Dear @javer
if you read my posts you’ll see I’m also pretty new with this pathology. Thanks god for this forum!
it has helped me immensely to navigate the past few months and not going crazy, and understanding this illness.
I was diagnosed on June 29th 2023 with acute HEP B I have been waiting month after month for six months to clear the virus and Unfortunately so far I haven’t been able to.
My doctor/Hepatologist thinks ( given the recent blood tests) I’ve gone chronic. and I have been on antivirals ( TDF) since October 27th 2023 becauseI had very high viral load and AST ALT. ( my viral load was in the millions but has gone down to 55.000 since the antivirals, its still high, but hopefully will go down further) .
I think your situation its still unclear and you might still clear the virus.
the reason I’m answering your post is because I wanted to tell you that I had very strong symptoms (similars to yours) back in June/July.
I was advised to not take Ibuprofen or buscopan etc ( of course if you can manage and you are not in terrible pain. Drink a lot of water and eat vegetables and fruits) as it may injure the liver that is already under stress,although you have quite normal AST/ASL .
good luck Gregory
It is important to remember that Gregory’s abdominal symptoms (which were accompanied by classic acute HBV infection with high viral load and liver inflammation) likely do not have the same cause as Javer’s symptoms, where liver inflammation (and liver disease) is not evident and HBV viral replication is very low. Please be cautious in attempting to correlate the resolution or causes of these symptoms between these two cases.
In the case of liver disease, the use of ibuprofen, aspirin or naproxen are not advised as they place an additional burden on liver metabolism. Acetominophen (aka paracetamol) can be used for pain relief in patients with liver disease if daily intake is kept to 2000mg or less. There is no published contraindication regarding the use of buscopan with HBV or with liver disease in general.
In Javer’s case, there is no evidence of liver disease and he has been prescribed buscopan medication following evaluation of his liver. Buscopan is a completely different class of drugs from those above and acts as an anti spasmodic designed to relieve cramping in the smooth muscle in many parts of the gastrointestinal and urinary tract.
Good luck to you both!
@Gregory, thank you for your post, I appreciate the fact that you shared your experience too. Even if we develop chronic Hep B-at least from my perspective I have accepted it already - we should not lose hope, it’s really not the end of the world. With a healthy diet and cautious lifestyle we have high chances to stay strong for really long time.
@availlant The buscopan didn’t do anything by the way, I took one after dinner and couple of hours later the dull pain is still there. Can’t wait to resolve this problem with the abdominal pain soon, because I want to go back to the gym and to carry on with my life. Unfortunately, the last two months I have neglected myself and the pain makes it even harder to go back to my routine.
@availlant @ThomasTu
Could you give me some insight and tell me whether abdominal symptoms persisting for over a month and a half indicate progression to chronic disease?
Please see my previous post on this thread. Thanks.
Dear @Johnjoe123 ,
Tenofovir (in different prodrug versions) is a component in the two approved medications for PREP (pre-exposure prophylaxis) treatment for persons as risk of contracting HIV infection. Tenofovir may have been written on the side of the box in addition to other medication (such as emtricitabine) which is also included in these drug products. So it is not clear if your partner has any infection or not (HIV or HBV). They could jsut be taking precautions.
It is not clear from your post above in this thread if you have been infected at all (or have a previous diagnosis of HBV infection).
If you feel you have contracted a viral infection, you should visit you nearest infectious disease clinic and get tested. This is an important part of understanding the basis for your gastrointestinal symptoms.
Best regards,
Dear @Johnjoe123,
There are many causes for abdominal distress (e.g. Upper right quadrant pain and Feeling hot flare on upper right abdomen especially liver area). As @availlant has mentioned, it is difficult to link it directly to the Hep B itself.
Thomas
I have received diagnosis of acute infection from my doctor.
I work in the pharmaceutical industry and I am 100% positive that the box said tenofovir disproxil. This drug on its own and not in combination with emtracitibine is not lndicated for pre-exposure prophylaxis and therefore I am certain that this encounter is where I was exposed.
