Halo to everyone.Can someone please explain me HBV-DNA quantitative results.
@ThomasTu @availlant
Update since march-
ALT/AST remained high till may 23 , inspite of having HBV DNA <32 IU/ML
I went for fibroscan in may 23.
Got following result -
stiffness - 7.1
UAP - 283
My doctor told i have fatty liver and asked to eat more protein and less sugar/carb and add exercise to my routine. Added vitamin e supplement too.
Then in june 23 i got my ALT/AST normal.
Since then i am following diet and exercise and my ALT/AST are within range.
My current medication is -
25 mg TAF in morning after breakfast
Vitamin E cap after dinner
Earlier i used to experience pain in upper right quadrant a lot and almost everytime after having a meal.
Now that has improved and i dont feel pain after eating a meal.
But the pain still remains there and keeps coming and going , though at very less intensity than before.
Is this pain due to fatty liver or due to hep b , this i don’t understand also is it possible that ALT/AST have gone normal but there is still inflammation in my liver due to which i feel pain , does inflammation take longer time to get resolved. Also as per fibroscan score how much fatty liver do i have and how much time does it take to resolve that ?
Thanks to all for all the support.
Dear @data_guy788,
Accumulation of fat in the liver (steatosis) can also cause inflammation and elevated ALT.
Your previous CAP (not UAP) score of 283 with relatively normal liver stiffness is a sign of steatosis.
Normal ALT readings can be a sign of reduced steatosis but this should be confirmed with other tests.
It is difficult to determine the source of your upper quadrant pain. If your HBV DNA is well controlled it is unlikely to be your HBV infection. While possible, this side effect is rare with TAF.
Keep up with your improved diet (exercise is also helpful here).
Best regards,
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Good day experts:
I’m happy to join this group. I would to share my recent results and request for an explanation on the confusion I have.
I did my first HBV viral load blood test in Nov 2021 and it was showing 459 IU/ ml. On the interpretation it says patients with >=2000IU/ml require treatment or medication. Obviously the doctor confirmed that I do not need medication and there is nothing to worry.
I did another HBV viral load on 2nd of Sep 2023, the viral load shows 1394 IU/ ml plasma. And further reads on the notes that patients with viral load of >=5000 IU/ml require treatment.
My confusion is, on the first test report, the units of measurement is written as IU/ml while on the second report is written as IU/mlplasma. Is there any difference? Secondly the flactuation seems too big( more than 3 times).
Secondly, why does the first report shows that only a minimum HBV load of >=2000 IU/ml requires treatment whereas on the second report shows that a minimum load to take treatment is >=5000 IU/ml.
Thirdly, I can not confirm if there is improvement or not because the criteria for the tests looks different unless if I’m missing something.
Please help, I’m confused.
My liver function test, abdomen ultrasound and other tests shows that everything is normal.
Hi @PuallyHBV. Thank you so much for taking the time to explain this in detail. Now I have a much better understanding.
I wonder how the HBIG assessment is positive, since I have never been given HBIG. At least not that I am aware of.
Hi @ThomasTu. Thank you so much for the response. This is good news.
At these viral levels, am I still infectious? And are there any medication options to lower the viral levels even more or completely get rid it it?
Thanks again.
Dear @Max, not clear what you specifically want to know, but this shows that the level of HBV DNA in your blood is very very low.
Dear @t202309, welcome to the forum and thanks for the questions. I actually had not heard about this before and can’t seem to find anything on this. Perhaps some @HealthExperts can comment on the difference in HBV DNA PCRs between serum and plasma samples.
Dear @brnie80, at <10IU/mL the risk of transmission is very very low, and would essentially require you to donate a large amount of blood to someone for them to be at risk. No medications would be recommended to lower this even more. There is currently no approved medicine that would completely get rid of it.
IU/ml of serum or IU/ml of plasma is the same…………
PL
Prof. Pietro Lampertico, MD, PhD
Full Professor of Gastroenterology
Chief, Gastroenterology and Hepatology Division
Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico
Director, CRC “A. M. and A. Migliavacca” Center for Liver Disease
Department of Pathophysiology and Transplantation
University of Milan
Via Francesco Sforza 35
20122- Milan
Italy
Phone +390255035432
Fax +390250320410
Email pietro.lampertico@unimi.it
Thank you for the replies. Now looking at these two reports, can I conclude that the viral load went up 3 times ( from 459 to 1394). What can I do to ensure it doesn’t continue going up.
On the other report it shows that I need medication when it goes above 2000IU/ml and on the other report it’s shows that I need medication if it goes above 5000IU/ml.
I am really confused.
Dear @ThomasTu thanks for responding, I don’t understand how much IU/ml is in my blood und what is mean referenz-bewertungsbereich NEGATIVE?
