Hi Rebecca,
Thank you for sharing your story! I really appreciate it. May I ask if your ALT/AST were within normal range? In my lab the upper limit normal is 36 U/L but I know that it’s been recommended that the range be reduced to 20 U/L for females. As well, did you achieve an undetectable viral load while on Vemlidy? My daugter’s ALT/AST levels are normal within our lab’s range and thankfully her viral load is undetectable but it took a few years to achieve this milestone. She is also on Vemlidy.
If you don’t feel comfortable sharing this personal information I understand. I am just trying to understand how potentially serious this nodule is based on the information I have on her situtation since she will not be getting an MRI yet and will just be on ultrasound surveillance.
I don’t mind sharing at all! On my most recent labs, before finding the nodule, my ALT was 24 and my AST was 26. I achieved an undetectable viral load very quickly after starting Vemlidy in 2018, I think it was within 3 months, and it’s been like that ever since. I’m 41 by the way. I think due to your daughter’s age, the size of the nodule and her lab results they are going to want to just watch her but I certainly understand wanting to get the MRI for peace of mind!
Rebecca
Thanks Rebecca for sharing your experiences and lab values, etc. It’s really great to hear from more people on this forum. We’re all experts because most of us are living with hep b. So sharing information is really helpful. And your advice is sound about staying calm and watching since @wml’s daughter will probably be monitored closely with ultrasound. But I still hope that an MRI will be possible at some point since no matter how thin or slender a person is, an ultrasound will never be able to image the liver in as much detail as an MRI. But yes, staying calm is the best advice in any difficult situation. Always, Joan
Dear Joan,
I agree that I would prefer an MRI be done on my daughter. I will wait for her AFP results to come back and her next US report. If any of them are concerning I will definitely request an MRI. Yes we are all experts in living with this condition as we must navigate through so many tests and appointments. As many of us have hoped for I certainly look forward to at least a functional cure being discovered as I know the Hep B foundation has been trying to find for years now. It is one of the reasons I decided to become involved with such a valuable organization.
Thank you for all the work that you and your colleagues are doing to promote this cause.
Best regards,
WML
Thank you Rebecca for sharing this information!! I was feeling a bit more relieved after finding out that both you and Joan were not diagnosed with HCC after finding a liver nodule. My husband had read that if a liver nodule was found in a person with HBV it was assumed to be cancerous. That was certainly disconcerting information. It was also good to hear that your other lab results were similar to my daughter’s although it took her longer to achieve normal levels while on antivirals.
I wish you all the best of health!
WML
I was reading through the messages on this group today.
I have only recently been diagnosed with HepB accidentally when I was in the hospital for some other process.
My hepatologist has ordered a baseline MR Elastogram of my Liver and there was a tiny liver nodule of Size 6.4 mm in my liver. I must confess that I was unable to sleep the night as I was to meet the Hepatologist the next day while I had the reports to do all the research about what each of those words in the report meant. The next day as I met the Hepatologist with my reports she studied them and after talking to the radiologist who had conducted the MRI informed me that the Nodule was benign and a simple cyst that need not be followed up. I was relieved to hear that.
However, I see that despite a cyst in some cases regular MRI follow-ups have been done by some people as frequently as within 3 months of discovery. This concerns me a bit. Maybe I should ask my doctor if I should also follow up for the tests. In my case, I need to travel to a different country for the tests, and hence it kind of worries me.
We all live by hope each day. So, I hope all will be well with your daughter too.
Thanks,
Hi CGNepal,
I completely understand about not being unable to sleep while waiting to talk to your hepatologist about your results. I felt the same way!
Have you been scheduled for 6 months ultrasounds as a part of your regular care? I will admit I only got them annually in my younger days but ever since I started the anit-viral medication I am committed to the 6 month ultrasounds. I got my MRI to followup on the nodule that was seen on my regular ultrasound checkup, but after it was determined to be benign, I got switched back to ultrasound checkups at 6 month intervals as usual.
Rebecca
Hi @Rebecca ,
Interestingly the nodule didn’t come up in the ultrasounds as they only showed very little fat in my liver. My Hepatologist went for MRI to determine whether I should start the treatment or wait further. The liver came our fine so she has delayed the treatment by 1 more year.
Now that the nodule has been discovered in MRI maybe it should be detectable in Ultrasound too. It is a good idea to follow up with it in 6 months. As of now I have been asked for Liver Function and Lipid Profile every 6 months and a detailed testing for viral load, and other things along with Ultrasound every 12 months.
Thanks for the suggestion. Take care.
Regards,
Hi I am 31 years old female. I have chronic hepatitis b and am currently on entecavir. My LFT and viral counts have been stable for a long time. However there is a lesion on my most recent ultrasound. I have a follow up MRI later this month. Meanwhile, I am worried and I am hoping to get some information. I really appreciate this group and everyone here! Thank you so much for everything you all do.
LIVER: Normal size. Homogeneous echotexture. Echogenic lesion with central scar in the right lobe measures 2.7 x 2.4 x 2.0 cm.
IMPRESSION: 2.7 cm echogenic lesion in the liver, may represent hemangioma but nonspecific. Recommend MRI abdomen without and with contrast
Hi @Bhakkd,
You are welcome to the community, and I am sorry to hear about your recent ultrasound findings. It is scary and troubling with such news I bet? Please, remain hopeful and try to stay positive. I understand that might not be easy to do given the circumstances. Fingers crossed, that it turns out from the MRI being nothing to be worried about. We will all keep you in our thoughts that all goes well for you.
Best, Bansah1.