I am still quite worried about my situation and whether or not prolonged abdominal pain which has persisted for a month and a half is a bad prognostic sign. I keep reading that people often recover in a few weeks from acute infection.
Dear @Johnjoe123 ,
So quite right if the medication just said TDF it is only used for the treatment of HBV infection.
With your recent diagnosis of acute HBV infection your prolonged abdominal pain should be taken seriously and you should visit your doctor to discuss and receive a new round of virology and liver function tests. In cases of acute HBV infection which develop serious liver complications, TDF is indicated to control viral replication and reverse these liver complications.
Hi, @availlant and @ThomasTu I’m wondering how exactly to interpret my test results and what might be a possible outcome.
I’m 28 and on a recent test for hepatitis b, I was found to have a positive result for Hbsag. The test was done on October 25th.
I was vaccinated normally with the 3 dose series as an infant. So I should have immunity.
After getting these results, my physician ordered for me to get additional testing on November 17th in which the results were as follows;
• HBsAB- reactive
• HB core AB Total- non- reactive
• HBeAG- non-reactive
• HBeAB- non- reactive
I also tested negative for hepatitis A and C
I will have to test again in 6 months. Can anyone help me to understand what this might mean? Does this mean the HBsag can possibly resolve?
Hi @Mimi19 ,
Your HB core AB total non reactive result indicates you have not developed a HBV infection. Your positive HBsAb result is consistent with your vaccination. This is inconsistent with your initial positive result for HBsAg.
It possible (but very unusual) to have a false positive HBsAg result - perhaps it could be laboratory error.
How are you feeling, did your additional testing include a repeat HBsAg and liver function tests? Were these normal?
I am inclined to favour a false positive result but be sure yo keep your next appointment.
@availlant I’m not having any symptoms. The positive HBsAg result just gave me some anxiety.
I had an appointment on December 19th however we didn’t do a re-test as yet. It was advised that I should do the tests for Hbsag and Hbsab again in 6 months. I was also advised to make another appointment to see a specialist to get an ultrasound on my liver as well as other liver tests.
Based on the information I’ve found online I was thinking that my positive result for HBsag was false as well. As my immune system did have a response.
Not sure what to think.
Hi @Mimi19 ,
I can see how this can be confusing and a source of anxiety but all of your planned visits an procedures are perfect. In my view this is all precautionary and I would expect that the next result will be HBsAg negative.
Keep positive!
@availlant Thanks so much for the response and advise! I’m trying to stay positive with this and hoping that the next liver test are okay and the hbsag test be negative as well.
Got some updates I wanted to share. Definitely confirmed that I have chronic Hep B. The vaccine wasn’t administered in the country I was born at the time, and I didn’t get the vax until I was 8. I must have gotten the virus sometime beforehand, making the vaccine ineffective. It is what it is.
Since finding out, I’ve gotten my blood test, ultrasound, and fibroscan and my liver is in good shape. I am so relieved and feel a lot less stressed and panicked. I’ve been drinking and living normally up until this point in life and had no idea what kind of damage may have been done, so having that confirmation gives me peace of mind.
Next up is checking my viral load and deciding if treatment is necessary. I already got the result in my medical portal but haven’t discussed it with the doctor. Is there a certain threshold before medication is considered? I think mine is low, but I don’t know how to gauge it in order to make a decision. My understanding is that the standards are also different in the U.S. vs. Asia etc.
Appreciate you and the community’s help and support throughout this time.
Dear @that.girl1 ,
Yes guidelines are different in US/EU/Oceania (wait until liver disease presents unless viral titer is high) versus China (treat with any viral titer present).
The debate between these two options centers around the ability to HBV to integrate into the chromosomes of your cells. This is a process which begins right after infection and progresses as long as viral replication remains unchecked. This HBV DNA integration is the primary cause for liver cancer developing in the long term. You should discuss these issues with your doctor.