Dear @t202309,
The notes at the bottom (that mention 2000 IU/mL and 5000 IU/mL) seem to be talking about genotyping and drug resistance, not treatment. My impression from this is that if the person taking the test was on therapy and their HBV DNA levels were above this limit, then the proper procedure would be to test the virus DNA for drug resistance mutations (or find out the viral genotype). The decision to treat would be based on viral loads >2000IU/mL (as per EASL guidelines -https://easl.eu/wp-content/uploads/2018/10/HepB-English-report.pdf) among other factors. I wouldn’t worry too much about the difference in cut off that the different labs are suggesting as they should not be applicable to your case.
There aren’t any proven ways specifically to keep your viral load low, but it is recommended that you give your body the best chance to fight the virus off by sleeping well, eating well, and getting regular exercise.
Hi @Max,
The test can only quantify levels down to about 10IU/mL. If it is anything lower, then it is hard to give a specific value, but it can still detect whether there is HBV DNA present or not. So essentially this result is saying that you have between 0 and 10 IU/mL. The reference level refers to what a “normal” result is. In this case, a completely negative result (not between 0 and 10 IU/mL) is the unremarkable result.
Hope this helps,
Thomas
Hi. Family iits a pleasure once saying hii. Had my recent blood tests and this came out seemingly with high figures that kept me worried and sacred more especially after developing nausea, body itching and abnormal pain at the right hand said of the abdomen.
Kindly waiting for your interest interpretation
Dear @opa,
Your ALT levels are mildly elevated, suggesting some liver inflammation. This may the the cause of your symptoms.
The doctor has calculated your APRI score, which is a way to see if you have liver damage. From my calculations, the score is low (~0.2) which does not indicate any significant damage.
Hope this helps,
Thomas
Thanks @ThomasTu and other health experts here. Your quick response gives great hope to many hopless patients here especially those not yet on medication.
Just forgot to add that my dr recommended for other health test given the symptoms I have and turned out that I am pylori positive. Could this be real cause of the pains and other symptoms or ALT alleviation has something to do with this.
Thanks for your usual positive response
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Indeed, h pylori infection could explain the pain and is apparently occasionally associated with increased alts. But it is best to keep monitoring as your h pylori is being managed to see if the alts and other symptoms normalise before being sure.
All the best,
Thomas
Hello everyone,
This is my first post on this forum, and I would like to seek the expertise of the community regarding my recent blood test results, specifically related to my liver function.
In my recent full blood test report, I noticed that my white blood cell count (WBC) is below the normal range, measuring at 3.4. Furthermore, my neutrophil count falls below the normal range, measuring at 1.4, and my platelet count is also below the normal range, with a measurement of 185. It’s worth mentioning that in my previous blood test results, my WBC has consistently remained within the normal range. In my full blood test conducted in November 2022, my WBC was 5.4.
Upon discussing these results with my doctor, they advised me to undergo a Peripheral Blood Film test due to my low WBC. The results indicated “White cells show relative monocytosis.” I have not experienced any noticeable symptoms thus far. But, the unusual result makes me worry.
I have attached the screenshots of my 2022 blood test results and the recent blood test results for your reference.
Given these findings, I am growing increasingly concerned about the health of my liver. Therefore, I kindly request the experts in this forum to review my case and provide any advice or insights that could help me better understand the significance of these results. Your expertise and guidance would be greatly appreciated.
Blood Test Result on 2022
Blood Test Result on 2023
Thank you in advance for your time and help.
Best regards,
John
Hi @John,
Welcome to the platform. I hope you take some time to check out all other discussions on here.
Yes, your WBC and neutrophils are low. Do you have any current infection or are you recovering from a recent infection? That could cause your numbers to fall as WBC helps our bodies to fight infections and other ailments. Your liver function numbers are normal ALT/AST 20, 20 in 2022 and 24, 23 in 2023. Both within normal range, which makes me doubt that your lower WBC numbers has anything to do with your liver. Your platelet count is normal for both years. The range is between 150-400 and your 2023 results is 185 but was 230 in 2022. Some of these numbers can fluctuate from time to time, but 185 is still within the normal range.
Try having a conversation with your provider to dig further into what is causing you to have lower WBC and neutrophil count. Share your concerns with the provider about this, maybe he/she will need to do further testing on this.
I hope this is helpful. Others will chime in on this as well. Best, bansah1.
Hello I am Edd from Ghana. I’m a chronic Hep B carrier and as far as I know, was born with it. almost everyone in my extended family has it.
At the moment I take Tenovovir Alafinamide 25mg proscribed by my doctor.
Please can you explain these labs to me
Thank you very much for this informative platform.
Hi @Edd ,
Welcome to the platform and you take some time to look/view other discussions on here. Your results are great, HBV viral load was not detected (undetectable) meaning it is too low in your blood to be measured. It is a good thing. Your ALT/AST are also normal. The range for AST is 0-40 and yours is 33. ALT range is 0-41 and yours is 28. As you can see they are both within the normal range.
The medicine is doing its job, keep up with your treatment and follow-ups with your provider. You are doing a good job here. I hope this is helpful. By the way, Bonti was my dads middle name. That is just by the way. Best, bansah1.
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