1 week earlier i was diagnosed hbsag positive and hbeag negative. My age 41year hight 170cm weight 71kg
My viral load is 5000iu/ml, sgpt 97 sgot 62, fibroscan 5.4 kpa cap 284, usg liver size 12.5cm with fatty liver grade 2. I was heavily drink alcohol 4 to 5 time in a month and eat a lot of oily diet.
My doc not start antiviral tharepy and hold me observation for 3 month with fatty liver medicine like ursodeoxycholic acid 300mg, spotaglitazar 4mg with low fat, zero sugar mediterian diet with regular brisk walking 5 to 6 km.
Its ok or need immediate antiviral. Can my immunity concour the virus to inactive again? Its my first time screening, i was not aware till screening about hep b positive. Need advice
Hello @HepWarrier, welcome to the community. Your liver enzymes are certainly elevated, and on paper, you would meet the criteria for treatment. The caveat is that it’s hard to say whether it’s the alcohol, or hep B that is causing the elevated liver enzymes.
I’m not a doctor, but I do believe that quitting alcohol is the most important lifestyle change that you can make for your liver health. Your liver enzymes are not at dangerous levels, so I understand why your doctor wants to hold off and address some of the other issues first.
Hi @HepWarrier ,
Welcome to the community. I agree with @et5656’s assessment. Viral load can fluctuate during flare-ups. If the flare-ups are controlled, yes, they can go down. If the drinking is the problem, then you should see some changes in your lab results the next time since you stopped consuming alcohol. Hepatitis B and alcohol are not a good combination for the liver. I am glad you stopped drinking. With time, hopefully your liver can recover. Keep us updated. Bansah1
Hi @HepWarrier welcome! I think your doctor’s plan sounds reasonable for now, especially because this is your first test.
your ALT/SGPT and AST/SGOT are elevated, which means your liver is under stress. your CAP 284 and fatty liver grade 2 suggest moderate fatty liver, which may also contribute to your elevated SGPT/SGOT. But your FibroScan 5.4 kPa looks reassuring, as it does not suggest significant fibrosis at this point.
The most important thing now is: no alcohol at all, keep the low-fat/low-sugar diet, lose some weight if possible and repeat HBsAg, ALT, AST, HBV DNA and ultrasound in 2–3 months.
If ALT stays high and HBV DNA remains above 2,000, you can discuss antiviral treatment again with your doctor or see a liver specialist.
Well the liver enzymes are lower than your last set of labs which is a positive sign. I would keep doing what you’re doing and hope they continue to go down. If not, it would be a good idea to discuss treatment in a few months.