I’m so glad seeing and other people sharing their stories on this post, and the very insightful and helpful explanations we are receiving from @availlant and @ThomasTu I feel so much better during the last 1-2 weeks, mentally I mean, nothing compared to the panic and shock that I went through when I was first diagnosed.
Now, a little update on my situation. The pain in the right upper abdomen area persists, it’s not sharp but rather dull, when I walk for more than half and hour or lift heavy boxes at work, the pain intensifies and spreads from the right upper side to the lower abdomen and sometimes it hits me on the waist area. The previous week I went to my GP and asked him first, to push things so I get appointment with gastroenterologist sooner and second, to prescribe me something stronger than ibuprofen and paracetamol for the pain. He prescribed me codeine 30mg, which I took for couple of days, but first it made me very sleepy and second, it didn’t do huge difference with the pain, I could still feel it in the before mentioned areas. To mention that, I am very careful with my eating, try to consume as much vegetables and healthy foods as possible, and I drink a lot of water, so the discomfort I feel is not based on bad eating or something.
Also, I ordered a home kit blood test for hep B, and I did it hoping that it might come negative, but nope - I’m still infected and I have the virus. Good news now, I finally got an appointment for ultrasound for next Friday! Of course, I am still worried of what it might show, but at least it’s a step forward for seeing what’s happening inside my abdomen, not knowing is worst. Cross fingers that everything will be OK.
I do like to ask something
If the infection is acute, how can you tell that your body is fighting the virus and recovers? Maybe the pain indicates that my liver or whatever, is battling with the hep b? Also, isn’t the my very low viral load an indicator of slow recovery?
Dear @Javer,
Thanks for keeping us updated and great to hear that you’re getting the support and care that you need to get through this. I hope talking about it on this forum is helping a bit to share the burden.
Unfortunately, I’m not sure there is a 100% dependable way of knowing if there is recovery until it happens (HBsAg becomes negative).
THomas
Thanks. I touching and encouraging. I too soon made a will to my loved ones just because my doctors had less information/ knowledge about hbv.
Thank God this community has helped me much through psychological support without taking medication.
Maybe if I can ask, do you live normal life free from pain?. Do u ever eat fried food most especially meat. Because this is shattered me out a lot since evey food I eat goes through oil.
May Thanks
Hallo @Opa and wellcome into this lovely group. I am sorry to hear that you are going through this too, but trust me, it’s not the end of the world.
Little update on my case. Since I was diagnosed (2-3 months ago), I’ve visited my GP 7 or 8 times, and still haven’t been seen by a hepatologist, in the UK things just work really slow. I had though an ultrasound scan a week ago and it showed that my liver is perfectly fine. However, they couldnt tell where the pain in the abdomen is coming from, the ultrasound didn’t show anything abnormal in the area. Now I’m trying to get and MRI scan to see more thoroughly what is happening in there, however the last time when I visited my GP, he told me to do pilates and didn’t even prescribe me any painkillers. I’ll go back again next week though. Thankfully in the GP I’m seen by different practitioners each time, so I hope that some of them will take things more seriously and will refer me to a specialist who actually can diagnose and help me.
I still hurt tbh, especially when I do some physical activities like walking for a longer time or lifting anything heavy, then the pain becomes acute and no ibuprofen or paracetamol can help me. Otherwise, when I am relaxed and do nothing, the pain is almost gone, just some dull annoyance here and there.
Next week, I’ve booked another blood test to check how the hep b infection is going, if the viral load is up or down etc. I still have that very little hope that the results will be negative all together and I will have cleaned it, because I’m still in that window period of six months since I had unprotected sex (last September it was). But I’m trying not to get my hopes very high and be disappointed eventually. Actually, I’m OK with the new condition and I want to live my life normally as before, it’s just that abdominal pain that annoys me and I hope to resolve this problem soon.
Hello @Javer
I read you took Codeine for pain. I also took only codeine and it did not work, but I was prescribed codeine with paracetamol and found that that worked well. Hope this helps and your pain resolves quickly.