Hi everyone, looking for some insight on my recent HBV DNA fluctuations

What do my lab results mean?
1

​For the last 10 years, my DNA was extremely stable, staying between 77 and 80 IU/mL. However, over the last 8 months, I’ve seen a gradual increase:

  • ​June: 86 IU/mL

  • ​December: 103 IU/mL

  • ​Now (February): 454 IU/mL

​My other labs are still very strong:

  • ​ALT: 26 (has stayed perfect throughout)

  • ​Fibroscan: F0-F1

  • ​Status: Inactive Carrier

​I recently started Sertraline for anxiety and have been under significant stress. Has anyone else seen this kind of ‘slow climb’ after a decade of stability? My doctor hasn’t changed my plan, but the jump from 100 to 454 feels significant to me.

​Is this still considered a ‘blip,’ or should I be concerned about a phase change even with a normal ALT?

1 Like
2

Hi @Miya , may I ask if you’re on any antiviral treatment for hepatitis B?

3

Hi @et5656 No, I’m not on antiviral treatment and I’ve never taken it before.

4

@ScienceExperts I’m very worried because my HBV viral load has gone up after many years of being low. My doctor suggested rechecking it again in 6 months, but I’m scared that it might continue rising during that time. Can someone explain why my viral load would increase after so many stable years, and whether it means it will keep going up?

1 Like
5

The interpretation depends on the HBV DNA levels and on the clinical phenotype (HBV phase) and on other possible confoundings

Regards

PL

6

Viral loads can change in any patient without explanation in many

This is why we propose :treat all patients who are DNA +

Why do we propose to patients with (SDM) to treat all patient with HBV who are HBV DNA+?

SDM is shared decision making

  • HBV DNA+ correlates with risk:
  • (risk of HCC, cirrhosis, LT and death)

Treatment decrease risk: 70% less HCC

90%+ decrease risk of cirrhosis and liver transplant

  • Decrease Risk of Transmission U=U
  • treatment to prevent infection- Reduce Stigma
  • Improve QOL
  • Reduce HBV related extrahepatic disease
  • Decrease other HBV related cancers (bile duct cancer is an example)
  • Reduce Discrimination
  • Partner with Patients who request treatment
  • Harmonize with WHO HBV elimination goals
  • Harmonize with HCV and HIV: treat all recommendations
  • Patients who are HBV DNA+ will not clear HBsAg, HBsAg clearance and functional cure is the goal of current and future therapies
  • Patient voice: Patient choice
  • New therapies work better if Nuc Suppressed (Nucs decrease the number of infected hepatocytes)
1 Like
7

I do agree with a lot of @rgish’s points here. While I don’t necessarily think that every HBV patient needs to be on treatment, I support shared decision making, and I do think that if starting treatment would reduce your anxiety about living with hep B, that would be a good reason to bring this up with your doctor.

1 Like
8

@et5656 @PLampertico @rgish Thank you for your reply. I’ve scheduled an appointment with my doctor, and I will definitely talk with him about therapy.

3 Likes
9

Hi Miya, if you don’t mind sharing, how old are you?

I’ve seen my viral load went up to the hundreds and then came back down to less than 100. I thought if it’s below 20000 it’s still very low. Correct me if I’m wrong.

1 Like
10

Hi @Leng I’m 37 years old. My doctor also told me that fluctuations are normal, but the upward trend still makes me anxious.

2 Likes
11

I think it’s still wayyyy below the “threshold”. That’s my take on reading the results. Perhaps keep monitoring it for the next couple months?

1 Like
12

@Leng Yes, I know my HBV DNA is still below the upper limit, but what worries me is the upward trend in my results. You mentioned that your HBV DNA was very high before it went back down. Would you feel comfortable sharing what your upward trend looked like, and are you currently on antiviral treatment?

1 Like
13

Mine went up to 400-ish two years ago and came back down to below 100. I don’t measure it so frequently but annually. And no, I dont want to start with treatment. We’re close in age though and it’d be nice to connect :slight_smile:

1 Like
14

Thanks for sharing, Leng.
Feel free to DM me whenever you want.

3 Likes
15

It’s been long dears: hoping it’s all fine with us throughGod’s grace. Happy New year.

Today did my blood work after a period of six months. Kindly help to share your thoughts on this and guide where necessary.

ASAT =30

ALT=21

PLT= 129

Am 40 years old. What scared me most is when I discovered my platelets being too low at 129. Has anyone of you here lived happily with such results and more so too low levels of platelets?

16

Hi @Opa ,

My platelets have always tended to run slightly low, (i.e. 150-165). I haven’t had any problems. They were a bit lower than that (in the 130s) recently when I was on Bepirovirsen, and I was having my clotting tested (with the PT/INR test). I would say that if you’re worried, you could ask your doctor to test PT/INR, which tests how long your blood takes to form a clot. If that test is normal, then I wouldn’t worry too much.

17

Thanks.

May be to ask. What were your blood work results before starting medication?