Increasing HbsAb and better ultrasound along with increasing Glucose

I am 45 and diagnosed with HBV 10 years ago, probably having it since birth. I have been on Entecavir for the last 10 years.

  1. The HBV viral load has been TND since I started the treatment.

  2. HbsAb was also insignificant but this time its increasing,

    01/2013 <1.0
    10/2013 <1.0
    1/2014 <1.0
    7/2014 <3.1
    1/2015 <3.1
    7/2015 <3.1
    1/2016 <3.1
    12/2020 0.7
    5/2021 0.8
    4/2022 4.3

  3. Ultrasound was always - “The liver shows coarse echotexture and diffuse increased echogenicity”, this time its - “Echotexture is normal. Surface is smooth”

I noticed more than 5% weight loss without any lifestyle changes and was always feeling hungry, hence blood work and Glucose came very high - 350, so was diagnosed with diabetes.

I am guessing that diabetes caused my body to burn all the fat in my liver and hence it shows a smooth surface on ultrasound. At the same time HbsAb increased to 4.3, not sure what is causing what. Even though HbsAab is still not at where it should be, should I feel happy about the fact that it’s increasing? or am I reading too much into it?

Any thoughts?

My doctor immediately started me on metformin which hopefully should keep diabetes in control…

Dear @hepb_user,

Thanks for your question and it’s great to hear that both your viral load is undetectable, your HBsAb is coming up, and your liver texture is normal. This is great and looks like you’ve cleared the chronic infection without detectable liver damage, it is definitely something to feel happy about.

Regarding the diabetes, that’s not usually how things go. Diabetes is generally associated with fatty liver disease. The coarse ultrasound is usually a marker of liver fibrosis, not liver fat. You should talk to a doctor specialising in diabetes to provide you with advice on it.

Hope this helps,

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