Dear all , I am new to this community
During blood donation I got Hbsag positive
please explain my results ,
I am from India
HBSAG - Positive
HBeAG - negative
ALT -26
Usg abdomen normal
HBV DNA QUANTITATIVE -29 Iu/ml
Cap Score is 232
And
Fibroscan is 8.2 kpa
My age is 35
At present do I require any treatment
Hi …pranu7767
welcome to hepbcommunity .According to your laboratory results, you are HBeAg -ve chronic hepatitis B infection or immune control inactive carrier ( ALT < 30 IU/L , HBV DNA < 2,000 IU/L. ) and your CAP score <248 dB/m which show steatosis grade S0 that mean you have no significant fatty liver , however , your fibroscan show significant fibrosis in the liver or F2 stage (>7 kPa ) . I am not sure that the result of liver stiffness measurement. may be overestimated eg : if the IQR of the machine isn’t in normal limit or you may have obesity . I think you should have done the others non invasive test such as APRI , FIB 4 index or repeat fibroscan ; if the results are concordance, so your fibroscan result is valid , which means that your liver may had sub clinical chronic inflammatory professes from HBV that left untreated for a long time ago before it turn to scarring / fibrosis . I think you should consult with your doctor to evaluate your laboratory results and consider appropriate treatment later . I don’t sure if other clinicians in this forum may have other opinions that may explain your laboratory results and give further suggestions. I hope this may help you .
Thank you sir for giving reply
After visiting doctor, he suggested Vitamin -E tablets for two months.
After six months followup he scheduled. I am not done with the
Non invasive tests .
And I have one doubt
Can I go with the Hep- C test also?
And HIV result - negative
According to US CDC (2020 guidelines) recommends universal hepatitis C screening for all adults 18 and older at least once in life time and periodically or annually in high risk groups people. In your country, I think that you should have test for HCV as WHO recommendations 2023 to test for HCV in all adults where seroprevalence in general population > 2 % and all high risk key populations to achieve hepatitis C elimination goal by 2030 . If you are high risk group eg PWID , you should be screened for others blood borne diseases such as HCV, HIV , STD (sexual transmitted diseases) .
Thank you for reply sir
My HCV- non reactive
HIV - negative
And last doubt sir after seeing my all lab results my doctor suggested vitamin -E tablets , is this sufficient?
And
f2 stage is reversible and to reduce the risk of next stage (f3) vitamin -E is ok or any anti virals are there ?
Please guide me and what is the life expectancy sir at this stage
Hi pranu7767
From your Fibroscan results which measure liver stiffness, in chronic hepatitis B patients, the cut off value in fibrotic staging F2 is> 7 kPa. Your result showed 8.2 kPa which means your liver had significant fibrosis from chronic injury. The pathogenesis and mechanism of liver damage usually depend on underlying etiology such as NAFLD , HBV, HCV , so, we should treat underlying disease that is the root cause of fibrogenic process. According to the 2018 AASLD practice guidelines , vit E dose of 800 IU/day showed benefit in NASH patients ( which is advanced stage of NAFLD )and can be considered therapeutic options for NAFLD patients after outweigh risk and benefit . There is no clear evidence based support that vit E has a beneficial role in chronic hepatitis B .
For your current situation, according to WHO guidelines 2024 for CHB management ( new recommendations) , you should be started treatment with antiviral drug due to the evidence of significant fibrosis ( > F2 ) based on liver stiffness measurement values of > 7 kPa regardless of HBV DNA or ALT level .
The reason for start treatment in these patients is due to the fact that it may lead to regression or reverse fibrosis and reduction of ongoing liver injury from HBV.
You should discuss with your doctor and make decisions about initiating treatment with antiviral drug.
I hope this can help you.
Hi @pranu7767,
I agree with @chul_chan, it’s hard to say anything about vitamin E and Hepatitis B, as there are limited good-quality studies.
Given your low viral load, guidelines suggest that antiviral therapy would not be beneficial for preventing disease progression (as the risk for disease progression is already quite low).
Re: life expectancy, if you maintain monitoring of your condition, it is essentially the same as someone who doesn’t have Hepatitis B.
Thomas
Thank you for your reply sir ,as you said
My HBV viral load is low . No need of antivirals
But I am worrying about my fibroscan result sir .
Hi @ pranu7767
From your concern and worrying about your Fibroscan results which shows significant fibrosis (F2) . Today , I just see the message from hepatitis B Foundation (HBF)which calling for expanded hep B treatment around the world.They are bringing the patient voice and community experience and giving position statements with evidence based from scientific and expert opinions that you can see the attached below .I think you may consider the following criteria which are 2 &4 . I think this may be alternative for you to make decisions and discuss with your doctor. I hope this may help you.
chul_chan
