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hep b treatment
Nov 27, 2010

I have been HepB chronic carrier for 25 years, however the last 3 years I have had a viral dna load going up from 69,000 to 250,00 iu. I also had a biospy of my liver and it came back with 0-1 fibrosis, very minimal. So I have been told to avoid the risk of cancer I should take a medication treatment called Viread. I understand that it's side effects are bad. I want to wait a little longer before starting treatment. All my liver test are all normal except my viral load that's increased and replecating. Do you know of a better medical treatment with less side effects or can I wait a little longer. My liver ultrasound is normal also.

Response from Dr. McGovern

The hepatitis B treatment guidelines are not recommending treatment based solely on HBV DNA levels alone, particularly in patients with persistently normal liver function tests. I understand why your doctor is concerned because there are some observational studies showing a relationship between the height of the virus and risk of cancer. However, there are no prospective studies yet showing that treatment will decrease the risk of cancer. This will be very important to study.

Truvada is well tolerated. The main concern is a small percentage of people who may develop some problems related to the kidney, which are monitored by blood testing and urine testing.

You can get a second opinion about your management, but I think if you wanted to wait on treatment, this is completely reasonable since your liver disease is so mild. You should discuss your concerns with your doctor since you make very rational comments....



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