Hi I am Gams based in Dallas Tx USA, and honestly don't know if I have Hep b or not

Introduction/Orientation
#1

Hi Thomas et al,
My name is Gams and I am pleased to join this wonderful community.

A brief background of my journey. I started somewhere in 2012 with a bout of upper abdominal pain just after moving to the US from Cameroon. After many visits to Drs. I was told I once contracted hep b and cleared off.

Many successive hep B tests with the recent at Dallas Methodist Liver Institute have shown the same findings; hepb surface antigen negative, hep b viremia negative using real time PCR test, positive hepb surface antibodies showing immunity, and positive hepbcore antibody referencing past infection.

Well when in pain, we become google masters especially when your humanly instincts keeps pointing to the liver. What baffles me most is that, my bilirubin has gradually been on an increase; from 1.2 mg/dl in 2012 to 1.4 in 2016, to 1.95 as of last week after applying for health insurance.

I feel like ‘crap’, my daily constant pain, most recent declining weight. I’m not a scientist but I over the years read tons of articles to acquaint myself with hepatitis b virus as a whole.

Irrespective of reassurances of me clearing the virus, could I be an unfortunate ‘occult’ group. I’m afraid as I am in daily constant pain since 2014 and numerous ultrasounds have ruled out any complications or cause for concern. I am just 37 years old and a father of two

Please I am writing in desperation and will love your professional advice how to move forward. I have found sonce living in Dallas, there’s very limited Medical resources related to Hep B.

Thank you

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#2

Welcome to our community Ngams and we are glad you reached out to us.

Of first importance: your daily upper abdominal pain and gradual increases in serum bilirubin are symptoms which should not be ignored by your doctor but should instead trigger additional evaluations such as a liver ultrasound or abdominal CT or MRI. Providing us with additional liver function tests (ALT, AST, GGT, albumin, INR, platelets) would be useful here. You may want to consider another medical opinion if additional testing for the source of your abdominal pain does not happen.

Of second importance: occult HBV infection is a real but very infrequent event, especially with HBsAg seroconversion in your case. There are non standard tests which can better detect the presence of occult HBV infection using techniques (PCR and nested PCR) which are designed to detect virus which cannot be detected by standard tests. These are typically only available at regional infectious disease laboratories.

Hope this helps.

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#3

Dear @Ngams,

Thanks for sharing your story and welcome to the community. I agree with @availlant here that the bilirubin increase and constant pain is definitely something that you should follow up on with your doctor. Given you are HBV DNA negative and HBsAg negative, it is not really consistent with an occult HBV infection. You should investigate with your doctor other potential liver issues that it could be.

Also, as Andrew has mentioned, if you feel like your doctor isn’t taking your pain seriously and isn’t following up, it is worthwhile considering a second medical opinion from another doctor.

Hope this helps,
Thomas

#4

Dallas is a good sized community. Maybe not too many hepatitis b specialists, but I m sure tyere are enough doctors/hospitals/etc for liver issues.

Have you tried to seek out medical help?

#5

Thanks everyone for the warmth advice. For the past year or so I have been treated by the Dallas Methodist Liver Institute and following my last appoinment with the Hepatologist I was seeing, her nurse reached out to me and told me that, the Dr. said she will no longer be seeing me as my labs have repeatedly turned out negative. When I asked about investigating other potential liver issues or even performing a biopsy, she never reached back. I’m actively seeking other medical advice and worse case scenario, I will travel out of State. They say ‘a stitch in time saves nine.’ Thank you all for the wonderful advice and I pray God continue to strengthen us in all of our different battles…

#6

That’s insane a doctor will tell you he will no longer see you. Never heard of it before. How many times did you go there. People with hepatitis b, for me at least, go every 6 months. Did you go like every other week?

If your doctor is like that, I would go get a new doctor. A quick google search show many in Dallas area.

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#7

Again, @ngams, being in constant pain as mentioned in your first post is a worrying sign and if you are not able to see a gastro, it would be at least worth seeing a GP to get it sorted out (or get a referral to another specialist).

Thomas

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