I was diagnosed with Hep b in 2021 and started my treatment in May 2024 (Viral load was about 130 iu/ml and ALT at 51 iu/L). My specialist recommended treatment because of my ALT. I started having burning sensation under my feet sometime last year. Recently my tongue also started having the same burning sensation. I went to see an Orthopaedic and did x-ray and MRI and nothing was picked. Now I have been referred to a neurosurgeon for EMG. Is this something related to Hep B? If there are people who had the same symptoms, how did you resolve them?
Hi Collen
I hope you are doing well. From your history of burning sensation of feet and tongue which start last year before you received antiviral treatment for HBV. Your symptoms are consistent with peripheral neuropathy. I think if you don’t have others underlying chronic diseases eg DM , these symptoms can occur in chronic hepatitis B patients which we call extrahepatic manifestations. The pathogenesis of HBV related neuropathy may be from process of vasculitis due to immune complexes containing HBV Ag and antibodies deposited in endothelium of blood vessels and impaired microcirculation to peripheral nerves. The treatment of HBV related neuropathy include antiviral drug to suppress HBV replication combine with steroid and vitamin B complex.Severe pain maybe controlled with gabapentin .You should consult with your doctor to manage your condition. I hope this may answer your questions.
chul_chan
Chulapong Chanta MD . Pediatrics
Hi Collen,
I agree with the peripheral neuropathy, that could probably explain your symptoms for the burning sensation in the limbs. Yet, the burning sensation in the tongue could have multiple causes, and further tests might be recommended. Does it also involve the other parts of the mouth, as lips or gums? are you better at night time?
Thank you very much. I have an appointment with my Liver doctor and Neurologist next week. In May I had a HBeAg test which came out negative meaning there is not active replication.
It is only at the tip of the tongue and no other parts of the mouth. What is confusing is that it was only the right foot having that sensation since last year. The tongue and left foot only started last week. What is more confusing is that the sensation is not static. Sometimes it is at the front end, sometimes in the middle and sometimes at the back side. When I go to sleep, wear open shoes or step on cold floor the pain reduces significantly. Did MRI and Xray and all came out clean.