Hello @Osmanmusedahir, hope you are well, how long can someone live with the virus without taking drugs?
When I was diagnosed of HBV positive, my doctor only used the results of my Lft to place me on Tenofovir Lamivudine 300 gms. I wasn’t feeling any sickness nor showing any symptoms of the virus apart from my swollen legs which were later confirmed to be varicose veins.
Starting on therapy, I got so much sick that my life couldn’t continue normally. The effects were so much that I stopped and since then, have not experienced such effects again.
Do I stand a chance of living normally without the medication? Kindly advise. I’m so much confused. I don’t know if I’ll ever have peace again. Have been through Dr. Google everyday the little moment I’m free, I’m always asking google about HBV this thing is eating my mind more than it’s doing to my liver. Please I need help.
You need to do tests to figure out your HBV viral load and Surface antigen HBsAG. Along with this your doctor should check ALT and AST to determine if there is active inflammation of your liver. Sometimes viral load can be high but if your ALT and AST stay normal you dont need medication.
Once your ALT fluctuates a lot then usually doctors start treatment antivirals which stops replication of virus. You will live normal and happy life if you take your pill everyday. Only issue with lambvudine is virus do get drug resistant so probably Tenofovir or Entecavir is your best bet. People have been taking antivirals and living for decades on this site so you are safe.
Please follow your doctors supervision and follow up every 6 months or 12 months to check for liver damage. Hope this takes some anxiety off of you
Please dont google stuff since it leads to unnecessary anxiety and your mind will pick worst outcomes
Thanks so much @Ash_Malhotra, yes my Alt was 78 and AST 57. A viral load at Lancet lab showed a HBV -DNA 2.234 n 174 IU/ML. (I don’t even understand what this means). HbeAg is negative. Please help me understand the meaning of these lab results.
Your viral load does seem normal. Below 2000IU is always a good sign. You doctor might have seen your ALT levels which again are 2x your normal levels which might have prompted him to put you on medicine.
Also another possibility is you have an acute hep b case where ALT jumps and typically we call them ALT flares which signifies clearance of infected liver cells. Generally too much fluctuation of ALT are sign virus is attacking liver cells and bodys immune response to it.
In this case you dont have to worry and keep monitoring if ALT fluctuates a lot and maybe even talk to doctor about his rationale to put you on meds and try to get second opinion. I myself have 16800IU but normal ALT and so doctor did not put me on meds yet and asked me to visit in February.
One more thing even i am HbeAG negative but i have a mutant strain of HBV which does not produce HbeAg so try to get a genotype of HBV done to rule out this possibility
Thanks once again dear, indeed this platform is one of a kind. If only you knew what Dr.google has done to my mental health since I learned of HBV in me, only God has been my strength.
Kindly advise, the impacts of Tenofovir Lamivudine 300 gms were so much that I stopped coz I’m living alone. I took the drugs for 1 month but it was heal. I’m a blood group 0+ apart from the varicos veins that subjects me to drugs, generally I hardly fall sick but when I was under the antivirals for the said 1 month, I was demn sick.
Incase I’m a candidate of medication in the future, will it work or the virus are already resistant?
I’m having an appointment with my surgeon in January coz they have to do ablation for the varicos veins. I’ll also consider another Lft hope it turns out well.
For the case of whether my HBV is acute, it’s not coz the first time I was tested positive was in 2010 when I first went for a blood test but none explained to me it’s danger so me I just continued with my life until this year again when a blood test confirmed that indeed I’m HBV+ but HCV -.
Not sure why the doctor asked both TAF and lamvudine. The issue with stopping anti virals is virus do get resistant (33% times with lambvudine) to it if you miss doses so please dont stop medication once you start it unless your doctors says. Entecavir and Tenofovir are best option since very few drug resistance <1% resistance is seen in these drugs.
Even for drug resistant virus doctor can suggest ETV since their functioning is different and it is hard for virus to mutate to all the anti virals. So dont worry if doctor sees lambvudine doesnt work on you he will give you entecavir or any other combination or increase dosage.
Side effects of HBV anti virals is normal but if it really affect you then doctor will change your medications. There are ETV, TDF and newest is TAF so doctor can switch to other drugs to see if that reduces your side effects.
Again it is crucial to know the genotypes and subtypes to see if your strain is particularly shown resistance to particular drug. This helps doctor to make proper treatment decisions
a viral load of log 2.234 (which means 10^2.234 or, in other words, 174) is low and your risk of transmission is minimal. Lower hbv dna levels are also generally linked with better outcomes, so that’s good!
your higher alts of 78 indicate there is some liver inflammation. If it is caused by the virus, then antivirals would help reduce this.
varicose veins have not generally been reported as a side effect of antivirals and may be due to other changes in your life at the moment (see this thread- Possible side-effects from antiviral therapy. Given the liver inflammation, you might want to consider changing how you take antivirals (with our without food, different times of day) or other antivirals (e.g. entecavir) to minimise any other effects. This is worth discussing with your doctor.
if you have been prescribed antivirals, you should keep taking them as per your doctor’s advice (even if you feel better), as reactivation of the virus can occur and could lead to severe liver injury.
