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Do I need Hepatitis B treatment...

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Posted 11/22/2017 1:21 AM (GMT 0)
Hi All,

I am 33 year old male and new to the forum hence will start with Hello!!!!.. I need help/suggestions on the recent visit and discussion I had with my doctor on my test results and treatment he suggested.

I have been diagnosed with hep B in 2008 since then I have been keeping an eye on viral load and ALT. Below are my recent test results:

1. HBsAg Screen: Positive

2. HBeAG: Negative

3. HBeAB: Positive

4. HBV Load: 3530 IU/mL (Log 3.548)

5. Liver Ultrasound: Normal

6. Liver Biopsy: Grade 2 out of 4 Stage 1 out of 4

7. ALT (SGPT): 29 IU/L (Normal Range- 0-44)

8. AST (SGOT) : 21 IU/L (Normal Range 0-40)

After looking at the result my doctor is suggesting to start treatment by taking viread (tenofovir tablet 300 mg).

I am little concerned about starting the treatment as it is way costly. I am not sure if treatment is right choice at this moment. Kindly suggest if I shall look for second option before deciding on medication or shall I start the it.

Thanks in advance for all your help..
Posted 11/22/2017 3:12 AM (GMT 0)
hi adi1984 and welcome,
I would follow your drs advice. you have become active.. If you are seeing a liver specialist, i would give it a try. We have one member who did the tenofovir clinical trial. i will bump it up for you to look at. your situations are somewhat similar. you will see bloodwork for every 3 months ans the improvements from treatment. let me know what you think.
Posted 11/22/2017 3:17 AM (GMT 0)
I put it right above your thread. if you decide on treatment, your drs team may be able to help you get help with the cost
Posted 11/25/2017 4:57 AM (GMT 0)
Thank you so much for the advice ... I will see if there are any options for clinical trials here at my place before that I am thinking to go for second opinion and see what he is suggesting. I will start VIREAD if in case he also suggest that.... I am surprised to see why my liver biopsy is showing Grade 2 out of 4 and Stage 1 out of 4. I monitored by liver profile frequently and all values including ALT and AST have been in normal range. Not sure if it is because of bilirubin as it is as recent lab work shows Bilirubin Total 0.9 (normal range 0-1.2)... Thanks again for inputs and suggestions.
Posted 11/26/2017 7:50 PM (GMT 0)
I noticed that also. Need to see your testing history. And dates of biopsy and your recent blood work and ultrasound.
Posted 11/28/2017 5:25 PM (GMT 0)
I had the ultrasound 15 days back and biopsy on oct 17, 2017. Doc says ultrasound is good no issues detected in it. He than asked me to go for biopsy which turn that I am in Grade 2 out of 4 and Stage 1 out of 4. My HBV Load: 3530 IU/mL (Log 3.548) this test was done this month as well. Bilirubin Total was 0.9 (normal range 0-1.2). AST (SGOT): 21 normal range (0 - 40) and ALT (SGPT) : 29 normal range 0-40.

I was diagnosed back in 2008.
Posted 11/29/2017 1:21 AM (GMT 0)
That helps!!!
Your biopsy shows grade 2 inflamation, and your stage 1 is your fibrosis level. ( liver damage)..

One month later your liver enzymes( liver inflamation) is normal and your ultrasound is normal. You may have been in a chronic flare.

I would ask your dr to monitor your viral load, to see if your virus is replicating.. you mentioned that you have been monitoring your viral load for a while.. if your viral load fluctuates to levels such as now or higher. I would consider treatment. Are you seeing a liver specialist.

In 8 years you have minimal fibrosis.. Ask your dr why he would consider treatment. Let me know what happens. Good luck Adi
Posted 12/8/2017 8:34 AM (GMT 0)
Hi I would like to see the response to your post above ppm guy. The doctor is starting to insist on treatment for me. Last bloods taken all was normal except for viral load (naturally)which wasn't massive, can't remember off hand what it was. Above 1 million though.
I go to see her again in March for fibrosis scan. But I haven't seen her for a year, she didn't require me to.

I saw somewhere a while ago now, a medical conference in Europe where someone was saying there is evidence that these new drugs may cause cancer. I am apprehensive to partake as there is no long term evidence that it does or does not.
Posted 12/8/2017 7:31 PM (GMT 0)
Hi Bilalovina and welcome,
I would follow your drs advice.. Can you look at your viral load again. 1 million viral load is quite high, for having normal bloodwork. Definitely get your fibroscan.

Treatments for viral hepatitis are powerful drugs. Hep b and c drugs are used to stop progression, that can lead to transplants, cancer, and death. It comes down to risk vs reward.

Most people that post here have improved or cured there viral hepatitis. Im in that category my self. I cured my hep c and alcoholic hep, with sobriety and antiviral treatment. My dr checks me regularly for adverse problems that could come from treatment. I have had skin cancers, and Afib problems after treatment. But im alive, hep free, cancer free(now) and I have a pacemaker to regulate my heart.
Most patients don't have these problems, and go on to live normal lives. The sooner you treat, the better the outcome. I had cirrhosis when I cured my hep. im very lucky
Posted 7/14/2018 8:12 PM (GMT 0)
Hi All,

Update: I went for second opinion on starting antiviral treatment, Doctor monitored me for 9 months before deciding on treatment. My ALT, AST and rest of liver enzyme were within normal range except viral load went up. Below are the last 9 months results:

HBV Load: 3530 IU/mL (Nov-2017), 2,580 (Jan-2018), 4,800 (April-2018), 14,500 (June-2018).

ALT (SGPT):29 IU/L (Nov -2017), 35 (Jan-2018), 29 (May-2018), 42 (June-2018) - (Normal Range 0-44).

AST (SGOT) :21 IU/L (Nov-2017), 27 (Jan-2018), 23 (May-2018), 32 (June- 2018)- (Normal Range 0-40).

Looking at the viral load and slight increase in liver enzyme, Dr suggested to start antiviral treatment. I have started taking Enticavir .5 mg daily. Dr is afraid that I will have to live on the treatment for life. Hope medicine would not have any drug resistance. Hoping a brighter future in term of functional cure sad . Will keep tread updated on progress.
Posted 7/15/2018 2:56 AM (GMT 0)
Look forward to seeing that viral load come down
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