Hi @Larry,
Welcome to the platform. Your labs indicate that you have hepatitis B. You do not have antibodies or protection. Your HBV DNA has decreased from October 2023 test which shows the impact the treatment is having. The ALT is a bit high but not by much, lower from your 2023 test. Your glucose is high, you might want to keep an eye on that. I don’t see any reason why you cannot be on PrEP, I think it should be ok. I hope this is helpful. Bansah1.
Is it possible that the Hep B Viral Load fluctuate? I am currently on Observation Study right now and last November 2023, they drawn blood from me with a Viral Load of 130 and now this March 2024, it shown that I have a viral load if 190. Do I have to worry about it?
The second question, is it okay to take HIV PrEp and Vemlidy at the same time in a day? Does it has long term effects in my body?
Hi @Larry,
Yes, it’s possible to have your numbers fluctuate from time to time.
Regarding PrEP, I will encourage you to talk to your provider. I think it should be alright. But some PrEP medicine might contain similar ingredients in a antiviral for hepatitis B. You don’t want a situation where you are taking too much of something. Please talk to your provider regarding this issue and they will be in a better position to answer your question. I don’t know what you are taking for your PrEP. I hope this helps. Bansah1
There are very MINOR abnormalities in your hematology and liver function tests.
Bilirubin is slightly elevated but this does not necessarily mean anything without some other time points to see if there is a trend. Your liver enzymes (ALT AST GGT) are generally fine - even the minor elevation in ALT.
You will have to remind me are you on treatment? If so for how long? We will look forward to seeing your virology results.
@availlant was more worried about high basophils and high MCHC and Low monocytes. Was also thinking of taking vitamin B12 and folate for two months. What’s your take on those two?
Am.not on treatment but my Viral load in Oct 2022 was as below
14. Alanine Transaminase 29U/L
15. Viral load 264 from 121 8 months ago
16. No DTV from Doppler test
17. High AFP 6.6ng/ml with or using a ref range of 0 to 5.8
18. 3.9 kpa on fibroscan meaning absent or mild fibrosis. No mass or nodules seen
19. CAP 270 dB/m grade 2 steatosis
Chronic HBV infection can also have hematological effects - these may be the underlying cause of the mild alterations in your hematology results but they are not too concerning. Absolute WBC, RBC and hemaglobin are good and the other out of range results are only really slightly out of range.
HBV does not cause steatosis (fatty liver) but it is not uncommon to also find fatty liver in persons with HBV infection. This may be the underlying cause of mild elevations in bilirubin and some of your liver enzymes. Increased fat in the liver also leads to increased inflammation.
You have partial cure of your infection (pending your latest virology results): HBV DNA is < 2000 IU/mL and ALT is normal with normal fibroscan. Mild AFP elevation (which you have) is also not uncommon in chronic HBV infection but does not signal the presence of liver cancer. AFP levels > 20 usually warrant further investigation for HCC.
With such low HBV DNA, your risk of developing HCC is much lower than someone with chronic HBV infection so starting antiviral therapy may not be the best course. You should discuss this with your doctor.
Supplementation is always a good idea but this will not likely have any impact on these results.
CNN here. My hospital Lab DNA viral load results for April 2024 are now out at 171 IU/ML up from 121 in August 2021 (same lab ).
In Nov 2022 I went to a different lab from the above that gave a result of 264 . Both are good hospitals. From a mathematical perspective if difference was machine calibration maybe today they would be giving me btn 350 and 373(but can’t rely on maths here)
My last question for now, and I have asked this before. From existing research et al (forget guidelines) if I were to begin treatment say Velmidy, what would be the projected reduced risk for HCC? And what added risk? I am 44yrs old now. Despite your response, I understand this decision needs to be ultimately made between me and my doctor. I truly appreciate your honest reflections @availlant This platform is the best .
The differences in your HBV DNA values are normal wobble in HBV DNA which happens during chronic HBV infection.
Given that your HBV DNA values are so low, the benefit from taking NUC therapy in terms of reduced HCC risk will be minimal. The only way to get lower risk of HCC in some one with partial cure (such as yourself) is by achieving functional cure. This cannot be achieved with NUC therapy.
My respect to you, doctor!
I found out about my presence of HBV by accident. I do not take antiviral drugs. I received the results of my tests.
