Fibrosis and Hepatitis b

Hi, I am new to this forum. Thanks for this amazing forum to share information about our disease.
My question:
I have been diagnosed positive since 15 years ago and now I am 38 years old. At first my viral load was low and I didnt get any medication. But in 2019 the viral load got around 13000 and I started TAF Tenafovir and the load became undetectable. I never had Fibroscan and always just Blood test and ultrasound. And everything was fine with them. Last year I moved to the Netherlands for my job and the doctor asked a Fibroscan and the result was F3 (9.9 kpa). But the dr did not seem worried and told me that just continue with TAF and everything is under control. But I am very worried with F3 fibrosis. Why the preveious doctors never asked me to have Fibroscan? And why now my doctor is not worried? Because I see that F3 is sever scar on liver.

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I was told that fibroscan looks and grades on the hardness of the liver. So, it could be lots of fat stored in your liver.

Are you overweight or are skinny fat? Are you inactive, and have high carb and sugar diet.

Sorry for the high score on fibroscan.

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Hi thanks for your reply. No I am not overweight at all. I have a normal weight and my diet is normal. I don’t think it is because of my diet. Something else that was in my result is
S0 steatose

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Dear @Goldmond,

Thanks for sharing your story and welcome to the forum. It’s a fact that many doctors do not know about the best way to monitor people with hepatitis B, particularly if they do not see the disease present very often. The best way around that is to educate yourself about your condition, so you can suggest these tests at your consults or find a doctor with more experience with Hepatitis B.

The TAF will likely lead to reversal of the fibrosis levels. The important thing is to maintain monitoring so that you know it isn’t getting worse. People can live with liver fibrosis, as long as they do not stress the liver out too much.

Hope this helps,
Thomas

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Thanks @ThomasTu for all your efforts you put to help people in this forum. So now I think ultrasound and MRI and blood test are not enough to show the damage on the liver. Because my liver looked healthy in all of them, but only fibroscan showed the scar.
I wish I had it before starting the treatment so I knew how it is going after almost three years of tenafovir. I saw somewhere in the topics that you had shared an article that most people using this medication do not get worse and around 40% even get better. So I will stay positive and keep healthy diet.

I think fibroscan shows hardness and stiffness. Yes some could be scarring from hep b. But it could also be stored fat in the liver.

Start believing in a positive mindset that good foods, exercising, and positive cures all. And go with it. Yes you can be the healthiest, have the best life and think your the best and cancer at young age, but start enjoying now.

Hi @goldmond,

I would have thought ultrasound and MRI should be sensitive enough to pick up F3 fibrosis. Have you had the US and MRI recently before the fibroscan? It might be worth repeating the fibroscan or have another ultrasound done just in case it might be a false reading. I’m not sure, but worth talking to your doctor about next time you see them.

In the meantime, taking TAF as your doctor has recommended is likely to stop or reverse the fibrosis - Viral Load & Cirrhosis - #16 by ThomasTu.

Thanks @ThomasTu for your reply. My Last ultrasound goes to two years ago and it was normal. The MRI is at the same time with Fibroscan and it mentioned that liver has hemangioma. I was told that I had hemangioma before too. But the result of MRI doesn’t have anything related to fibrosis. So, is there any possibility that either of them are wrong?
Like Hemangioma is a fibrosis scar that is wrongly interpreted as hemangioma or the other way around? For example wrong detection of fibrosis due to hemangioma?
I will share the results in the topic related to laboratory results too.

Hi Goldmond,

I’m not a clinical doctor, so can’t really answer your question. It’s possible that a haemangioma (which has different density to the normal liver) could be wrongly interpreted as increased fibrosis by a fibroscan (previously reported - Liver Hemangioma Might Lead to overestimation of Liver Fibrosis by Fibroscan; A Missed Issue in Two Cases), but I’m not sure how common this is. This will require some expertise from our @HealthExperts to answer fully.

Thomas

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Thank you @ThomasTu for your answer and sharing related article. I will share the results of my examination in the related topic. I have an appointment in a few months to redo the fibroscan. This time I will talk to the doctor about this matter.

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Hi Goldmond.
I think I have shared my fibroscan results somewhere. 3yrs ago I was F3 but today I have cleared the fibrosis.
Kinoti

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2 posts were merged into an existing topic: INTRODUCTION THREAD: People affected by Hep B

As I previously mentioned, my liver started to show fibrosis after I started Tenfovir (TDF) and in my case, it’s the TDF which causes the fibrosis? It’s not an option to stop TDF due to the virus, just wondering if I replace TDF with TAF can help in my situation since my liver has been showing higher kpa consistently for the past 4 ultrasounds (6 monthly).

Dear @Sahara,

Usually it is the case that the TDF is prescribed precisely to slow down the amount of inflammation or fibrosis. This may take some time to work.

It also needs to be interpreted with your other results (e.g. ALTs) to see if the liver inflammation is still occurring. There may be several options, which might include changing to entecavir or looking to see if another liver disease is there that might be causing fibrosis progression (e.g. fatty liver disease).

Hope this helps,
Thomas

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