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After Liver viopsy (2)
Nov 27, 2004

Dear Mrs. McGovern,

Thank you for the kind help so far. My doctor (spesialist in liver) although I have Fifrosis stage 2 liver disease,has rejected treatment as long as my ALT, AST are normal and the HBV DNA is quite low (2,000 cp/ml). He is insisting that only if I have elevated ALT and/or HBV DNA more than 50,000 cp/ml, he may consider treatment (I have e-antigen negative type of chronic HBV). He also says to me that I have to make again viopsy in 5-7 years.

What is your opinion? Shall I seek second advise?

Finally ,is there any study on the average life span for those people affected by chronic HBV that they know and follow up on their disease regurlarly ?

Once more, thank you for your advises and support.

Response from Dr. McGovern

I agree with your physician that it is reasonable to wait since you have normal liver function tests. Many specialists believe that over the natural course of hepatitis B there are times when liver function tests "flare" and become very abnormal. Most physicians would favor this as the time to begin therapy since it is more likely for you to get benefit from treatment at that time.

The other important issue is that you have hepatitis B e antigen negative infection, where there is no clear end point for treatment so again with normal liver function tests, it is reasonable to wait.

Close follow-up with your physician will be important over time to keep you healthy. I also agree that a repeat biopsy five years after the first is a good idea to be certain that your disease has not progressed. I think you are in very good hands.

Dr. McGovern



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