August 2023:
HBsag - 2002,
DNA plr test - 2.36*10^2,
HBeag - 0.012, negative. ALT, AST - normal.
November 2023:
HBsag - 2555,
DNA plr test - not detected, negative.
HBeag - 0.012, negative.
ALT, AST - normal.
fibro scan - F0.
Anti-HBs - 4.67.
New analyzes have recently arrived.
April 2024.
HBsAg - decreased by almost two times, in three months to - 1400.
DNA plr test - 1.35*10^2
HBeAg - 0.15 negative
Anti-HBs - 4.47.
AST, ALT - normal.
Alpha-fetoprotein AFP-2.
In 6 months, my HBsAg decreased from 2555 to 1400. DNA viral load is low and changing -
08.2023 - 236
11.2023 - 0
11.2024 -135.
Maybe my DNA went from 0 to 135 due to stress?
Can HBsAg disappear forever (decreased from 2555 to 1400)?
Anti-HBs appeared, but not yet enough to reach the norm of 10.
What is my prognosis HBV?
(Wrote via google translator).
Hi @Antony,
Welcome to the platform and thanks for your question. I think it is possible that one’s surface antigen (quantitative) can disappear if the person has cleared the virus or does not have hepatitis B. But this happens in less patients with chronic hepatitis B. Your HBsAg of 1400 is actually low and so is your DNA viral load. Treatment might not be an option for you currently. But you need to continue with your scheduled follow-up and monitoring. I hope this helps. Bansah1
I join @Bansah1 in welcoming you to the forum. It’s a great sign that your viral load and HBsAg is reducing over time (even without antivirals). A low viral load like yours is generally stable and is associated with good health outcomes (low risk of liver injury and liver cancer).
HBsAg can disappear over time if these reductions keep happening and your immune response keeps the pressure on (which these results suggest).
Thank you very much for your reply! Your words give hope for a full recovery from the disease! Does stress affect the increase in DNA and other indicators? I serve in the army. I am constantly in a state of stress and high physical exertion.
14 April 2024, 05:44:31, from “Thomas Tu via Hep B Community” < info@hepbcommunity.org >:
What a great question. I didn’t really know so have done some quick research about it. In essence, there have not very been very many studies around this:
Hello,
I was first diagnosed with hep b in 2020 during my pregnancy. Ever since then 2 other times within that same year I was tested again and was positive. But now that I am pregnant with my second baby I was tested for hepatitis again as a part of the regular pregnancy testing. It is now showing negative. Can this be a false negative? Please help me understand my results before I get my hopes up.
(My first baby was given the immuglobullin at birth and is fully vaccinated and protected)
It would be worth testing again, but it is possible you have cleared the infection. With the additional test you should also test for anti-HBs antibody as well (which should be positive if you have cleared the infection)
My name is Mike and today is my first time putting something here and I must admit that we are all very grateful for the wonderful team we have here assisting us with every information regarding Hep B.
I always read the replies given by Mr. Thomas and the rest of the team and I really appreciate your support.
I was diagnosed with the hep B almost two years ago. Hence, I follow the healthy diet plan although not at all times and I also visit my doctor with my lab results twice in a year. I have been going through the usual symptoms of fatigue, joint pains, light coloured stool and dark urine. But currently I have some small blisters on my skin (not really conspicuous). Should I be concerned?
This month, I visited my doctor and she suggests there is a likelihood I would be put on treatment next year considering how my viral load has shot up. I have done the Abdominal USG Scan, FBC, HBV DNA and LFT. The results for the liver function however is not ready.
I have included this year’s lab results here for an advise in terms of if I could start medication.
What is the implication of my results?
And any other advise on travel. I am an African, and I would like to pursue my masters degree in Europe. I am afraid I would be worried of being sick and alone while pursuing my studies.
Hi @Michael,
Welcome to the community. Thanks for sharing your results. From your lab result you ALT and AST numbers are normal, your abdominal ultrasound also shows a normal result. The only problem has to do with your viral load which was 10,4
76 back in May but has risen to 42,719. I believe that is why your provider is suggesting treatment next year if the numbers remain high or get higher. Protecting your liver is important and I believe your provider is making the right call here based on your results and his or her judgement. Much of your results are normal except the viral load that has shows a huge spike from where you were in May. Best, Bansah1.
