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Flare in Chronic HBV Infection
Mar 16, 2007

Hi, I was diagnosed with HBV in November 2006 in a routine test prior to dental surgery. My serology as of now is Serum AST 40 U/l, Serum ALT 26 U/l, Serum Total Bilirubin 10 umol/l, Serum Alkaline Phosphatase 90 U/l, Serum Albumin 42 g/l, AFP 0.92 lU/ml, IgM antibody to Hep B core antigen negative, Antibody to Hep B core antigen positive, Hep B DNA PCR negative, liver and abdomen ultrasound normal. My questions are:- 1) Is it possible that a chronically infected person may never have a flare in her whole life? 2) How do i know if and when i have a flare (as i have read that it may be absolutely asymptomatic)? 3) What tests should i repeat on a routine basis? 4) I have had severe stomach ache for a month now, of unknown origin and took Anafortan (thrice daily) and Librax (twice daily) on the advice of my hepatologist for two weeks, but the pain has not gone, any comments regarding that (of course i don't want to bother you as you cannot give a diagnosis online with just this much info). In the end sorry to bother you and also i love your site it is very informative and helpful. Thanks. Tas.

Response from Dr. McGovern

Thank you for your kind words.

It appears that your blood tests look good, particularly the fact that your HBV DNA is not detected and your AFP is normal. It appears that you may be an inactive carrier. I would be more sure of that if you had repeat liver function tests that show normal enzymes (ALT and AST).

If you do have normal enzymes, I would repeat the ALT and AST every six months. If they remain normal, you are doing just great and you are an inactive carrier. If they become abnormal, then you may be having reactivation of your disease with a flare, and then I would recheck a HBV DNA.

Your severe stomach ache is probably not related to your liver health and needs further investigation if it is continuing.

Best regards,

genotype 1
undetectable and alcohol use

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