High AFP after acute hepatitis b

Hello, First I want to make my apologies if my English is bad. I am an Asian 23M who was diagnosed with hepatitis b in February 2023. After taking TDF for 10 months, my GP order me to re test the hepatitis b (B combo) and the results came back as negative Hbsag (non-reactive), Hbeag(Non-reactive) etc. Then, I did test Hbsag ii quant and the result was <0.05. Everything was fine but I got high AFP which is 6.3iu/ml. I am so terrified and my hands were shaking when I saw that result. I thought that I have a cancer or something :sob:. After deep researching, one place said it could be regeneration of liver after a huge damage from hepatitis. Could it be that or prediction of cancer? I really have no idea why everything is not easy for me. I currently facing depression and health anxiety and can’t even perform my daily activity well.

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Dear @Khant ,

Its good to see you back on the forum!

First congratulations on your very excellent response to therapy. It looks like you have cleared HBsAg (quant HBsAg < 0.05 IU/mL). This is a strong indicator that you may have achieved functional cure. Current guidelines indicate that TDF can be stopped with two consecutive HBsAg < 0.05 IU/mL spaced 6 months apart. I assume your HBV DNA result is “target not detected”. It would be useful to know if you have HBsAb yet.

Second, there is nothing concerning about your AFP result. I am not sure what units your AFP test result is in but this is largely irrelevant since 1ng/mL AFP = 0.83 IU/mL AFP (the two units used to report this test result). The reference range for AFP in healthy persons is 0-5.8 IU/mL so your AFP is only MARGINALLY outside the normal range but not really high and most likely due to liver healing following your successful response to antiviral therapy. Liver cancer is only suspected when AFP is > 25 IU/mL.

You should have another follow-up with your hepatologist 6 months after your last HBsAg result and if it is still negative (you should also have HBsAb as well), you can discuss discontinuation.

Please relax! From the information you have provided, everything looks very good!

@availlant

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@availlant

Thank your very much for your kindly response sir. It makes me relieved. Sorry for my unclear statement about AFP unit. My AFP measured unit is IU/ml. HbsAb is still non-reactive. Appointment with my hepatologist is next Tuesday and I hope her insight will also be positive like yours.

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@availlant
I have just completed my appointment with my hepatologist today. She mentioned that all the results are very good and instructed me to take TDF for the next six months. She will decide whether to continue my treatment afterward. Everything is as you said. Thank you so much, sir.

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@Khant

You are very welcome!

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