Thank u so much @ThomasTu
What are the chances of virus mutation in this phase…??
Or it will stay like this for the rest of my life… !!
However recently my doctor suggested me liver accumulates fat to protect liver at times in HBV
Its does not sound reasonable. Any expert can relate ?
Dear @Guru777,
If you maintain daily treatment, this will prevent viral replication and therefore reduce the numbers of viral mutations.
Hope this helps,
Thomas
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Hi @sorte, I would agree with you that this does not sound accurate. Studies have actually shown that people with Hepatitis B are less likely to get fatty liver:
- https://www.journal-of-hepatology.eu/article/S0168-8278(11)00775-6/
- Hepatitis B virus infection and the risk of nonalcoholic fatty liver disease: a meta-analysis - PMC
Thomas
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Will chronic hbv petients go through all the phase…??
If yes… then Suppose if i am on inactive phase and on antiviral treatment …
What will be my next phase ??
reactivation phase or immune clerance phase ??
Hi @Guru777,
There’s no guarantee that people go through these 4 phases in the same order or even at all. On treatment, you are unlikely to proceed to reactivation or immune clearance phases.
Hope this helps,
Thomas
Thank u so much @ThomasTu …
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What will then kill some who does not through this four stages at all because hbv causes death as a must??
Secondly, what should one do to a void going through this four stages??
Thanks family
Dear @Opa,
Hepatitis B is a condition that is manageable: there is no guarantee that people will die of it or even live less because of it. Appropriate monitoring and taking medication when prescribed by your doctor can prevent a lot of the impacts of hepatitis B.
Thomas
Just found by coincidence, there is some unexpected corellation indeed https://www.taiwannews.com.tw/news/6035444
But I guess most of the people with fatty liver got some other condition(s) like diabetes or pre diabetes
Hi @ThomasTu
@availlant
@Bansah1
I am 36 male its been 1 year when i was diagnosis with chb… and i am on taf 25mg from past 1 year
My hbsag is 2800 iu/ml which is fluctuating … in past 1 year it was 2000 iu/ml then 1500 iu/ml and now its 2800 iu/ml… when i was first diagnosis it was 2800 iul/ml only and hbv dna was 800iu/ml
I am hbeag neg and anti hbv positive , latest fibro scere was 5.6kpa… fatty liver grade 1…
My concern was have i started treatment late , if yes then what are the chances of hcc in this case … i am assuming the i am chb carrier by birth only… coz i have a hepatitis b vaccination certiface whne i was 9 years old … but still i am positive for it… is their any other test that shows that how much my liver is damaged in past 35 years… before starting antiviral…
Hi @@Guru777,
I think HBV DNA is closely related to HCC than HBsAg quantitative. The higher ones viral load for a long period, the risk of liver damage and HCC increase as well.
Surface antigen quantitative doesn’t play a significant role in HCC compared to HBV DNA. If you remember the current antivirals work in lowering viral load and not necessarily HBsAg quantitative. For example, I have been on treatment since 2015 then my HBsAg quantitative was around 25000. After these years it has remained around that number. But HBV DNA has been undetectable all those years. In my case, I cannot stop my treatment anytime soon with such a higher quantitative number.
We can’t account for what happened in the past and there are no tests to look back. Your ongoing tests will be compared to your initial one as your base. As long as HBV DNA remains undetectable, your HCC chances remains low. All HBV patients have an increased risk for HCC, but we also know lower viral load reduces ones chances. Keep doing whatever you are doing and remian in care.
Best, Bansah1
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Dear @Guru777,
@Bansah1 is current about this. HCC risk is a cumulative effect dependent on the level of HBV replication and for how long it remained uncontrolled.
We do know that HCC rates are lowered in patients who started NUC therapy before 50 years of age I would think you can also expect a lower rate of HCC than an untreated patients.
Without knowing what your HBV DNA levels were before NUC therapy, it not possible to comment beyond this. I think you should not really worry about this. You are on a very effective therapy.
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What’s the difference between hbsAg QUANTITATIVE TEST and hbv DNA?
I have never done hbsag quantitative test ever since my diagnosis a part from hbv DNA.
Thank u @Bansah1 and @availlant for the rply…
My hbv dna was 890iu/ml when i was diagnosed in march 2024…
Hbeag was negative
Hbeab was positive
Hbsag quantative was 2800 iu/ ml
Fibro was 5.6kpa
And immediately after the diagnosis i started the treatment … its targent not detected now…!!
Hbsag is surface antigen and hbv dna is viral load…!! @Opa
Dear @Guru777 ,
This is very low HBV DNA (likely you had partial cure). So your HCC risk was lower before treatment. HBV DNA is not detected so everything is under good control.
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functional cure mean absence of hbsag…
What is partial cure???
Dear @Guru777 ,
Functional cure means complete immunological control of HBV infection. This includes complete inactivation of cccDNA (although it still remains in latent form) and no production of HBsAg by the liver (involving reduction or elimination of integrated HBV DNA). This outcome is the best possible result for a patient as they never have to take treatment for their infection, will not develop liver disease and have the lowest possible risk of developing HCC.
Partial cure (also historically called inactive HBV) occurs with the the immune system can control some but not all of the viral replication in the absence of therapy and there is no evidence of liver disease (normal ALT). These patients have a lower risk of HCC (but not as low as with functional cure) but are more likely to reactivate their replication to develop viral hepatitis.
Current guidelines do not recommend the starting of therapy in patients like this but your physician has been proactive in starting you on antiviral therapy in order to minimize your risk of getting liver cancer.
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Which of the two indects danger??
Secondly, is DNA test enough to follow the level of infection or one should perform both hbsag quantitative test and DNA test at once??