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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Ok To Be Not Eligible For Drugs For Hepatitis B But Needs To Be Monitored By LFT And Viral Load?

I tested positive for hepatitis B Virus about 10 years ago and my LFT is normal and viral load is very minimal. I am told that I am not eligible to be placed on drugs but to be monitoring by LFT and Viral load. I am scared but i don't know what to do.
Wed, 3 May 2017
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General & Family Physician,  's  Response
Hello I hope you are well. You must know that chronic infection with hepatitis B virus has different phases:
1. Immunotolerance: It is characterized by HBeAg positivity, high levels of virus DNA replication and normal or low levels of hepatic enzymes. There may be mild hepatic necroinflammation.

2. Positive HBeAg Immunoreactive: HBeAg Positivity, elevated levels of viral replication and an increase or fluctuation of aminotransferase levels, moderate or severe hepatic necroinflammation, and rapid progression of fibrosis.

3. Inactive Carrier: It is characterized by very low or undetectable DNA levels and normal aminotransferases.

4. HBC negative HBeAg: It is characterized by a periodic reactivation with a pattern of fluctuating levels of DNA, aminotransferases and active hepatitis.

For what you mention you are in the Inactive carrier phase, where you should effectively monitor every 4-6 months with a hepatic chemistry and viral load for HBV; any elevation of hepatic enzyme levels may warrant a liver biopsy to assess the degree of fibrosis and, if so, to institute a treatment.
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Is It Ok To Be Not Eligible For Drugs For Hepatitis B But Needs To Be Monitored By LFT And Viral Load?

Hello I hope you are well. You must know that chronic infection with hepatitis B virus has different phases: 1. Immunotolerance: It is characterized by HBeAg positivity, high levels of virus DNA replication and normal or low levels of hepatic enzymes. There may be mild hepatic necroinflammation. 2. Positive HBeAg Immunoreactive: HBeAg Positivity, elevated levels of viral replication and an increase or fluctuation of aminotransferase levels, moderate or severe hepatic necroinflammation, and rapid progression of fibrosis. 3. Inactive Carrier: It is characterized by very low or undetectable DNA levels and normal aminotransferases. 4. HBC negative HBeAg: It is characterized by a periodic reactivation with a pattern of fluctuating levels of DNA, aminotransferases and active hepatitis. For what you mention you are in the Inactive carrier phase, where you should effectively monitor every 4-6 months with a hepatic chemistry and viral load for HBV; any elevation of hepatic enzyme levels may warrant a liver biopsy to assess the degree of fibrosis and, if so, to institute a treatment.