Am i in the Risk of hcc

Hello.

I am 33 years old male from ethiopia with a hep b and ultrasound reading of coarse parenchymal eco structure , liver function and all tests seem within range/normal. But i had a brother,37 years old died of HCC(portal vein thrombosis) before 4 months.

although there is a brother between us and all of family members are negative including mother .the doctors are suggesting i have childhood cld recived from mother.

What i am wandering is some of the doctors are sugesting only follow up since everything is good while others docs belive i am in high risk of hcc so i ve got to start TDF(i am hbe ag negative and core antibody +ve,viral load 6000).

i am feeling of a tight stomach and pain on the right side, where my docs r belive i may b visualizing from family trauma.
Pls note

  1. I am hbeag negative
    2.core antibody postive
    3.my mother ,older brother andd younger sistetr are negative
    4.i have mild fibrosis(not heavy drinker)
    5.i am careful on my diet

My quations are

  1. How to confirm its from childhood?(what if i am at acuye stage,the lab tests are not avaliable here
    2.TDF or interferon beter?
    3.the pain?

Pls help.

Dear @Breman,

Sorry to hear about your brother and your situation. I hope you can find the support you need from here and among your family.

Regarding your questions:

  1. There is no test to know if the infection is from childhood, but if you are HBsAg positive for more than 6 months it is a chronic infection (not an acute infection). You can test if this is a new infection if you test for anti-HBc IgM. If this is positive, then you have been exposed within the last months.

  2. These are different mediations for different circumstances, it’s hard to say one is better than the other. This is something you have to talk to your doctor about to see what is right for you.

  3. There are many reasons why you might have pain there. We have threads talking about this: Upper right quadrant pain; Titling feet and pain on the righ shoulder blade.

Hope this helps,
Thomas

Hi Breman

I appreciate the response given you by @Thomas as he reacts to your specific questions.
You have mentioned that your brother died of HCC due to hep b. This definitely will concern anybody familiar with chronic Hepb.
If I were in your shoes, in respect to family history, I would hasten to initiate treatment.
Wish you all the best and will be eager to know your progress.
Keep cool.
Regards
Kinoti

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A coarse parenchymal eco structure would suggest a diagnosis of cirrhosis. Would suggest to go to the local Liver Clinic for full hepatological assessment. Anti-HBV therapy to be considered.

Prof. Pietro Lampertico, MD, PhD

Full Professor of Gastroenterology

Head of Gastroenterology and Hepatology Division

Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico

University of Milan

Via Francesco Sforza 35

20122- Milan

Italy

Phone +390255035432

Fax +390250320410

Email pietro.lampertico@unimi.it

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Thanks for your response. But the last 5 months results are the same coarse parrnchymal eco structute suggesting CLD everything in the abdomen is ok . All my lab results are good.i feel the right last rib pain and feel my stomach stressed.FYI my fibroscan result is 4.6(mild fibrosis).
Fyi it always makes me wonder ,my brother had passed of hcc before 5 months and all family members are checked free(negative,our mother ,father and middle brother ans younger sister)
Including his wife ,2,5 and 9 years old kids;againest the conclusion he and i had this disease from birth.

Best regards

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Hi Breman
According to what your results are, you don’t have to worry alot safe to initiate treatment.
I understand your anxiety is informed my fear of what you saw your brother go through. I am sure you will soon stabilize and live a normal life.
Please feel encouraged.
Regards
Kinoti.

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Today my viral load comes to be 46000 , it was 6600 before 4months.my doc already told me i am chronic, but other docs suggesting this is charactor of acute case…i have already changed my life style to vegeterian.
My hbe ag was negative and i wonder hiw it replicated so fast like this?

Hi Breman,
Sorry for what is happening in your life.
Thomas has already advised you to test for ant - Hbc 1gm to ascertain whether your hep b is chronic or acute.
Unless you have tested for ant-hepbc 1 gm, then you are worring yourself without reflecting on the advice sort for and given but not followed.
Sorry, if am not very kind to you.
Kinoti

Thanks for your response but there is no such test in our country specificaly to diagnose acute or chronic.

Hi Breman
Am sorry about the State of health care in your country concerning hep b.
Another sure way of knowing whether you are chronic is “being positive for more than six months.” You are almost a month to six months. You can wait and since you have been positive for about five months am sure nothing will happen overnight. Stay calm and follow your doctor’s instructions.
Regards
Kinoti.

Thanks for your good advice it means a lot 2 me

Hi Breman,

Yes, if you have an infection still after 6 months, this would be classed as a chronic infection. HBV DNA loads can vary depending on if your immune system is fighting it off or not.

If you are taking the TDF and the increase keeps happening, it might be worthwhile to switch to ETV to see if that reduces your viral load.

Thomas