I am 27 years old (M) and i am new in this form.
I got my HBV positive in Nov,2019. My doctor asked me to do some test and found alt and ast are normal, HBV DNA was not detected but my HBsAg was around 500. After 6 month my HBV DNA is more in millions so my doctor asked me to start TAF and i started. After 6 months i stopped my TAF that time my DNA was 1700 (It was my mistake as i don’t know much about HBV I thought it is negative) but after 3 month HBV again go to millions so my doctor asked me again starting it.
Now i am taking TAF around 3 year (just 2.5 months i stopped that i already told above) but my HBV DNA is still 495 ( and alt is 46 U/I) . DNA was 83 three month ago (SGPT/ALT was 67) and 6 months ago it was around 3000 and 9 month ago it was around 2000, 12 months ago it was 800.
I am going to be married in 4 months and i am in kind of depression why HBV DNA is present in my blood and i am also following my diet. I never drink in my life and always follow healthy diet.
Please guide what should i do ? Tomorrow i am gonna meet my Doctor but earlier he said “Your case isn’t normal as almost every patient got HBV NOT DETECTED with in 6 months”
I am ready to share any report if needed but please guide and is it fine do marriage at my current stage.
Hi @garry5,
Welcome to the community and thanks from sharing your experience. If I understand you correctly, you started taking antivirals then you stopped for sometime and then started again, right? TAF is good at bringing down the viral DNA and I think the interruptions (stop/start) might be causing issues if you are not being consistent in taking your medication. It is important that we are diligent in taking our antiviral medicine as prescribed. It seems that you make progress when you take the medicine, but when you stop the numbers increases. Therefore you start each time from zero again. It is like taking 2 steps forward and 1 back each time.
At least one positive thing is your number was in the millions and now it is at 83 (3 months ago) which is a great improvement. 83 can be considered on the lower side so it looks like you are getting there. I will say give it some more time and take your medications as prescribed. If possible avoid these interruptions. HBV DNA undetectable can be achieved in some patients beyond 6 months. I believe there are some patients on this platform where this was the case.
Have a further conversation with your doctor tomorrow about this. Best, Bansah1.
Hi @garry5,
I get your point. It is a process and each person gets there at a different time. From the tests it shows that the antivirals are working, it might need a little more time to get to the undetectable level. I will suggest as well that you have a conversation with your doctor to explore more on this. Share your concerns with them as well and see the best way forward. We would not want this blocking or affecting your wedding. Best, Bansah1
I forgot to add, your partner can get vaccinated if they have not done so yet. If they develop high antibody levels, then your chances of infecting them decreases to zero which will take away some of your worry and stress. As long as they are vaccinated and have immunity, your numbers should not stop you from getting married. Bansah1
It can take years to get to undetectable, particularly if you’re starting with a level that is in the millions. There is no indication that this very low amount of HBV DNA in your blood of 83 is realistically any worse than undetectable HBV DNA while you are on treatment. The risk of transmission with this level of viral load is negligible outside of very specific circumstances (e.g., blood transfusion).
As @Bansah1 points out, the transmission is even further reduced if your partner is vaccinated and has protective levels of anti-HBs antibodies.
IN the end, HBV DNA levels should not impact whether you can get married or not. This condition can definitely be managed and risk can be limited.
Thanks for replying me. @ThomasTu Three month before my HBV DNA was 87 not it’s increased to 494 that’s is really concerning for me and my fibroscan result is 7.1 kPa and ALT 46 as i told earlier. I got very dark yellow urine when i took less amount of water and if i forgot i have HBV my dark urine remind.
i am only child of my parents and they very concern about me.
I never drink in my life and never took any drug to get high. I am following good diet and avoiding junk food. I followed each and everything that my doctor asked me and talking pill everyday.
i also vaccinated for HBV and still i don’t from where i got it.
