Need second opinion for diagnosis

Living With Hep B Treatment and Monitoring
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Hello everyone,

First of all, thank you for such a wonderful community. I would like to get a second opinion on my current treatment. This is my first post here, so if anything is incorrect, I apologize in advance.

I have hepatitis B and took tenofovir for eight years. In 2023, I was unable to get my medication on time and missed it for about one and a half months. After that, I started experiencing pain, and my urine color changed. I went to the hospital and was diagnosed with very high ALT (around 800) and AST levels.

Following this, my doctor recommended a one-year treatment of weekly Interferon injections. This treatment ended in July 2024, and my test results were only slightly above normal (e.g., AST: 14 and ALT: 15). Since then, I have been getting blood tests every two months, and my results have been gradually increasing.

Last week, I started experiencing whole-body itching, and my urine turned brown. I immediately went to the doctor for a blood test, and the results showed AST: 400 and ALT: 1200. I was shocked. My doctor immediately prescribed Vemlidy, and I have been taking it for two days now.

What are the risks in my case? How can I recover? What might have caused such a sharp increase? I am extremely worried, and Google searches are making me fear the worst.

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Dear @Lwin,

Welcome to the forum and thank you for sharing your story. Sorry to hear about your issues.

It is unclear in your case why you were not restarted on antiviral treatment when you had high ALTs. That said, it is common to have post-treatment ALT flares, which indicate your immune response is trying to clear the HBV-infected cells. Given the long-term elevation/inflammation and presumably non-clearance of HBV, you have been restarted on antivirals to lower the virus replication and prevent any more inflammation from happening. This should lower your ALT levels and reduce your symptoms fairly quickly.

Liver damage in these instances are seen when patients go of antiviral therapy, but can generally be reversible with appropriate management over time.

Hope this helps,
Thomas

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Dear @ThomasTu , Thank you so much for the response. Next week I have to go and do the blood test again. Hopefully, it come out with reduced levels. I am eating a healthy diet now. I don’t drink alcohol.

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That’s great, @Lwin. I wish you all the best with the upcoming results. Please keep us updated on how you’re progressing.

Thomas