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Treat or not treat - please answer
Feb 8, 2005

Dear Dr. DTD,

My mother is asian and she is 69 years old. She's been diagnosed as a chronic HBV carrier. The tests are as follow:

HBV DNA = 6034 copies/ml

HBeAG = negative

HBeAB = positive

ALT = 19 and AFP = 2.0

Her MD asked her to come back a year later for test again. We are afraid that her liver is being damaged since the HBV DNA level is over 6000. Please give us some advice. Thank you very much.

Response from Dr. Dieterich

That is generally considered a very low even insignificant HBV DNA. The guidelines which are changing daily suggest that 50,000 copies may be the significant number. I however am very unsure about this level. She should certainly have a CT scan or ultrasound yearly to rule out cancer. I have been treating some people with low levels like this, but she would have to take Hepsera. The only thing else to do would be to do a liver biopsy and make the treatment decision based on the biopsy. Good luck! DTD

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