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hbs ab and viral load both high
Dec 7, 2008

I was diagnosed with acute hep b in april of 2008. In July my Hb s Ab was at 5.33 and my viral load at 7.2 (log 10). I was tested again in November and my Hbs Ab is up to >24 and my viral load is >7.3 (log 10). I am continuing to enjoy unprotected sex with my chronically infected girlfriend. My questions are: am i still fighting this off and can i still hope to clear the virus? and, Is it possible that my viral load is high because I am frequently "reinfecting" with my girlfriend?

my doctor is recommending a liver biopsy (ultrasound guided needle) which i am a little nervous about. I'm trying to decide if I should delay it, hoping to clear spontaneously, switch to protected sex and hope to clear spontaneously, or just get it done asap. thank you

t

Response from Dr. McGovern

By November you should have cleared your hepatitis B infection. I believe that you have become chronically infected from sexual intercourse. It is unfortunate that you did not have past immunization for hepatitis B.

I do not think a liver biopsy is necessarily indicated since we know your infection is short-lived. There are no data on this, but I would wonder if you might respond quite well to early treatment with pegylated interferon alfa 2a for hepatitis B infection since you have been recently infected (similar to the great responses we seen in acute HCV infection). Again I stress that there are no data guiding decisions regarding your particular situation with recently acquired chronic HBV infection.

Alternatively, you can wait to see how hepatitis B treatment evolves over the next few years since I expect the paradigm of treatment may change to combination therapy. I say this because I am concerned about your high level of viremia and suspect that you might need two drugs for treatment to avoid drug resistance.

I would also get testing for hepatitis C. I would get immunized against hepatitis A. I would also get testing for HIV.



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