Hi
I understand you are concerned about this lesion found on your ultrasound. Hopefully the MRI you receive will clarify what it is. Last year a pancreatic lesion was found on my US. I later found out that people with HBV have 2X higher rate of pancreatic cancer than the general population. Thankfully the MRI with contrast showed it was most likely a lipoma. Try to take deep breaths and be calm waiting for the MRI. Unfortunately I was so anxious during my MRI that I had a panic attack and was unable to follow the tech’s instructions of holding my breath. I’m grateful he was a friend of mine and he was patient with my hyperventilating but he did say it was the most difficult MRI he had to do and he has years of experience! Wishing you all the best news.
Hoping for the best results for you. Try not to stress too much. Try not to think about until the test results come in.
Hi @Bhakkd,
Welcome to the forum and thanks for sharing your story. It can be so tough getting all of this information about yourself! Haemangiomas are actually quite common in the whole community (~20% of people will have them and have no symptoms whatsoever - Liver hemangioma - Symptoms & causes - Mayo Clinic). It’s just that since we have Hep B and get monitored, we find out (and worry!) about them. Really hope everything goes OK with the MRI and it really is nothing to worry about (indeed, most of these liver masses are benign).
Hope this helps a bit.
Thomas
Thank you all of you for sharing your experiences and knowledge. I feel a lot better.
Hay Thomas its been a while I hope your doing well 
As for me I’ve been working a taking care my self best I can. Doing my routine check up’s a such. I had my routine check a couple days ago my blood work an ultrasound. My blood work shows really low levels of hep b also all other work blood work doesn’t show any cancer going on. When they did the ultrasound sound on me they saw a a few cyst from the past that are benign from my previous ultrasounds. They found a new 3 cm solid lesion on the same lobe as my cyst are on. there not to sure if it’s benign a want to do a CT scan. I wanted to know what’s your input on this matter a strategies they use in these cases. I also would love if any other professionals on here you know that would have good input on this too. @john.tavis @availlant
Dear @Eddie,
Unfortunately, this is well beyond my area of expertise as I’m a molecular virologist, nor a physician or hepatologist. My only comment would be that as your physician feels a CT scan is warranted, then I would recommend getting one.
I wish you the very best.
John.
I totally understand. Thank you for the reply, though John.
Hi @Eddie,
Great to hear from you again, though sorry it is under such worrying circumstances. Indeed, my suggestions are going to be much the same as John’s above. And keep in mind that benign conditions are more common than malignant ones.
Hope this helps,
Thomas
Hi guys,
New member here. I am so grateful to have found such a wonderful community and appreciate all the contributors here, whether the experts or fellow patients.
I don’t know where to start a new topic so I will seek opinions here. Long winded post, sorry 
Background:
I’m 40y Chinese male from Malaysia. I was diagnosed CHB (HbeAg-) in 2014 at age 30. Later found out my mother is & my late grandmother was CHB so most likely that’s the cause of infection. Grandmother died from stroke at age 80+ but her brother (who was also CHB) died from HCC at age 40+.
I have been monitored regularly since 2022 in a public hepatology center. Occasionally get ultrasound screenings from my family doctor (who urged me to get monitored) if the appointments with hepato are over 6 months. I have not started any treatment.
Some quick stats:
HBV DNA:
18 Oct 2021 - 4632 IU/mL (first-ever HBV DNA test)
11 Oct 2023 - 739 IU/mL
Fibroscan:
11 Oct 2023: 5.3 kPa / 0.6 / CAP score 211 (no fibrosis, no steatosis)
ALT:
Always hovers around 14-20, latest result (14 Mar 2024) - 25.2 U/L (slightly higher)
AFP:
Always @ 2.0 or below, latest result (14 Mar 2024) - 2.0 ng/ml
Imaging tests (a few ultrasounds & a 4 phase contrasted CT):
Multiple lesions were found. Details follow.
24 Apr 2022 - First ultrasound with family doctor. Found a lesion measuring 1cm x 0.8cm at segment IV. He said hemangioma.
27 Jan 2023 - Second ultrasound with him found another lesion measuring 0.7cm x 0.6cm at segment VII. Again, he said hemangioma.
11 Oct 2023 - Ultrasound at hepato. Findings as below:
The liver has normal echogenicity with smooth margins. Liver span measures 12.6cm in right midclavicular line. Multiple subcentimeter hyperechoic lesions seen at segment II, IV and VII. Largest at segment VI measuring 0.9 x 0.9 cm (I guessed she had a typo here - should be segment IV?). No intralesional vascularity.
Impression: Multiple hyperechoic lesions may represent regenerative nodules. Suggest AFP correlation, KIV contrasted CT scan if AFP high.
14 Mar 2024 - CT scans at hepato despite low AFP @ 2.0. Findings as below:
Liver is homogenous and has smooth outline. There are several ill defined non enhancing hypodense liver lesions scattered in both liver lobes, at segment II, IVa, V, VI and VI. Largest at segment IVa measuring 0.8cm in diameter. No focal enhancing liver lesion.
Impression: Non enhancing liver lesions in both liver lobes may represent regenerative nodules.
So my questions are:
-
Hepatologist told me regenerative nodules happen when you have fibrosis/cirrhosis which I have none according to my Fibroscan. He was kind of disagree with radiologist to characterize the lesions as regen nodules but he has no conclusion of what they are. But he does not seem too concerned either. What can the lesions potentially be or can a non-cirrhotic liver have regenerative nodules from past damage?
-
Are the so-called regenerative nodules potentially cancerous?
-
How can a HCC history of an extended family member (in this case my granduncle) affect my own risk or only first-degree relatives matter?
-
Does the fluctuation of HBV DNA mean anything when someone is in inactive carrier phase without the evidence of fibrosis &or elevated ALT? Is it kind of normal when not treated?
Thank you so much for your time to read through.
Regards
Steve