I’ve never gotten a viral load test done before that I know of (perhaps doctors have tested me in the past but I was unaware). I believe the viral load is at the bottom. How serious is my viral load? Is it high?
My Dr. wanted me to come in & review the results (I had other blood work done too, not just for Hep B so idk if he wants me to come in for these Hep B results or something else) but idk when I’ll be able to go in bc of my work schedule plus impending work travels and I’m very, very anxious to know.
I know I have Hep B / am a carrier but that my liver is normal (ALT levels of 33 as of this most recent blood work from below and an abdominal exam in Aug showed a healthy liver) but idk much else other than that so hoping this will tell me more.
Hi @ThomasTu@HealthExperts@ScienceExperts is anyone able to provide some insight into my viral load count? This is my first time getting it tested, that I know of. Perhaps when I was younger doctors tested me but I was unaware. The Viral load appears to be at the bottom - Is it high? How concerned should I be? I’m not sure why there are 2 different values and I was unsure how to interpret the results
Hi @PLampertico thanks for the insight. What’s the difference between the 2 values they gave me? (49 H IU/ml and 1.69 H Log IU/mL) I got concerned when I saw the 49 because I read online that anything > 10 IU/mL is considered high, but it seems I interpreted it wrong.
The two numbers are the same - just a different way of expressing them. As @PLampertico stated this is a very very low level. We generally start thinking about treatment when level is >2000 IU/mL.
@simone.strasser OK thanks for letting me know. I was concerned at first because I was misinterpreting what I was seeing online. This is refreshing to hear, I was hoping it would say undectable, but I’ll take these very, very low levels too and start to more regularly monitor since it’s, admittedly, not something I was doing in the past.
Do these low levels decrease rise of transmission?
Hi @ThomasTu thanks for the input - is it generally recommended that people w/ my levels take meds? I’m curious if my Dr. will prescribe any? Granted, my primary physician is the one I’ll be discussing the results with…he’ll probably send me over to a specialist.
Also, is there anything I can do to make sure my levels stay low and don’t increase?
As mentioned by Professor Strasser above, treatment is generally considered only when viral loads are above 2000 (unless you have obvious, severe liver damage - in which case you would be recommended treatment).
There is no proven and consistent silver bullet way to maintain low levels, but liver (as well as general) health is improved by a balanced diet, appropriate exercise, and sleeping well.
@ThomasTu Thank you! I forgot Prof. Strasser’s comment above. I got a chance to squeeze in a visit with my primary care provider yesterday, and he said the same thing. At first I thought maybe I should see a specialist, but after getting a chance to chat with my primary doc and seeing everyone’s reassuring comments here, I feel like I’m safe to forego seeing a specialist unless anything gets worse. He just recommended getting rechecked every 6-12 months to compare, I’ll probably just get checked yearly during my normal annual bloodwork where I test for the typical stuff.
Are low Absolute Neutrophil counts associated with Hep B? I noticed mine are quite low but my doc didn’t mention anything about them, and I forgot to ask if there’s a correlation.
This is a relatively low HBV DNA result. However, HBV DNA is only one of the tests you should have to understand your HBV infection and if you have viral hepatitis. Other tests which are important include measures of liver inflammation (ALT) and liver function (bilirubin, albumin and INR). All of these results will be considered by your physician in their decision to start antiviral therapy or not.
@availlant Andrew, reading the posts in this topic I have a question and I would be grateful if you could help me:
Is it possible to have a liver infection without changes in ALT?
I had two contrast-enhanced MRIs that showed iron concentration, but liver rates were normal. only slightly altered ferritin and ALT and the increase in viremia made my doctor decide to biopsy my liver.
One of the challenges we face with getting everyone with HBV infection diagnosed and given access to care is that HBV infection can persistent silently for many years before evidence of its existence is discovered. Even with normal blood work these individuals can have normal ALT test results. Very often diagnosis only occurs after someone does not feel well and then blood work returns an elevated ALT result - which leads to testing to confirm (or exclude) HBV infection as the potential cause.
Can there be severe liver damage without changes in enzymes?
Can there be an increase in viremia (above 2.000 UI/ml, which is the indication for treatment) without changes in ALT, for example?
This was the question I had with my doctor. My hbv dna is 20.000 but I do not have altered liver enzymes. If there is liver damage, would it be best to modify the treatment protocol?
In patients with HBV DNA < 20,000 IU/mL, current treatment guidelines recommend starting treatment only if ALT is elevated. These guidelines are rather complex and vary slightly between regions:
Note that in China, treatment is now recommended for any person with detectable HBV DNA.
Yes HBV DNA can be above 2000 IU/mL with normal ALT.
The issue regarding these guidelines is that they focus on treating liver disease when it appears and do not consider the potential for liver cancer. Liver cancer is driven by HBV DNA integration events into host chromosomes. These events are progressive and cumulative throughout the duration of HBV infection if replication is not suppressed (even if no liver disease is present). This is the underlying principle behind the newer Chinese guidelines - to have the greatest possible impact on reducing liver cancer rates by suppressing HBV replication as soon as it is detected, regardless if liver disease is present or not.
I have done my profile test which my hbeag is positive. This viral load result is after 8months of taking tenofovir.im just concerned about my recent ultrasound. Is everything okay??
I expect that your HBV DNA result was significantly higher before taking TDF. You can expect your future HBV DNA results to continue to fall as the TDF therapy continues its work.
The terms “starry sign” and “demonstration of the portal vein radicle walls” in your liver ultrasound report are older terms used to describe particular patterns of ultrasound imaging of the liver which are typically associated with acute hepatitis (inflammation). However, these terms are less frequently used in modern ultrasound reporting as they are not considered a highly specific or accurate predictor of liver inflammation.
The most likely situation is that your liver was inflamed (from HBV infection) prior to starting therapy and still containss residual inflammation. Sometimes this process reverses itself only very slowly. Another blood test for the liver enzyme ALT is useful in monitoring liver inflammation. This rest should be done alongside your other evaluations.
There is nothing alarming in your current ultrasound finding (given the fairly recent introduction of TDF). Please remember to discuss these issues and your concerns with your physician at your next visit.
Thank you for your replies. What does decreased echogenetic of the liver mean? I mostly feel burning sensation around my liver most times . I’m worried.
