Pre-Core Mutatnt - I am scared to death
Aug 8, 2007
Hi Doc First of all thank you for running such an informative service for us who do not have access to good and well informed GPs let alone hepatologists. I am 39 F with CHBV. Last month I had my labs and the results came as below: HBsAg [+] HBeAg [-] Anti-HBe [+] Anti-HBcIgM [-] Anti-HBc(Total)[+] Anti-HBs [-] HBV DNA by PCR: One lab detected with 63000U/ml. Other did not detect. Third detecetd with 6,000 U/ml. I do not have access to a physician right now and I will have to travel to another country (5 hours flight) to see a doctor for follow-up and treatment. Kindly advice what to do now? Except the HBV DNA these results were the same four years back. I was diagnosed CHBV carrier in 1998. God bless you.
Response from Dr. McGovern
Your laboratories are wildly discrepant in terms of your hepatitis B DNA levels. I would follow these DNA levels serially along with liver function tests. If your ALT/AST are persistently abnormal and you continue to have viremia (virus in your blood) I would suggest a liver biopsy to determine how much disease you have before going on therapy. I think a biopsy is helpful in this circumstance, because in chronic HBV E antigen negative infection, you would need long term treatment. If your liver function tests have been abnormal all along, then I would biopsy earlier if you have an additional DNA that is significantly elevated.
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