hepatitis B and Fatty liver
Jul 8, 2008
I'm a 38-year-old man. In 2006, I was diagnosed with Hepabitis B and Fatty liver. My test results were as follows:
01/2006 ------- HBsAg: Positive AST (SGOT): 39 reference [<40 U/L] ALT (SGPT): 68 reference [<60 U/L] AFP: 2.45 reference [<10 ng/mL] HBeAg: Negative HBeAb: Positive Hep B PCR Quant: <60 iu/ml (< 1.8 Log 10) reference: 60 to 38,000 iu/ml (1.8 to 4.6 Log 10)
Ultrasound(impression): Very dense and fatty liver without focal mass. Folded gallbladder versus small gallbladder polyp.
08/2006 ------- AST (SGOT): 19 reference [3-50 U/L] ALT (SGPT): 18 reference [3-60 U/L] AFP: 1.6 reference [<6.0 ng/mL] Hep B Viral DNA QT: <100 iu/ml reference: <100 iu/ml Hep B Viral DNA QT: <160 copies/ml reference: <160 iu/ml
Ultrasound(impression): Fatty liver without focal mass. Right liver lobe calcification. Gallbladder adenomyomatosis.
03/2007 ------- AST (SGOT): 20 reference [10-40 U/L] ALT (SGPT): 17 reference [9-60 U/L] AFP: 1.6 reference [<6.1 ng/mL] Hep B Viral DNA QT: 163 iu/ml reference: <100 iu/ml Hep B Viral DNA QT: 266 copies/ml reference: <160 iu/ml
08/2007 ------- HBeAg: Negative HBeAb: Positive Hep B PCR Quant: 110 iu/ml (2.0 Log 10) reference: 60 to 38,000 iu/ml (1.8 to 4.6 Log 10)
Ultrasound(impression): Diffusely coarse, echogenic, and heterogeneous liver echotexture most compatible with fatty infiltration or other causes of diffuse hepatocellular disease. No focal liver mass is identified. 3 mm gallbladder polyp without gallstones or biliary duct dilation.
05/2008 ------- AST (SGOT): 23 reference [<40 U/L] ALT (SGPT): 20 reference [<60 U/L] AFP: <2 reference [<10 ng/mL] Hep B PCR Quant: 3,400 iu/ml (3.5 Log 10) reference: 60 to 38,000 iu/ml (1.8 to 4.6 Log 10)
Please explain the HBV carrier status and give me advice on what I should do next. My primary doctor says there is no need for treatment yet.
Response from Dr. McGovern
If you have evidence of high triglycerides, mild high blood pressure, high insulin levels or high cholesterol, you have some of the findings associated with metabolic syndrome. This is a collection of findings that is associated with fatty liver - or non-alcoholic steatohepatitis. Liver function tests are usually normal in these patients. A liver biopsy would help sort out if you have significant disease.
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