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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


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.

HIV and Hepatitis Co-infection
hep c1a cirr

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