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Please Help, very Scared.
Nov 27, 2004

Dear Dr McGovern,

I was detected positive for Hepatits B around a year back. My recent tests said HbsAg +ve (obviously) HbeAg -ve HbeAb +ve Negative for HIV , Hep C and Hep A ALT - 50 (slightly elevated) AST - 42 (slightly elevated) HBV DNA PCR - negative HBV Quantitative PCR - less than detectable range.

The ultrasound said "Mild Hepatomegaly".

These tests were repeated once in three months from the past year and the results were the same , the ultrasound was done once,but in one reading the ALT and AST were within normal.

I have not undergone any treatment as I had already seroconverted by the time it was known that I was a carrier. My doctor who is a gastroentrologist said that I am a healthy carrier, not infected by pre-core mutant.

My Question is

1) How serious is my condition with "Mild Hepatomegaly"? 2) What are the chances that the virus will become active again? 3) I heard there can be spontaneous flare up without any reason. Is it common? 4) If so ususally at what age will it become active again? 5) Is it possible for the virus to be passive for a lifetime once suppressed? 6) What are the chances that I will become HbsAg negative? 7) Are there any good treatments available in the near future other than interferon or adefovir ?

I hope U will reply back to all my questions.Thanks a lot in advance.

Response from Dr. McGovern

You ask excellent questions.

It is wonderful news that you do not have any detectable virus. There is about a 10-15% chance that you will clear completely. I would have follow-up with your physician about every six months for evaluation. There are multiple new drugs for hepatitis B being developed and I expect new medications to be available shortly.Yes hepatitis B can reactivate but this is usually in the setting of immunosuppression ie, getting chemotherapy or steroids or another infection like HIV. Finally I am not sure why you have mild hepatomegaly and would follow-up with your physician on that as well including any other causes for liver disease like hemochromatosis or fatty liver for example. Dr. McGovern



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