Hello dear friends, I am new to this group and I was diagnosed by accident last year on 8-2023 and I was positive in chronic form.
I don’t know how many years I have had this disease. So my questions are:
Can I take hepatitis B medication based on the hbsag marker?
How can I know how many years I have had this disease?
what is the factor that changed the amount of hbs ag in a significant way ?
Hi @Mas,
There is no test to tell exactly when one was first exposed or got infected. The test only can tell whether you have been exposed to the virus in the past or currently have the virus. HBV can stay in the body for a very long time without showing any symptoms.
Under the new guidelines I think you might qualify for treatment (surface antigen above 2000, normal ALT and AST). But have a conversation with your provider to determine the best path forward for your care. Things to consider might be availability of antivirals, we don’t want a situation where you start treatment but don’t have frequent access to such medicines. This should be considered in the decision with your provider about starting treatment.
I don’t think the change from 3750 to 3740 for HBsAg quantitative is such a big difference. Labs tend to have some small variations from time to time so, this change can be negligible.
Thank you very much for your answer Bansah1. I will talk to my doctor. Before I thought that to be eligible for treatment you have to do the DNA test. The question is what is the big change that happened after 6 months on my ag hbs ?
The change in HBsAg level could be due to many things (e.g., immune system acting against the virus), but is not usually linked to differences in liver health.
Thank you very much for your answer Dr ThomasTu and bansah1. My 3rd visit is in September and I will discuss my concerns with the doctor. So my questions are: I felt a slight discomfort in the liver area and which sometimes becomes constant and sometimes I felt nothing. Is it due to HBV?
I have no other symptoms.
My second question is, I have been epileptic for 5 years and I have been taking the drug phenobarbital for 4 years. So can this drug trigger hepatitis lesions?
Can I stop this drug if it has major effects on the liver?
If you have any recommendations and opinions, share with me. Thank you.
Hi Mas.
According to your first question, I think that your right upper quadrant discomfort may be nonspecific , it may be occurred in some conditions like dyspepsia. If it was caused by HBV , it should be considered from stretching of liver capsule that condition your laboratory findings may show elivation of liver enzymes and you may have other symptoms like anorexia, nausea and vomiting.
From your second question, long term use of phenobarbital rarely causes hepatitis , it usually occurs after about weeks or months after phenobarbital usage and manifests as DRESS ( Drug rash with eosinophilia and systemic symptoms) or Steven Johnson Syndrome which is life threatening conditions and phenobarbital must be stopped urgently. The more common antiepileptic drug that may induce hepatitis is sodium valproate but you haven’t used it. So I think phenobarbital doesn’t trigger hepatitis in your cases or you should consult with your doctor. I hope this help you
chul_chan
As @chul_chan mentions, there are multiple potential causes for this discomfort and it does not necessarily mean it is due to Hepatitis B. There is an ongoing discussion about this in other threads: Upper right quadrant pain.
Thank you Dr. Thomas Tu I am impatiently waiting for their contribution. I can’t stop phenobarbital because I will see the crisis again. But since I started this treatment, there is no epileptic seizure. The seizures that I often had are when I sleep.
If I share a little my situation before I started the crisis, when I sleep at night, my brain does not sleep (that is to say my body sleeps but my brain is on standby). and when I get up in the morning, I am like a tired person, I have headaches and also I want to go back to sleep. if you have any advice, give me, I will share with my neurologist.
Hi everyone.
I am a male, 38 years old from Europe. Last year, I found out that I have chronic hepatitis b. Since then, I go for a blood work every 3 months plus Ultrasound. I also quit drinking and start to eat quite healthy since my diagnosis.
When you find time, could you please explain to me my lab results. According to my doctor at this point I don’t need treatment, something does not give me peace, and will be very appreciate if you give me some advice do I need to push for a treatment. As I said I am with chronic hepatitis b, with HBeAg-negative.
First result HBV-DNA 240 iu/ml
Second - 2000
Third - 3300
Fourth - 3100
Fifth - 1800
Last one-1100
ASAT and ALT in normal range (around 20,25)
CT showed light Steatosis. Elastography - light. Ultrasound only a little fatty liver.
My doctor will not recommended treatment at this point, do you think that this is a best option? I actually don’t know since when I am infected.
Will be very appreciate for some advice!!!
Hi @ka85,
Welcome to the community. Based on the results you have shared, I have to agree with your doctor about not starting treatment yet. Your HBV DNA is not that high and actually seems to be coming down. The continued monitoring is important as things might change down the road and treatment will be required. But currently, I don’t think a treatment is warranted based on your test results. Best, Bansah1
Hi @Carlos_Gomez,
Welcome to the community and thanks for your question. Your labs indicate that you do not have hepatitis B (HBsAg negative/non-reactive), you have protection or antibodies against HBV which is great (HBsAb positive/reactive). No vaccination is required and you are good. I hope this is helpful, Bansah1
Hi Bansah1. I really want to thank you for your time and responding to my question. I will continue make blood tests on every 3 months. I had read, that viral load above 2000 and elevated enzymes required treatment. But actually my enzymes are in normal range, and my viral load were just two times above 2000, and now I am a bit confused. I also check my Afp and was 3,2. Do you think that my results are more likely like inactive carrier?
Regards.
You bet. So the new guidelines say HBV DNA of 2000, which you seem to be hovering around but your LFTs and imaging are normal. With just the viral load below 2000, treatment is not required. Unless you have a family history of HCC or a dramatic change in these numbers then I can see the need for treatment. AFP of 3.2 is still considered normal. AFP less than 6 is good. Higher than 6 then there is a concern. The lack of stability in your numbers tells me it is possible to have an active case. It can also be an inactive case with just flare-ups as indicated by viral load fluctuations. It is hard to say exactly. Keep up with your monitoring and continue doing whatever you have been doing. Thanks, Bansah1
Thanks one more time for your answers, I appreciate it!
This sentence from you “Afp 3,2 is still considered normal” can not give me peace somehow. I thought that 3,2 is like very good result
Yes, I will continue monitoring!!!
