Please Help .... Very Concerned!!
Nov 20, 2004
My boyfriend was detected positive for Hepatits B last year. His tests said HbsAg +ve,HbeAg -ve,HbeAb +ve anti HIV 1 and 2 -ve . He was also negative for Hep C and Hep A . His ALT was 54 and AST was 42 and all other tests were normal.The ultrasound said mild Hepatomegaly. His HBV DNA PCR was negative and HBV Quantitative PCR was less than detectable range. He has not undergone any treatment because he had already seroconverted by the time it was known that he was a carrier. The gastroentrologist said that he is healthy carrier, not infected by pre-core mutant but his liver enzymes is slightly above normal and has asked for a repeated LFT after 3 months.
When asked whether my boyfriend would live his lifetime, the doctor said that he may live for another 20 years(My boyfriend is now 29 yrs of age).After which his immunity may go down and the virus may become active again. My boyfriend does not have any family history of Liver diseases or cancer or diabetes.
My Questions are:
1) Is he going to live only for another 20 years given his present condition of a healthy carrier. 2) What are the chances that his virus will become active again? Is it possible for the virus to be passive for a lifetime once suppressed? 2) Is it OK to have ALT and AST slightly above normal in his present condition or is there any other reason for it? 3) Will he ever show negative for HbsAg. 4) Are there any other tests that should be undergone like alpha feto protein (AFP) or an ultrasound every year.
Sorry for a long letter.I hope U understand my concern and will reply back to all my questions.
Response from Dr. McGovern
There are many issues to discuss here. It is good news that he is an inactive carrier and there is hope that over time he will also lose the surface antigen. I think he has a long life ahead of him - I am not quite sure of the 20 year limit. He should continue to have monitoring with liver tests and hepatitis B serologies to see if this may happen. Yes hepatitis B can reactivate, but he is in a low risk category. For example the use of steroids or chemotherapy can sometimes cause hepatitis B to flare up again. He should undergo 6-12 month screenings with AFP but the use of ultrasound is less well established in patients like him who are at low risk for cancer due to his inactive carrier state. As for the liver function tests, if they continue to be abnormal, other causes of mild elevations of LFTs can be considered such as fatty liver or medications, or hemochromatosis for example. No alcohol please! Dr. McGovern
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