Just diagnosed, confused, depressed, and looking for answers

Just diagnosed or new to the community
1

Hello and welcome, thank you for creating this community, it truly has helped me understand the scale of hep b,

about myself im a 33 year old male from the MENA region, i did bloodwork’s last week with the usual std checks and noticed i haven’t checked for Hep b since last april, and as you might expect it came back positive, here are my results:

ALT 32 U/L
AST 24 U/L
ALP 84 U/L
Total serum Bilirubin 1.3 mg/dl
Direct Bilirubin 0.186 mg/dl
Indirect Bilirubin 1.11 mg/dl
HBsAg 15.41 COI ( >1 = Positive)

the last check up i did for hep b was in april last year and it came back negative, so #1 i have no idea when i contacted it, because i only had two sexual partners during that period and both tested back as negative and are vaccinated, #2 i’d like to believe i am in the acute phase and im part of the 90%-95% of individuals who reach a ‘functional’ cure.

i have told my close family and friends and people who i interact with, for some reason everyone is vaccinated except myself, and i received the usual stigmatizing response as anyone but i will deal with that later.

i went to my doctor to do more tests and i did an ultra sound for the liver, which came back to be have mild enlargement CC measured at 16.9 cm , normal outline & texture, normal Parenchymal echogenicity , hepato-renal index at 0.99, no fatty liver changes, no focal lesion, portal vein is of normal diameter

and did a pcr test to measure viral load for Hep b&c incase for cross infection (my std panel showed negative, HIV, and HCV), the pcr result should come back next week

i browsed the forum and got plenty of answers (thank you all) but would still want to learn more, assuming (hoping) im in the acute phase:

#1 is the 90%-95% ‘functional cure’ thing real? because my doctor said there was no such thing as acute/chronic hep b, all hep b is chronic and you have to medicate it for the rest of your life, because from what i read after the 6 month markup (which i still don’t know the exposure date) i was hoping i would get rid of the virus and only do 3 months check ups to see if i need an intervention

#2 in terms of lifestyle changes, i already don’t drink much and cut that out completely, reducing my smoking and with the current plan i should cut out cigarettes in a week, my diet is now whole grains, chicken and fish all cooked without oil in a pressure cooker, green juices, turmeric, ginger, my main concern is with working out, my doctor advised that i cut out the gym completely aside from cardio, i have some muscles and i don’t mind cutting back a bit but not entirely, is it true i can’t workout any longer

#3 i take supplements in terms of multivitamins, b complex, d3-k2, magnesium, pro biotics, omega 3-6-9, milk thistle, and now the doctor advised i take another ‘forte’ milk thistle supplement, i cut out protein powder and creatine, is that ok or are protein powder and creatine not harmful for the liver?

#4 as i said i do not know the exposure date and im not sure if im the first or final stages of the hopefully ‘acute’ phase, i haven’t experienced major side effects aside from fatigue, but i already have a cold so i hope it’s that, but i want to do anything possible to avoid or prevent jaundice, as i can’t cope with the stigma of it, are there any ways to help with that?

#5 i am currently taking ozempic, 0.5 every two weeks, i know it doesn’t work on the liver, but i just want to be safe, my concern for cutting it out, is that im afraid i will have blood sugar spikes that will affect recovery, is that reasonable?

#6 in terms of antivirals, i know they do not work on the acute phase (again i don’t know if im in this phase) but is it possible to take just to help even a little bit?

#7 in terms of future tests, i see people posted to do tests every 3 months, and at the same time seeing fluctuations in liver functions happen over the course of a week, is it reasonable to keep doing the tests every week or two weeks?

i’ve also posted this as reply in another discussion because i wasn’t able to write a thread

thank you for going through this thread, this community truly is a godsend : )

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Dear @Daylen ,

See replies to your questions below.

#1 is the 90%-95% ‘functional cure’ thing real? because my doctor said there was no such thing as acute/chronic hep b, all hep b is chronic and you have to medicate it for the rest of your life, because from what i read after the 6 month markup (which i still don’t know the exposure date) i was hoping i would get rid of the virus and only do 3 months check ups to see if i need an intervention

80% of people who are initially infected with HBV (acute HBV) self resolve their infection without therapy (they achieve functional cure on their own). We do a test called HBV core antigen IgM antibody to see when someone has acute infection. Generally when infection becomes chronic after 6 months, this specific form of antibody disappears. Of the 300 million or so who have developed chronic infection over the years, antiviral medication is required to suppress viral replication and prevent the progression of liver liver disease.

#2 in terms of lifestyle changes, i already don’t drink much and cut that out completely, reducing my smoking and with the current plan i should cut out cigarettes in a week, my diet is now whole grains, chicken and fish all cooked without oil in a pressure cooker, green juices, turmeric, ginger, my main concern is with working out, my doctor advised that i cut out the gym completely aside from cardio, i have some muscles and i don’t mind cutting back a bit but not entirely, is it true i can’t workout any longer

Everything you are doing here is fine and you can still workout.

#3 i take supplements in terms of multivitamins, b complex, d3-k2, magnesium, pro biotics, omega 3-6-9, milk thistle, and now the doctor advised i take another ‘forte’ milk thistle supplement, i cut out protein powder and creatine, is that ok or are protein powder and creatine not harmful for the liver?

Too much protein in you diet can be harder on your liver but if is reasonable (this seems to be the case here) there is no real issue as long as you done forget to include carbohydrates in your diet. Milk thistle (and its main active component, silymarin) do have any definitively proved activity against HBV infection. Its much better to take one of the approved antivirals in this case.

#4 as i said i do not know the exposure date and im not sure if im the first or final stages of the hopefully ‘acute’ phase, i haven’t experienced major side effects aside from fatigue, but i already have a cold so i hope it’s that, but i want to do anything possible to avoid or prevent jaundice, as i can’t cope with the stigma of it, are there any ways to help with that?

You need to have your viral load (HBV DNA assessed) to determine how active your viral infection is (this cannot be determined from any (HBsAg test). From there your doctor can better decide if you need to start therapy. This is the best way to prevent the development of liver disease.

#5 i am currently taking ozempic, 0.5 every two weeks, i know it doesn’t work on the liver, but i just want to be safe, my concern for cutting it out, is that im afraid i will have blood sugar spikes that will affect recovery, is that reasonable?

You should not stop taking any existing medications without consulting your doctor first. There is current no known issue with taking this kind of medication for people with HBV (or how are also taking antiviral therapy for HBV).

#6 in terms of antivirals, i know they do not work on the acute phase (again i don’t know if im in this phase) but is it possible to take just to help even a little bit?

Approved antivirals are indeed effective during the acute phase as they control viral replication. In cases where acute infection causes liver function uses, these antivirals are used to control / r verse these symptoms.

#7 in terms of future tests, i see people posted to do tests every 3 months, and at the same time seeing fluctuations in liver functions happen over the course of a week, is it reasonable to keep doing the tests every week or two weeks?

You should have your HBV DNA and liver function tests done every 6 months.

@availlant

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