Even though everyone else has some calming words, I’d like to share that I know exactly how you’re feeling. I was diagnosed 2 years ago at the age of 27. My levels were crazy high and I probably had it since birth, but Hep b did no damage to my body whatsoever. Be soooo glad you found out now so you can treat it and live a long healthy life.
Are you taking any medication for high viral load? I am really confused but i also dont want to die by HCC since this beast can shock you even in non cirrhosis liver.
I really dont want to die by Hcc. I am glad that i found out about my condition in my early 30s and i can probably start with anti virals to stop the progression in my liver.
My question to @ThomasTu@availlant is since i have been reading that my mutation BCP/Precore is linked to greater HCC progression should i start antiviral despite my viral load less than 20000IU and normal ALT?
I want to know your opinion so i can talk to ny doctor and explain her about my mutation and hopefully she is knowledgeable.
If i take antivirals would it reduce my risk of HCC since the infected cells with HBV integrated DNA will be less?
My fear is if i have high persistent viral load more virus will integrate and cause more chance for HCC so i want to limit it. My nights are sleepless seeing the survival rates of HCC please help.
Yes, I’ve been on Entecavir for 2 years. No side effects. I visit the gastroenterologist that specializes in Hep b. I get an ultrasound, blood work, and fibroscan every 6 months. Everything has been great.
My dna went from 999,999,999 range to 100 in about 6 months.
Read over previous posts and you’ll see lots of evidence of people living long full lives with Hep b. You’ll be just fine. I understand why you’re so scared right now, but trust me, it’ll pass and you’ll come out a lot stronger from this.
Yes, there is life with Hepatitis B. The secret is to accept and cope with its simple living conditions. Do not start Medication without proper consultations with the Right Doctors. With my Dr., He was quite clear that no Medication if your viral load is less than 20000 iu. Mine reached 104,000 iu and i never used any drugs. Its now descending to a level of 8000 iu.
Eat healthy, sleep well, exercise, Avoid too many Drugs,
Thanks once again, honestly for drugs I can’t tell with certainty when I won’t take any coz my varicose veins is severe that ablation must be done but that will be next year
I think it is not clear why the mutation is associated with HCC. It may be just reflective of older patients (who are more likely to have both mutations and HCC), but I’m not sure that the mutations themselves have any direct effect on HCC. There is no strong evidence to alter any treatment based on these, as far as I know.
This is a good question and one that I am actively doing research on. The simple and accurate answer is “we don’t know”.
Hi, man!
Dont worry! I was hep B chronic since 3 or 4 years of age. Now I am 41 and finally my infection is gone! In 2022 I got spontaneously (without treatment) converted from BHsAg positive to BHsAg negative and I have antibodies to surface antigen.
If this thing didnt kill me after almost 40 years then it will not kill you either. Actually the virus itself does not kill or damage anything. It is your own high immune response that kills liver cells. Things go bad only after many years of inflammation caused by continuous and unsuccessful immune response. If you have high ALT and AST for many years without break, then there is something to worry.
In your case virus is not in active state judging by your tests, so it is either kept in balanced check by your immune system or is being sucessfully eliminated. More test are required to ne sure.
Be heakthy bro!
I got my blood work done recently and here were the results
Hbeag still negative but bcp and precore mutation detected
My viral load has gone down in 3 months from 16600 IU to 5050IU. I havent done hbsag quantitative till now but have scheduled it on next 3 months.
The viral load going down with relatively normal ALT 14. Is that good sign? Or does everything ultimately depends on hbsag?
My doctor recommended we continue to monitor and take actions only if it rise. If it falls below 2000 then no actions.
What do you suggest?
My Ultrasound and fibroscan detected f0-f1 fibrosis
Its hard to think of starting therapy with normal liver function and declining HBV DNA. Here HBsAg decline is also a good sign if you start to monitor it. HBsAg loss defines functional cure when it is accompanied by undetectable HBV DNA and normal liver function.
Hi Osmanmusedahir,
I just got diagnosed with hepatitis B during my medicals as I was preparing to move to Australia to study masters in Nursing. I Feel so down and cannot trace how I got the hep B. I have no symptoms. The doctor working with the immigration ordered Liver function tests, and they came out Norma.
I am scared that this could affecy visa since y will be studying a course in healthcare.
Have less worries. We have been there and coped with these shocks. Hep B is a viral disease and you can live with it.
It needs an understanding and acceptance to live with it.
Let me know if you are in Kenya and want to have direct communication.
. HbeAg is negative. Please help me understand the meaning of these lab results.