Hi all. I’m very concerned about the increase in my viral load! I would appreciate any input, advise, or just support

What do my lab results mean?
21

Hi @Anon2023,
HBV treatment has a high possibility of being lifetime. With that said it will all depend on the individual’s case. No two HBV cases are the same, so that must be considered. The only time people are recommended to stop treatment is when there is seroconversion from positive surface antigen to negative with normal ALT/AST, undetectable viral load, and liver imaging. Until this happens one must remain on the antivirals. It might seem like a lot to start treatment, but it is so simple and easy. One pill taken each day, becomes part of your routine that won’t even think about it. I have been on treatment for 11 years now, and I don’t even think about it. I have built it into my routine so it is easy and simple for me. The beginning can feel scary, but it is worth it. The alternatives are not great. Best, bansah1

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Hi @Anon2023,

Great questions. Treatment is generally considered life-long, but there is more and more understanding of when someone can come off treatment.

  1. People can come off treatment when they become HBsAg-negative for at least 6 months - this happens relatively rarely (1-2% chance each year).
  2. There have now been studies looking at stopping treatment in some patients: generally these are people who are HBeAg-negative for at least a year, have undetectable HBV DNA levels for at least that long, do not have existing cirrhosis, and low HBsAg (<1000 at least, <100 in Asian populations). About 5-30% (depends on the population) of people that stop treatment get a reactivation of their immune response and clear the infection. However, there is also a proportion of people who may get significant liver damage because of the immune response - so it is important that this be done under very close surveillance and monitoring. There is ongoing research to identify and predict people who are very likely to clear or the people who would get significant liver damage.

Hope this helps,
Thomas

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Hi @ThomasTu regarding the spontaneous clearance of Chronic Hep B, is this only possible if someone is on viral meds?

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24

Hi @Anon2023,

Spontaneous clearance can occur even when someone is not on antiviral therapy.

Hope this helps,
Thomas

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