Hi - so I’m a lifelong carrier from birth 29 years old now.
My HBeAg became negative about 10 years ago. Until recently my viral load was low usually under 1000iu/mL. This month my bloodwork showed it’s 29,500iu/mL.
From researching paranoidly online I saw that the HBeAg negative + viral load rising means I might have a mutant virus or something which is bad. I also read some stuff that said HBeAg negative might have a worse outcome and prognosis… I’m not on treatment yet but my doctor wants me to start soon now.
This doesn’t necessarily mean there’s a mutant virus, and even if you did, it doesn’t necessarily mean that it leads to worse outcome. First line antivirals will slow viral replication (regardless of mutations) and help reduce any disease progression.
HBeAg-negative is linked to diseases because it is mostly associated with later phases of disease and past inflammation, it’s a way of categorising patients, rather than something specific about being HBeAg-negative.
Do not worry about “mutants”………what is relevant if you are still in the “inactive carrier state” (HBeAg negative chronic infection phase) or if you are moving to the HBeAg neg chronic hepatitis phase. If this is the case, antiviral therapy is recommended………
If your hbvdna is greater than 2,000 IU/ml and ALT > Upper Normal Limit, then you may be in the Immune Escape Phase and treatment is needed. Antiviral drugs such as Entecavir and Tenofovir are very effective for this phase too. In the old days, this phase was usually called Immune Escape Phase, nowadays, it is called HBeAg negative chronic Hepatitis.
Thank you @ThomasTu for your reply and information. I’m very glad I found this community you’ve built and the information you provide here to all of us