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Please clarify-Part 2
Sep 6, 2004

Dear Mrs Mc Govern,

Continuing from my previous question I have HBV DNA 2,000 copies/ml, normal ALT, AST (18,25 respectively), AFP 5,5 and normal U/S picture. I have HBeAG negative and positive Anti-HBe. My wife has been tested negative three times in the last 6 months but also does not have antibodies. I feel fine without any symptoms.

How serious is my HBV situation? What is the threshold for HBV DNA for starting therapy?(if any).

My wife is going to deliver at the end of September- she made Engerix only the first dose then she stopped due to her pregnacy. Should she repeat the 1st dose or continue with the second? Is our baby at risk?

Thank you for the patience.

Response from Dr. McGovern

I would simply repeat your HBV DNA, liver function tests, and your hepatitis B surface antigen over the next 6 months to see if your are continuing to be a carrier or not. There is no clear cut level are which you would treat. The decision to treat is often based on pathology of your liver. I would not rush into treatment just yet.

As for your wife, there is no risk to the baby because she is not infected. The manufacturer of the hepatitis B vaccine does not recommend immunization in pregnancy but there does not appear to be any clear risk. However, I think the you can easily prevent any transmission and so far she has never been infected which already says alot! Continue to use condoms for any sexual exposure, don't share razors, etc... Best wishes for your baby! Dr. McGovern

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