As @Bansah1 has mentioned here, yes, the virus is still present in your liver as you are HBsAg positive. It is best to maintain monitoring (even if you don’t feel symptoms) to make sure that your liver health is not getting worse. And if it is, then you can manage it with medications.
Hope this helps,
Thomas
Thanks for your attention, @ThomasTu and @Bansah1.
That’s my big fear: of developing liver damage without changing my enzyme levels. This is my anguish since I crossed the 2000 hbv dna marker. my rates remain normal, the result of my MRI with contrast (elastography) in January/2024 showed only mild ferric overload, my biopsy showed mild inflammation and mild a1f1 fibrosis.
In my country, it is not possible to carry out the treatment privately. it is monopolized by the state that grants the medicines based on the protocol. As I am a carrier of a mutant virus, the protocol indicates treatment for hbv dna > 2,000, however it requires proof of liver damage with ALT 2x the normal value or F2 fibrosis (which I still don’t have, I don’t know if for good or for bad).
My anguish is this: waiting for more serious liver damage to be able to treat it 
What gives me relief is that for now I am ruling out the possibility of another complication (HDV) in addition to the ones I already have.
but this is what we have, let’s fight, let’s follow. hug
Oh wow, that’s interesting and sorry to hear that. I empathize with you and I understand your concern. I hope your country can change that policy because it does not make much sense. Their standard is not in line with the other international ones out there. At least you are keeping up with your care so that is good. Hopefully, things changes soon. Thanks, Bansah1.
I really appreciate your attention, friend @Bansah1 .
in fact, we always have to try to look at things from the best side. The monopoly on treatment in Brazil prevents me from starting now, on the other hand, once started the medication is completely free. and, by the grace of God, I have been able to see a good hepatologist and undergo regular tests. As I said, look on the positive side, pray and live.
I wish you the best. fraternal hug
Dear @La.sciamachie,
Thanks for bringing this up and it’s great that HDV has been ruled out.
Just to let you know, the WHO has recently launched their new guidelines for HBV care and treatment (I was there at the launch in Japan, so I’ve been away for a bit). These can be accessed here: Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection. They now include some additional provisions for the issues you are raising in the key remarks of chapter 5:
There may also be individual circumstances in which, although individuals may not meet any of the four options for treatment eligibility, there are specific individual concerns regarding infectivity, transmission, associated stigma, the risk of oncogenicity and progressive liver fibrosis and a strong individual motivation to consider treatment, despite the lack of direct evidence. In such cases, a patient-centred approach with discussion between individuals and their health-care provider will be key in helping them make informed decisions about whether to begin treatment or not.
Hopefully you can find a health care provider who will allow treatment along these guidelines.
TT
Thank you very much for the excellent news Dr. @ThomasTu !
I will soon see my hepatologist again and I will discuss this new treatment possibility with him. I hope that with this guideline I can finally receive treatment.
