I recently went to the doctor I once went to after 7 years. The doctor didn’t prescribe any medicine. My viral load is extremely high but LFT and ultrasound are normal. Seven years because I used to get tests done and monitor myself.
This time I went, and I regret going to the specialist. I don’t know why these specialist are so ignorant. I asked him about if any work on cure is going on. He said all trials have been done, there is no cure. I try to keep up with news etc and it seemed he is not aware of functional cure. I know it’s not ready yet, but the doctor should support and promote constructive news. I always feel miserable after going to the specialist.
He did not tell me about anything. Medicine, stages etc.
I’m just sharing with the community that I think there is no awareness and Knowledge upgrade among professionals in different countries. It seems they are all working based on old research.
I’m sorry to hear about this experience. Just curious, what type of doctor was this that you went to? In my personal experience, primary care, doctors know almost nothing about hepatitis B. They will recommend that you get the vaccine, and hopefully know the appropriate tests to order to screen for it, but most are not comfortable prescribing medication to treat it. Even some general gastroenterologists don’t know very much about treatment for hep B, and are probably not following developments in clinical research around functional cure.
My advice to you is to find a doctor who specializes in treating liver disease, and who has experience with hepatitis B in particular. I know this may be easier said than done, depending on what country you live in, or if you live in a rural versus urban area.
My initial heptatogist liver specialist for 2 years left my hospital and transferred care to another liver specialist. There seems to be high turnover of doctors at this major hospital or in general. I asked new doctor about any updates on hepb functional cures that was fast tracked by FDA. His response was if there were any that were fast tracked by FDA there should be cure by now and he wasn’t aware of any at the moment. I knew he wasn’t up to date on the latest developments on hepb. One that was on my mind was Bepirovirsen which I read about being fast tracked. I suppose if the doctors aren’t up to date in this topic we need to be and keep bringing it up so they are aware of it.
I certainly understand your frustration, and there is no excuse for a hepatologist not to know the standard HBV treatments and not to have at least a vague understanding of the efforts that are ongoing to improve HBV care.
In my (non-patient) experience dealing with my University hepatology colleagues and teaching HBV to medical students for >25 years, I found that many of them feel HBV to be extremely complicated. It also does not help that (in my opinion) the international treatment guidelines are excessively complex. That leads a small minority of the hepatologists to be reluctant to engage fully with the state of the field, and you appear to have encountered one of them.
You may wish to seek another physician for your HBV care. It is very important that a patient have full confidence in her/his caregivers.
This unfortunate experience highlights the need for the HepB Community where you can get accurate and up to date information from other people living with HBV, HBV physicians and other caregivers, and HBV researchers.
So sorry to hear about your experiences @Hf334. Indeed, I myself have had many instances where I have had to explain what lab results mean to clinicians who do not specialise in the condition - this includes some people working in gastroenterology units. As a patient, it is difficult to not only stay up to date with the ongoing research and complexities of your own condition, but also advocate for yourself.
these are results. All the tests were done in January. I am not on any medication.
My LFT from year 2024 was as below. I used to do tests once every year and lft was in normal range. However I feel this time SGOT is little higher. 2025 was a stressful year. I don’t know. I don’t eat junk food eat fruits and vegetables and no other bad habits. Everytime I go to doctor, they say same thing so I stopped going. I was infected as child or baby. My mom doesn’t have it. God knows how this happened to me.
Thanks for sharing your results. The combined blood tests and fibroscan tests are consistent with the “immune tolerant” phase. This is reflected by your high HBV DNA levels and HBeAb-negative results, as well as your normal liver ultrasound.
It is important to maintain monitoring: yes, this can be stable for many years, but people generally go into immune active phase sometime in their 20s-40s, which involves liver inflammation. It may be important to make sure you know when this happens as hep B can cause liver damage in this phase, but without any obvious symptoms - a blood test is sometimes the only way you’ll know. In these cases, the liver damage can be prevented with antiviral medication.
Agree with @ThomasTu ! Definitely important to know when you’re transitioning from immune tolerant to immune active. No one can say when this will happen, whether it will be next year, or 10 years from now, but if you do have symptoms, the things to look out for are very similar to symptoms of acute hepatitis (fatigue, loss of appetite, nausea, jaundice, and possibly upper right abdominal pain). If you notice these signs, don’t panic, but do go in for some blood tests. If you can’t get in with your liver specialist right away, I would advise going to a GP/family doctor, and asking them to run a comprehensive metabolic panel, and some blood counts. These are very common tests that they would be used to ordering for people. If the results are abnormal, typically your liver specialist should be able to make time to see you sooner than your next visit.
As Thomas said, there are antiviral medications that can help in this situation. It’s just one pill per day, and you really do get used to it. The medications are generally well-tolerated with minimal to no side effects.
