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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Chronic HepB case
Oct 22, 2004

I have chronic HepB. ALT=54, AST=37, Liver Biopsy Grade 1, Fibrosis stage2, HepBeantigen positive, HepBeAntibody Positive, AFP = 3.6, Ultrasound = Normal. HBV DNA log = 8.1 HBV DNA Log in year 2002 = 8, Do I need to start the treatment? If so what treament? What is the prognosis? How long will it take to reach to end stage if untreated.

Response from Dr. McGovern

With a liver biopsy with fibrosis stage 2 I would start treatment now.

Treatment for hepatitis B has reached a great stage. We now have a variety of drugs and this is only going to improve over time with other new drugs soon ready for use.

It would be reasonable to start adefovir (Hepsera) daily which is very well tolerated and has slow to evolve resistance. Another drug is lamivudine. It is also well tolerated although resistance is a big problem. Pegasys has also been used for hepatitis B with good results but has more side effects.

The time it would take to become end-stage is difficult to predict. Everyone is different. And there is no guarantee that you would become "end-stage". Not everyone progresses. Stay away from alcohol for sure.

Get vaccinated for hepatitis A.

Dr. McGovern

Chronic Hep B meds and HIV impact
ALT test?

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