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Do I need treatment?
May 28, 2005

Dear Drs.,

I am a married male, 43 years old. Last Febraury, I have undergone Hepatitis Panel and and I had liver biopsy a month ago. Here are the results:

HB Surface Antigen - Positive Hep B Core AB-Total Positive Hep B Surface Antibody Negative

ALT(SGPT) 37(2-60) AST(SGOT) 26(2-50)

HEP BE Antigen Negative HEP BE Antibody Positive

HEP B Viral DNA QT PCR: HEP B Viral DNA QT 278 (<100 IU/ML) HEP B Viral DNA QT 472 (<160copies/ml)

Live Biopsy:

A. Portal Inflammation, grade 1 B. Lobular Inflammation, grade 2 C. Fiborosis, stage I

Ultrasound results are very normal.

My doctor said I got Pre-core mutant HBV and need treatment so he prescribed Hepsera (adefovir dipivoxil). I believe I have had HEP B for a long time (15 years or more) since I could not recall the scenes I could got this in last 15 years.

My question is: Do I need treatment? and How long could this treatment last.

Thanks for your help and You are doing a great job helping frustrating groups.

Response from Dr. McGovern

Personally I would not treat based on the results of your liver biopsy and also due to the fact that you are hepatitis B e antigen negative. Patients with this type of infection need treatment for a long while and it usually is not recommended unless the liver disease is moderate or severe.

I would ask your doctor why he wants to treat you for mild disease since he or she may have very good reasons for this decision that are not obvious to me since they know you well.

Dr. McGovern



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