Hi @anonymous54,
Your lab shows that your viral load is a little bit on the high side but not in the extremes. With that being said 4130 won’t be considered to be very high. A few questions for you; Has your viral load always been around this number? Do you know what you ALT/AST numbers were? Are you currently on treatment?
I hope this is helpful. Best, Bansah1.
Thank you For your reply.
This is my first test. I diagnosed in september. I am not on any treatment as they said , everything is notmal.
1 Like
You are right about things being normal. It is a good thing. Let’s hope your other tests come back normal as well. Good luck with your upcoming appointment. Best, Bansah1.
1 Like
Thank u so much.
My next appointment is in May now.
1 Like
Hello everyone,
I’m very afraid. Last year in July I found out I had hepatitis B because my mother died of liver cancer. The first test showed 1.6 million HBV DNA. I have been on tenofovir disoproxil since October 2022 and currently the viral load is undetectable and the other enzymes are ok. I had a Fibroscan done in October 2022 which showed 5.3 KPA CAP 246 but at a different doctor. Currently my enzymes are all ok. Before 2 days ago I had an ultrasound done by my doctor and everything was fine again, except that his machine (ultrasound elastography) showed 9.1 KPA and since then I have been very upset. He told me not to worry because these are different methods and that we will do it again done after a year. I asked him to do a classic fibroscan and he said there was no need. I’m very upset and I can’t sleep for 2 days. I made an appointment for 28.11 to repeat the classic fibroscan that I did last year. In the last days I am very upset and I am looking for information on the Internet because 9.1 KPA is a very large number and I am afraid of cirrhosis. Just to mention that I do not drink alcohol, I am active and watch what I eat. Last year in 4 months I lost 22 kilos because I was on a strict diet but I’m not anymore.
1 Like
Hi @max,
Sorry to hear about the stress you are going through. There are many things that can raise your ultrasound elastography score which are not liver cirrhosis. I know it’s hard, but there is not much you can do until you have your test again.
It seems like you are doing all you can to protect your liver health (antiviral therapy, diet, and exercise), so well done and keep it up!
Thomas
2 Likes
Thank you @ThomasTu for your support and quick response. I will wait 2 weeks and see what the fibroscan will show.
1 Like
I have one more question. I was in the gym 2 days in a row and I worked out very hard and the next day I had an appointment for a fibroscan. Could this have affected the results and how long before the appointment for the fibroscan should I not exercise or does it not matter ?
Hi Max,
I’m not sure if this is known. The increase in serum ALTs from exercise is due to muscle cells also carrying ALT (so if they die, they release it into the blood). A fibroscan will measure liver elasticity and I’m not sure whether this is affected by any exercises (if any at all).
TT
Hi All,
Finally got the viral load test, unfortunately it is 3000.000 copies/ml, must convert this number to IU/ml. 2 years ago it was 150.000 copies/ml. I am not happy with this at all. Will talk with doctor what his advice will be, dont feel motivated to take viral meds at all,who does right ?. Beginning to feel a bit deppressed, I would like to get married some day, but with this situation I think it will be superhard, thing is, it would be nice to find someone with same condition, then we are even, but thing is where can we find ? This situation is absoluteltly not my own doing, got it from my mom, she dont even know where she got it from, she was never promiscious lifestyle, propably dirty needles vaccination when she was a child.
Br,
Dear @hepb1,
Sorry to hear about your stress with the situation. If you read around the forum, there are varying attitudes towards treatment: some (like myself) are relieved to have some measure to reduce the risk of liver injury and subsequent liver cancer; others are very much impacted by having to access and take daily medication; many are in-between.
You will also be able to see many people being married despite their status and status of their partners. I am HBV-positive, married to a HBV-negative woman. She knew about my status before starting our relationship; armed with facts, we were able to discuss the real probability of transmission and measures that we could both take to mitigate or eliminate any risks.
It is common to get chronic hepatitis B as a newborn or during childhood (could be something as simple as a scratch or transmission during birth). I myself don’t find it helpful to dwell on how someone was infected, because in a sense it doesn’t really matter and makes the person just relive potentially painful, regretful, or traumatic past events.
I hope you find the support you need during this time and please feel free to share your worries with the community. There will be many who are reading this forum may be experiencing what you are going through and it helps give a voice to them, even if you don’t see it.
Thank you again for sharing your story,
Thomas
1 Like
Previous LFT test
T-bil 1.82
D-Bil 1.51
Alt 78.8
Ast 72.5
Alp 123.1
Y-GT 64.1
TP 72.1
Ast/Alt 0.9
Ibil 0.3
Alb 33.1
Current LFT test (done in Nov)
Gamma Gt 16.2
Total Bilirubin 8.8
Direct bilirubin 0.9
Alt/Sgpt 34.3
Ast/sgot 24.5
Albumin 2.3
Total protein 5.7
Alkaline phosphatase 245.5
U/E/C’S
Chloride 98.4
Potassium 4.11
Sodium 138.1
Urea 5.4
Creatinine female 103.5
HBSAG POSITIVE
HBA1C 6.2
ULTRASOUND - NORMAL
PREVIOUS VIRAL LOAD Test
Hepatitis B virus DNA 174 1u/ml
HBV-1 LOG UNITSR 2.241
Hep B e Antigen NEGATIVE
HELLO Everyone, today I had appointment with a gastroenterologist. After comparing my results, especially Previous and current LFT, she told me to stop using the drugs for six months and do another viral load and left after six months which will be may 30th 2024.
