Wonder why your doctor put you on medication for possibly a lifetime, bc you are in the monitor stage.
Maybe get a second opinion on it? I don’t know your whole medical history or not a doctor, but maybe get a second opinion before starting the treatment, since this is your first day. Just my opinion
The gastro told me because of the increase in HBV DNA and family history.
This is helpful @Suwang88 as someone who is starting the treatment. I have low viral load too but with the information you shared about how the virus integrates in the hosts DNA and you can get HCC even without a cirrhotic liver in HBV. I am 39 now and time to look for my health. Thank you @Suwang88 and hope to hear more information from you.
Hi @jeandoe, thanks for sharing the story of your journey. This are good (and recommended) reasons to start therapy.
Regarding the anxiety, I think the more you find out that people do take these drugs for years/decades on end without having any side effect, the better you will feel over time. I have been on them for years and have had no troubles. I think @Suwang88 and @MarkDouglas have prescribed hundreds of people these medicines and the majority are absolutely fine for years on end.
Maybe others can share their strategies?
Cheers,
Thomas
Thank you @ThomasTu for this. I really appreciate your response. I am on my second day today. I am feeling good, no side effects so far. After 1 month I will go back to my gastro for CBC monitoring. I am really grateful for this community. Thank you!
Hi everyone,
I’m having Hepb since 2019
Just got done with mandatory 6 monthly tests
LFT is in normal range.
HBV Viral load – 36,345 iu/ml (which has been pretty much same since I first tested)
Confused whether to start treatment or not.
Please help
Hi @kevin ,
Welcome to the forum and thanks for your question. The answer would depend on other tests including HBeAg, anti-HBe, ultrasound, etc. as well as your age and family history. Your specialist will be able to discuss with you whether you are recommended for treatment based on all of these.
Thomas
Thank you @ThomasTu
HbeAg is Non-reactive.
Age 25.
No family history of liver disease.
No other symptoms.
If it is beneficial to start treatment early then why do doctors wait for ALTs or other things to spike up and then advise for treatment?
Need advice , do I need/ or should I start treatment?
also done an ultra sound,here is the finding.
No suspicious liver mass. US-1 Negative. Recommend repeat surveillance US in 6 months. (#US1)
Narrative
ULTRASOUND LIVER
** HISTORY **:
43 years old, hepatitis B. Screening for hepatoma.
** TECHNIQUE **:
Ultrasound images of the right upper quadrant of the abdomen acquired. Color and spectral Doppler images of the main portal vein also obtained.
US visualization score: A. No or minimal limitations.
COMPARISON: None available.
** FINDINGS **:
LIVER: Normal echotexture. Smooth contour. Normal hepatopetal flow in the main portal vein. No suspicious mass.
GALLBLADDER: Present.
BILE DUCTS: Common duct measures 2.4 mm, which is normal. No intrahepatic biliary ductal dilation.
ASCITES: None.
No other family member has liver disease, no other noticeable symptom except having a hard time to sleep.
thank you
That’s an excellent question and the answer is a bit complicated. We know that people at the very beginning of a chronic infection (when they are children) they are not very likely to get liver cancer or liver disease; as you get older and your immune response starts attacking the virus in the liver, you start getting disease.
Doctors need a way to decide when to give antivirals. The current guidelines do not recommend it when you’re very early in the infection because of the following reasons:
There is a growing movement that maybe we should be giving patients the choice to be treated earlier if they want to. There is also new data which might suggest that there are early on in the infection that may still contribute to cancer or disease risk.
Assuming your ultrasound/fibroscan is normal, the current European guidelines do not recommend that you be treated. But this is a conversation that you should talk to your doctor about.
@wayyan, you are in a sort of grey area where you can decide to take antivirals or not. Because of your age (>30) you could be considered for antiviral treatment, even though by other measures your hep B is fairly stable (normal ultrasound and normal ALTs). The pros and cons are something you can talk to your doctor about.
Hope this helps,
Thomas
Thank you very much, Thomas.
Sir Thimus Which 1 is the best Vired or vemlidy?
Dear @ajab,
As far as I know, both are as effective as each other. Vemlidy is generally used if you have a problem with Viread (e.g. potential side effect issues).
Thomas
HI @Ajab, just to further clarify what Thomas wrote. Depending on where you live and what kind of health or prescription drug insurance you have might determine what medication your doctor prescribes: Vemldy or Viread. Since Viread is now “off-patent” and available as a generic drug, it’s cheaper and more readily available. The side effects associated with it can include kidney issues (but this can be easily monitored with blood tests by your doctor) and bone mineral loss (a problem particularly for older women who are more prone to osteoporosis than men. Vemlidy is still a patented drug so it’s more expensive and not available in every country. It doesn’t have the side effects of Viread (kidney and bone loss) and the pill size is much smaller because it’s only 25 mg (something I really appreciate since big pills get stuck in my throat). Vemlidy is known to sometimes elevate a person’s cholesterol and lipid levels, but it’s not common.
OK with all of that said, it’s a decision to make with your health care provider! Cost, access are important issues for everyone, which is why Viread is sometimes chosen over Vemlidy. Keep us posted on what you decide to do. Thanks for sharing your posts with us. Always, Joan
Thank you so much for your valuable advice . let me share with you that in @Pakistan viread is expensive that vemlidy & not available in the Market. But vemlidy is available easley in the Market.
Then you are in luck!
Doctor can recommend liver biopsy even your fibro scan, ultrasound is okay … Doctor wants to know the clear picture of liver as se said to me regarding liver biopsy… From last four years my hbv dna is undetected but now he found detected viral load… So we should go with liver biopsy or anyone has better suggestions here. Please:pray:
and please share liver biopsy experience…
Regards
Nisar
Hi @nisarr,
Thanks for your question. Generally a liver biopsy is recommended if your blood or fibroscan results are unclear about what is happening in your liver. It can be used to see if there is some inflammation or fibrosis occurring.
Hope this helps,
Thomas
Thanks… Indigestion and not gaining weight is main problem I facing regular… Ultrasound is okay fibro scan is on border line… Alt is remain little high always.
Thanks for for valuable advice,
According to you we should go with liver biopsy.
Regards
Nisar Ahmad
