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Chronic hep B
Sep 27, 2009

I am a hep B carrier. My recent HBV viral load count is 5.77 LOG. All other symtoms i.e. liver function and enzymes are normal. Do I need anti viral treatment?

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   Response from Dr. McGovern

My advice is to get serial follow-up for now. With normal liver function tests, I would continue to monitor to see if they indeed remain normal. Would also determine if you have HBeAg negative or HBeAg positive infection. This is important since it would dictate how long you would need therapy, if a decision is made to treat. Would follow-up on your HBV DNA as well.

If your ALT stays normal over time, there is no pressing need to treat right now. However, the guidelines continue to change and so it is important to keep informed based on the latest evidence.

Your doctor may eventually decide to get a liver biopsy if you are over 40 to see if you may have any disease despite normal LFTs. The important overall message is to continue to get repeat testing to learn more about your HBV. One "snapshot" in time is never enough.


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