Hello. I was diagnosed with chronic hepatitis b during pregnancy. My family has a history of hepatitis b and close family members whom i lived with also have CHB, so I’m probably a carrier since birth or very young. Back in September, during my first trimester, i had a viral load of 21 million. Now not even 3 months later, my viral load is 38 million. I was advised to start Tenofovir in my 28th week, but I’ve read research indicating that starting Tenofovir in the second trimester (or late second trimester) is safe and could achieve better viral load suppression
I’m really concerned about liver damage and the stress that this is causing me. Would it be ill-advised for me to speak to my doctor about starting the medication now? Also, is it concerning that my viral load has increased so much in such short period of time? All my liver enzymes are normal and a liver ultrasound i had back in October indicated everything was normal with my liver and surrounding organs.
Hi @optimisticmama,
I hear you. Your numbers are concerning and I agree with you worrying about liver damage.
Find here the guidelines addressing HBV, pregnancy and treatments etc. shared recently. I hope you can bring this to your doctor and discuss this matter further. Keep us posted. Bansah1
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Dear @optimisticmama,
Congratulations on your upcoming motherhood. The medical advice you are getting is consistent with the recommended practice as outlined in the reference materials that @Bansah1 has posted.
The increase from 21 million to 38 million isn’t really considered clinically significant. What’s more is that it is expected: during pregnancy your body undergoes a lot of changes, including having a reduced immune system - this ensures that the mother’s immune system doesn’t start attacking the baby. We do know of post-partum flares, which are caused by the immune system waking up again after the birth and attacking the HBV-infected liver cells.
That said, if you feel that you would benefit from antiviral therapy now (e.g., that it would ease your anxiety), it would be worth discussing it with your provider.
Hope this helps,
Thomas
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This is such useful information to have. I’m in the process of switching my liver specialist because my current one has provided absolutely no information about my condition, which led me to reading medical journals and research online on my own. Your explanation not only soothe my anxiety regarding my current problem, but you also provided useful info for what I should be expecting for postpartum. I really appreciate it.
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