Has anyone taking this lab work while on antiviral medication? I heard Dr. Gish (liver specialist) said it is very useful to predict HCC risk. That is very scary to find out I think. Any thoughts? My lab results always mention positive and not the quantitative level. I am planning to request this lab from my GI but I am very nervous to find out. My history is chronic hep b for I think 20 years plus. Not sure where did I get it from but not from my parents. I have been monitored for years. Until 2020, my fibroscan shows I had fibrosis stage 2. I was on Entecavir 0.5mg since March 2020.
It’s great you have found us. And I’m sorry you are feeling scared.
Recommendation is six monthly blood work and ultrasound to monitor what the virus is doing whether you are on medication or not.
It is better to know so the doctors can intervene if they need to.
That way they have a chance to stop further damage.
I have been on Entecavir for years and get bloodwork and ultrasound every six mouths. My DNA is undectable.
It seems like you are under a doctor who would be doing all the necessary tests. Maybe he’s not explaining them to you.
What test are you refering to?
Maybe others can help too. @Bansah1@john.tavis
Not sure what country you live in, but I’ve noticed that not many doctors test quantitative surface antigen in the United States. I’m not sure how well surface antigen levels correlate with HCC risk, but it does indicate how well your immune system is controlling the virus. I would recommend getting your levels checked. I think the test will become more common with new therapies like bepirovirsen coming to market, because the trials have shown that success rates of such treatments are heavily dependent on surface antigen levels.
I am also sorry to hear that you are worried about HCC. That is quite natural, but the good news is that you seem to be receiving good care for your infection.
Quantitative HBsAg tests are most commonly used during clinical studies to measure progress towards a functional cure and to help interpret the results of the studies. They are not usually done in the USA as part of regular monitoring, but they appear to be more common in Europe. I don’t know how often they are used elsewhere.
HBs levels do appear to be correlated with HCC risk (see the free pub med central article PMCID: PMC6852811). From my understanding of the virus, that reflects the sum of HBs from ongoing viral replication (making HBs from the cccDNA) and HBs made from the HBV DNA integrated into the liver cells’ DNA. In short, the association is that more virus and viral activity in the liver causes greater risk. HBs is just the most convenient tool for measuring this long-understood risk.
I encourage you to discuss your worries with your care team. They will understand your concerns and help you to manage your fears and your risk of HCC. There are things they can do to help reduce your risk of HCC if they find you are in a higher risk category, such as increasing the frequency of monitoring for HCC. That’s really valuable because outcomes for all cancers are better the earlier they are caught.