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Hep B
May 3, 2002

Dear Dr. Fried,

my daughter aged 14 was detected with Hep B during a school screening exercise. she was positive for both surface antigen and e-antigen. i took her to a doctor who did a liver function test. it is as follows: it shows Globulin as 40g/L, AST as 46 and ALP as 144, GGT as 11 and ALT as 50. The Bilirubin (Total) is 12 umol/L , Bilirubin (Conjugated) is 4 umol/L and Bilirubin (Unconjugated) is 12 umol/L.

When i asked the doctor for treatment he said there was none., but to merely monitor her liver function every 3 months.

pls advise what i can do for my daughter. she is so young.

thanks

Response from Dr. Fried

It would be helpful to have laboratory studies over several time points to judge the chronicity and the pattern of your daughter's HBV. In addition, HBV DNA would be useful. It appears that her ALT is mildly abnormal and, if her HBV DNA is high and remains so, a liver biopsy would be indicated. There are treatments available which include lamivudine or interferon. You should discuss possible treatment options with your doctor once all this information is available to see if it is appropriate in this particular situation (There are some cases where observation only is reasonable).

In addition, members of the household should be tested for HBV and, if not immune, should receive the HBV vaccine. Other family members who may carry HBV should be referred to a specialist for full evaluation.



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