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Suggest Treatment For Chronic Hepatitis-B
Question: my Friend age 36 male - underwent routine test and in same Hepatitis B surface antigen test came positive on 6 XXXXXXX 2017 . But repeat Test was done on 18 XXXXXXX 2017 . ie HBEAG and Anti HCV was negative . Kindly advise - whether this is final test . whether he is Hepatitis B negative . what is the future risk ,complications and any further test investigations required to completely rule out the chances .
Brief Answer:
having chronic hepatitis B.
Detailed Answer:
Hello,
Thanks for query.
Hepatitis B surface antigen (HBsAg is a protein on the surface of hepatitis B virus it can be detected in high levels in serum during acute or chronic hepatitis B virus infection. The presence of HBsAg indicates that the person is infectious.
A "positive" or "reactive" HBsAg test result means that the person is infected with hepatitis B. This test can detect the actual presence of the hepatitis B virus (called the “surface antigen”) in your blood.
HBeAg stands for hepatitis B e-antigen. This antigen is a protein from the hepatitis B virus that circulates in infected blood when the virus is actively replicating. The presence of HBeAg suggests that the person is infectious and is able to spread the virus to other people.The disappearance of HBsAg from serum with development of the corresponding antibody, anti-HBs, indicates conventional resolution of infection.
Anti HCV-(Low sensitivity test)
A reactive or positive antibody test means that Hepatitis C antibodies were found in the blood and a person has been infected with the Hepatitis C virus at some point in time.If the antibody test is positive, then you might have hepatitis C, but it's hardly definitive. According to the standard text approximately 15%–25% of people who are infected with hepatitis C are able to clear the virus on their own. This means that they have hepatitis C antibodies, but no virus. No virus means no hepatitis C.
To sum up-
Complete eradication of HBV is difficult because of its tendency to integrate into the host genome. Patients with HBeAg‐negative CHB generally require longer duration of treatment than those with HBeAg‐positive CHB, particularly when oral treatment is used. The recommended ALT levels for treatment initiation in these patients is different, as the levels of ALT often fluctuate and may even be normal. As about 50% of HBeAg‐negative patients have active liver disease with HBV DNA levels <105 copies/ml.
In easy words-
He is having chronic hepatitis B at present and can spread infection.
Risk in future-
Hepatocellular failure
carcinoma
cirrhosis.
Goal-
The main goal of treatment of chronic hepatitis B is to suppress HBV replication and to induce remission of liver disease before development of cirrhosis and hepatocellular carcinoma.
Treatment available-
Recombinant subcutaneous interferon-α (10 MU thrice weekly) and oral lamivudine (100 mg once a day) should be taken for 3 months.
Response to therapy is defined as undetectable HBV DNA (< 105 copies/mL) in serum after 1 month of therapy sustained loss of HBeAg with or without detection of anti-HBe (HBeAg seroconversion), and improvement in liver disease, normalization of aminotransferases and decrease in inflammation or fibrosis progression halted.
Follow ups are welcome.
having chronic hepatitis B.
Detailed Answer:
Hello,
Thanks for query.
Hepatitis B surface antigen (HBsAg is a protein on the surface of hepatitis B virus it can be detected in high levels in serum during acute or chronic hepatitis B virus infection. The presence of HBsAg indicates that the person is infectious.
A "positive" or "reactive" HBsAg test result means that the person is infected with hepatitis B. This test can detect the actual presence of the hepatitis B virus (called the “surface antigen”) in your blood.
HBeAg stands for hepatitis B e-antigen. This antigen is a protein from the hepatitis B virus that circulates in infected blood when the virus is actively replicating. The presence of HBeAg suggests that the person is infectious and is able to spread the virus to other people.The disappearance of HBsAg from serum with development of the corresponding antibody, anti-HBs, indicates conventional resolution of infection.
Anti HCV-(Low sensitivity test)
A reactive or positive antibody test means that Hepatitis C antibodies were found in the blood and a person has been infected with the Hepatitis C virus at some point in time.If the antibody test is positive, then you might have hepatitis C, but it's hardly definitive. According to the standard text approximately 15%–25% of people who are infected with hepatitis C are able to clear the virus on their own. This means that they have hepatitis C antibodies, but no virus. No virus means no hepatitis C.
To sum up-
Complete eradication of HBV is difficult because of its tendency to integrate into the host genome. Patients with HBeAg‐negative CHB generally require longer duration of treatment than those with HBeAg‐positive CHB, particularly when oral treatment is used. The recommended ALT levels for treatment initiation in these patients is different, as the levels of ALT often fluctuate and may even be normal. As about 50% of HBeAg‐negative patients have active liver disease with HBV DNA levels <105 copies/ml.
In easy words-
He is having chronic hepatitis B at present and can spread infection.
Risk in future-
Hepatocellular failure
carcinoma
cirrhosis.
Goal-
The main goal of treatment of chronic hepatitis B is to suppress HBV replication and to induce remission of liver disease before development of cirrhosis and hepatocellular carcinoma.
Treatment available-
Recombinant subcutaneous interferon-α (10 MU thrice weekly) and oral lamivudine (100 mg once a day) should be taken for 3 months.
Response to therapy is defined as undetectable HBV DNA (< 105 copies/mL) in serum after 1 month of therapy sustained loss of HBeAg with or without detection of anti-HBe (HBeAg seroconversion), and improvement in liver disease, normalization of aminotransferases and decrease in inflammation or fibrosis progression halted.
Follow ups are welcome.
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Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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