You are right if my wife is vaccinated she has around zero chances to get infected but i really afraid what if i get worse condition after my marriage like i get some complications ? Every doctor i talked with said you should have DNA not detected after 6 months when you start antiviral almost all patient got it in 6 months but mine wasn’t undetected after taking pills for around 2.5 years
You are doing the right thing with regard to your Hep B and on the path to better health. If you continue to have higher ALTs, then other causes might be worth exploring with your doctor (who can physically examine you and do additional tests)
DNA count went from 100 millions to hundred thousands in 3 months, then to hundreds within another 3 to 4 months. it kind of flattens since then. 300 in April 2024, 550 in Jun, 510 July, 400 this month. What do you mean by you are fine ? is your DNA count zero ?
@Liu , Mine DNA load is same earlier it was 87 now it’s 494. Are you taking TAF or any other drug ? and have to talk with you doctor what he/she said about it ?
In order to participate in a clinical trial of a new drug, it is required for me to take TAF to reduce DNA and surface antigen to zero for the new drug to kick in. it looks like it won’t go to zero.
@Liu I didn’t forget pill in my last 6 months. I don’t know it is drug resistance or not. I am going to meet a senior hepatologist very soon I will update you when I met about my case.
I didn’t marry yet.
I talked with a gastrologist resident he said " Your HBV DNA level is too low and you don’t need to take any stress about it."
About the clinical trial I think your DNA level is low and if you talk to clinical trail doctors they will allow you and if you talk about antigen I will be positive even if you have HBV DNA is zero and Antigen(HbsAg) always be positive for HBV positive patients. Antigen (HbsAg) negative mean you don’t have infaction.
Please don’t take any stress because stress can’t help you. There are lot of drug in line and you can know about them on internet as well Hep B community. I have posted one post recently you can find it with below link
Hi @Liu and other friends,
Hopefully all of you doing well.
I am just giving an update on my case so may be it will help someone who have similar issue with TAF or other antiviral drugs.
Yesterday again i met Head, Department of Heptalogy in a great medical college. Earlier he was asked me to some medical test so results are below.
LFT - In normal range
Fibroscan - 4.4 kPa (earlier it was around 7 from another hospital)
CBC - Normal
PT/INR - Normal
HbeAg - Postive
anti HBs - Negative
After these test doctor told me that i have Hbv infection but you it’s not effecting your liver. I asked about the drug (TAF) resistance. He told me this the best drug we have right now. So he suggested me let stop the medicine for some time we will do the LFT after two weeks then after two weeks and we will if your LFT will be normal we will stop the medicine until we wouldn’t need otherwise we will see other option. He also told me that your DNA viral load can go up but we see if virus attacking your liver or not. I also asked about virus mutation he said “it doesn’t look like that HBV is mutated”
Now i have stopped my medicine from yesterday and i will do my LFT again in two weeks and i will let you know about it.
Hi @garry5,
Thanks for sharing. But I do have an issue with this decision. One, your infection is not affecting your liver because of the antivirals you have been taking. Stopping the antivirals can lead to severe liver damage in some patients. Think of it as a controlled wild fire versus an uncontrolled wild fire. In taking the antivirals, you kind of held the virus in check or in a cell like a jail/prison (a controlled wild fire, it will burn but damage might be minimal), but uncontrolled wild fire everything goes which can be problematic and destructive. By stopping there is always a chance of releasing the kraken or the virus is free and it usually comes back with vengeance. I don’t think people should stop treatment because there is no liver damage, rather if there is some evidence of a cure such that there is continued loss of surface antigen, undetectable levels for viral DNA, normal LFTs, and normal liver imaging all considered before pulling the plug.
I hope your case is different and ends up being a great decision, but I won’t be taking that risk personally given the experiences others had having gone through similar situations. Pay close attention to your body and when you start feeling bad, get help as soon as possible.
because stress can’t help you. There are lot of drug in line and you can know about them on internet as well Hep B community. I have posted one post recently you can find it with below link