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Hep B treatment
Dec 22, 2002

Dear Doctor:

I am a female Chinese, 26 years old. I was identified as Hep B carrier four years ago (Only hep B not AIDS). And at that time, HbsAg (+), HbeAg (+). Thus I keep blood test every half a year to watch my liver function. Every time is normal until the recent one in recent October. I found out that my ALT and AST goes up dramatically to 437 and 259 (My last test result in March, every function are still within the normal range). > Hepatic function as following (Oct result): > Protein, Total 9.7 > Albumin 5.0 > Globulin 4.7 > A/G ratio 1.1 > Bilibubin, total 0.9 > Bilirubin, direct 0.3 > Bilirubin, indirect 0.6 > Alkaline Phosphatase 80 > Hep B DNA 2520 pg/mL

Retest in Nov.13 results shows AST and ALT drops down to 137 and 215 TP 8.5 Albumin 4.3 Bili, TOT 0.3 Bili, Dir 0.1 ALK PHOS 66

Doctors report shows that I have an oscillating liver enzymes with marked hep B replication. But the normal white count and platelet count. No splenomegaly by ultrasound. But the liver biopsy showed stage 3 fibrosis. No Hep C virus. Immune to Hep A. I am nave to treatment. I dont know how much will be the chance for me to get recovered from the fibrosis and even get rid of the Hep B virus. The doctor suggested me to take the medical trial for LD4FC or LDT or new liver targeted adefovir. However, I dont know which one will work better for my situation and fit for me. Thus I would like to have some more professionals opinion for treatment. Or do you have any good suggestions on treatment? Your advice will be highly appreciated! Sincerely yours Dona

Response from Dr. Dieterich

Dear Dona, This is one is easy. You need treatment now! You are lucky to have those crugs available to you. They are all good ones. I would use either adefovir, which is now approved in the US or the trial of the other drugs both of which are very powerful and likely to work. Your liver biopsy is serious so you need treatment soon. They should work very well. Good luck! DTD



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