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Will I be answered this time?
Dec 19, 2004

Dear Doctor Barbara:

I was diagnosted with HB in 1992 even then the doctor told me that I might have it for at least five years ago, so I was told I was a HBV a carrier. In those days I knew nothing about HB. Since then, I tried to learn more so as to avoid doing harm to other people. Now, Im in high hope that my condition is turning to better. Unfortunately, doctors say that this disease is very complicated and difficult to understand, so I still am not very sure about my present condition. I wrote twice to you (doctors from this web site) before, but got not reply. I hope and pray that this time I will have a reply.

My last test, done October/November 2004, has returned with the following results:

HBsAg positive HBeAg negative Anti-HBe positive Anti-HBc - positive

HBV-DNA (PCR) <3x10^5 copies/ml

The doctor said that the tests also showed that I had a fatty liver, but this condition could be caused by many reasons and the overhall has indicated that my HB is in a inactive state.

Apart from the HBV DNA test which is the first time I did all test result match those done several years ago, in 1999 and 2001.

I would be very glad to hear your opinion and advice. Thank you. M Frank

Response from Dr. McGovern

I am glad that you were persistent in trying to get an answer. Unfortunately, it is very difficult to answer all the questions we receive.

I am a bit confused by the way you listed your viral load as "<3 x 105 copies/ml". Usually PCR is more sensitive than this. I will answer your question this way:

1. If your viral load is not detectable by PCR, then you are an "inactive hepatitis B carrier" and your blood tests should be monitored every six months to be certain that you remain so and to also see if you completely clear the virus over time.

2. If your PCR shows detectable virus, and you have normal liver function tests, it is reasonable just to follow you over time with blood tests. You would be refered to as a "chronic carrier with eAntigen negative disease."

3. If your PCR shows detectable virus, and your liver function tests are persistently abnormal, then it is reasonable to have a liver biopsy and perhaps be treated based on those results.

You should speak with your provider about your liver function tests results and clarify the level of your virus detection.

Dr. McGovern



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