I don’t feel comfortable with this…as much as taking drugs daily is very tiresome, I’m cought in deep thoughts!!!
- what if my viral load increase after six months of not using the drugs
Incase viral increases, will I be told to start taking drugs again? What if the drugs become resistant?
If I stop using drugs without clearing HBSAG, what risk do I pause on those living around me?
If 1 day I get a partner who is HBV negative but vaccinated yet I’m not taking the antivirals, won’t I be risking his life?
If I become pregnant, won’t I be risking the life of my unborn child if I discontinue antivirals yet HBSAG is still positive in my system?
I feel so lost!! The news of stoping drugs yet HBSAG still test positive is not sounding as a relief to me at all
Kindly I need your help
Hi @Vera,
You are completely right to be uneasy about stopping treatment. This does not seem to be consistent with the current guidelines (from https://www.hepatitisb.org.au/treatment-of-chronic-hepatitis-b-virus-infection/):
In non-cirrhotic HBeAg-positive patients, who have seroconverted to HBeAb positive and had a HBV DNA VL < 20 IU/mL over a sustained period, stopping therapy can be considered. Most guidelines recommend a 6–12 month consolidation period before stopping therapy.
I am sure our @HealthExperts would agree that cessation while HBV DNA is still detectable is not a reasonable approach, and it may be worth printing off the EASL guidelines (https://easl.eu/wp-content/uploads/2018/10/HepB-English-report.pdf) to present to your doctor at your next consult.
Viral load is almost guaranteed to increase in this case (as it is with anyone who stops treatment), but the reinitiation of treatment would usually be based on whether there is sustained high ALTs.
With increased viral load, there is increased chance of onward transmission, but for casual contact there is not much risk of those around you.
Vaccination and raising antibody levels to protective levels (>10mIU/mL) effectively prevents the risk of transmission, so in this case, your partner would be safe.
Infection doesn’t generally occur with the unborn child (because the placenta is an effective protective barrier), but the transmission can occur during birth. There are many ways of preventing transmission to a newborn, including reinitiation of treatment, HBIG infusion for the newborn, and immediate vaccination. These measures are highly effective and there is usually sufficient time to implement them during pregnancy.
Hope this helps,
Thomas
1 Like
I agree if HBV DNA is still detectable at 174 IU/mL (2.2 log) we do not recommend stopping if the treatment indication was due to active hepatitis/liver disease (we do stop in some patients who were only treated in pregnancy to reduce the risk of mother-to-baby transmission or during short-term immunosuppressive therapy). (There may be some other reason that we are not aware). Even in patients that have undetectable HBV DNA (<20 IU/mL) it is important that you have close monitoring of ALT and HBV DNA. An additional useful test if available is quantitive HBsAg, if <100 IU/mL, there are studies showing lower risk of relapse after stopping treatment.
1 Like
Good Morning.
I’m new here. I’m 27 years old male.
On 9th September 2023 i was diagnosed with hep b after a random blood donation.
I did hep b e antigen test and it was negative. HBV DNA was 729 iu/ml and core antibodies were positive.
I did liver function tests and they were normal.
I re-did all the tests in November and attached herewith are the results.
Is it an acute infection?
Should i begin treatment?
Hi @ Kenyan,
Sorry for the late response. First your results show a normal ALT/AST and a very low viral load. Which is all good. Being HBcAb positive indicates either a current or past infection.
But your HBeAg is negative, meaning you have a very low to no amount of virus in your system making you less infectious. You don’t have a result for HBsAg. If it is acute you should be testing HBeAg positive and HBsAg positive for a few weeks when you are still infected. There are people with chronic infection whose HBeAg is negative. You have a positive HBV DNA, HbeAg negative and a positive HBcAb which makes me lean towards a chronic infection. But to be conclusive, you will need a HBsAg, HBsAb, and IgM anti-HBc test. If it turns out to be chronic and you still testing negative for HBeAg, then you will need to consult with your provider about the appropriate steps forward.
If it is an acute infection, you should test negative for both HbsAg and HBV DNA after 15 weeks after appearance of symptoms. I am not sure how long you have been dealing with this.
I hope this is helpful and I do stand corrected by others here as these tests could be a bit complicated when explaining. Best, Bansah1.
1 Like
Thank you so much for taking your time.
My HBsag is positive. Ive never felt any symptoms. I found out that i have hep b in September 2023 after going for a random blood donation.
1 Like
Hi guys,
Thank you for the wonderful work you are doing here.
I’ve done a lot of reading on chronic Hepatitis B e antigen negative patients & inactive carriers who are also chronic hep b e antigen negative.
Are they one & the same?
My understanding is that Inactive carrier’s have low to undetectable viral loads while chronic hep b e antigen carrier’s have high viral loads despite the e antigen being negative.
Is this the case? Am i correct?
Please advise.
Hi @Kenyan,
Yes, it can be confusing, as the naming has changed a bit, so there are now multiple terms for the same thing.
The two phases you are referring to is now called HBeAg-negative chronic hepatitis (or HBeAg-negative active carrier), or HBeAg-negative chronic infection (or HBeAg-negative inactive carrier).
Activity refers to how much liver inflammation there is. If it is persistently high, then it is an active infection. If it is persistently normal, then it is an inactive infection.
Inactive infections are generally linked to low HBV DNA levels (<2000), but the main differing point is liver inflammation.
Hope this helps,
Thomas
Thank you so much.
This forum is a life saver. At least we get the answers to our questions.
1 Like