while on treatment and there is a concern that this in tangent with the HBV may be too toxic for my liver. However, looking at the below, my HBV DNA seems tiny, almost too low to detect. Am I wrong to think that I barely have HBV and that the concern is overblown?
Thanks so much for your help!
HBV DNA REPORT
LAST MONTH, HBsAg NEGATIVE: HBV CORE TOTAL POSITIVE: PAST RESOLVED INFECTION BUT AT RISK OF HBV REACTIVATION.
RECENT PLASMA SAMPLE - HBV DNA DETECTED (71 IU/ml): MOLECULAR EVIDENCE OF HBV REACTIVATION.
ADVISE STARTING ORAL ENTECAVIR 0.5MG DAILY
[Normal range in brackets]
Hi @Lilgacon, this see-sawing could possibly come about as your HBsAg levels are similar to your anti-HBs levels. Did you get your anti-HBs antibody levels tested as well?
Welcome to the forum, John. Thanks for the interesting question.
I think the worry may be that the lymphoma treatment would alter your immune system, which is responsible for keeping your past infection well suppressed. While the HBV DNA is low at the moment, the fact that it is detectable means that this could be the start of a reactivation, which can be controlled by taking the antivirals. HBV reactivation can be a serious condition and can cause severe liver damage, so it definitely is not an overblown concern.
Thomas
Thanks @ThomasTu I understand now, I hope you don’t mind a few questions to get things straight in my head:
Thank you so much, my head is still spinning as this is the first I’d ever heard of Hepatitis B,
John
I had Hep B surface AB level checked only once last year and it was 13.4. Exact date of my lab work for last year:
Beginning of March 2022 - HBsAg negative
Retest end of March 2022 - HBsAg positive
5/2022 - Hep B surface AB 13.4
5/2022 - HBsAg positive.
12/2022 - HBsAg negative.
I’m confused. I rechecked my previous labs from a few years back. Like 2020 - hep B surface AB was like 3.0 and my HBsAg has always been positive until the last 4 draws-which is when it started fluctuating between positive and negative.
Hi too everyone.I just found in August about my Hep B status.I am 40 years old and started taking Tenofovird. i Oktober.When I found out about my status I wasn’t my self for a month but now I am okay and don’t have any health issues.I just need some morel information about my test results.
Hi @Max , welcome to the forum.
You have chronic HBV infection which is now HBeAg negative. Your viral load (HBV DNA) is high but your liver function is essentially normal (only a mild elevation in ALT).
Starting therapy in your case makes sense to minimize HBV DNA integration. Expect your HBV DNA result to be much lower when you get your tests done again.
Best regards,
Thanks @availlant for quick responding.My mother passed away from cancer and me and my brother found out that we are hepatitis b positive after blood donation.When you mentioned HBeAg negative is that bad or good sign?When I did fibroscan they told me I have fatty liver stage 2…Thanks to everyone on this forum.
Dear sir @availlant
Thank you for always enlightening me with all my concerns . 3 weeks ago i was able to communicate with my doctor, and it was only thru online consultation. It has to be done that way beacause I could not travel anymore because of my pregnancy, I have to ride ferry boat inorder to visit him.,that’s why I had online consultation instead.He was happy about the result of my labtest, and told me that there is no need for me to take antivirals based on my labtests results. Trully , I was not satisfied with our conversation because it’s just a video call, and I have so many things i really wanted to ask him, and I was not able to ask him.
I have few queries sir @availlant
If you were to ask sir, is it fine that I don’t need to take antivirals as this moment based on my labtest result sir?..I would be very happy if there is no need for me to take meds.
You have mentioned before sir, that I need to have an HBsAg test to be sure if I have a functional cure,…did you mean HbSAg quantitative test?
Does functional cure could lead to HBsAg negative?
Been infected since birth and I am 36 yrs. old , and my HBV DNA is undetected, what phase of HBV infection am I now?
God bless you and best regards to all health experts and scientists int this forum.
Jen
Dear @iamjen ,
I am sorry you were left feeling frustrated from your last (virtual) visit.
Assuming that your latest test result is HBV DNA target not detected and that this result is in the absence of antiviral medication, you have established immune control over your viral infection, which is very good news.
We currently classify this immune control into two types:
With either form of immune control, there is no progression of liver disease and reduced chance of liver cancer versus active chronic HBV infection. Antiviral medication is not normally prescribed for patients with immune control. The difference between the two is that people with functional cure is that there is no HBsAg being produced so immune control is stronger (no virus is being made) and the chance of reactivation or liver cancer is lower versus partial cure.
HBsAg loss is something that happens so that your immunity can establish a functional cure, not a result of it. You can test for HBsAg loss with a qualitative or quantitative test.
It is important to see your physician every 6 months to 1 year to check on the status of your infection.
Best regards,
Hi @Max ,
Becoming HBeAg negative is a good sign that some aspects of viral infection(but not all) are being controlled by your immune system. You still need to take antiviral medication to control the viral replication (HBV DNA) in your liver.
Your fatty liver is a likely cause for your mildly elevated ALT.
Best regards,
Thanks sir @availlant
does HBsAg loss and HBsAg undetected means from HBsAg reactive to non-reactive?
does this mean, it is possible to have an HBsAg loss after having a chronic hepa b.?
sorry for asking much sir, Im not really familiar with other terms .
Jen
I may be have HBsAg Reactive, but it could be not detected at same time ?..and this is when I can say that I have funtional cure?
How long does immune control last sir?
@availlant Would you be able to advise me on the above?
