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hep b meds
May 29, 2006

Dr Daar Thank you for your response. I am hepb chronic, active >>20yrs. recently, my viral load is ~77mil copies, ast/alt ~150. my dr. prescribed hepsera, but i stopped taking it after 1week because of fatigue and weakness.also, i had resistance to epivir since last year. what should i do now beside monitoring my liver/kidney? why are my liver enzymes relatively low and DNA quant so high? are there any options that donot make me tired? iam a single parent with two sons. also, i have numbness on my two lateral fingers (ring and pinkie)on both hands. recently, i felt numbnes on my left thumb as well. is this a complication of hepb also? i am asian, 46 yr old. i dont smoke or drink and i am aware of what i eat. is there anything else that i can do because i do not like taking meds that make me worse? thank you again for answering and God bless you and your family.

Response from Dr. Daar

The fact that your liver enzymes are approximately 150 along with hepatitis B virus (HBV) DNA positive suggests, but does not prove that you have some inflammation associated with your HBV infection. There is not always a direct relationship between viral load and liver enzymes, nor does the level of liver enzymes necessarily reflect the severity of liver disease.

It is important to know if you have HIV infection as well as HBV, and if so whether you are on HIV treatment or need to be. Before further treatment is considered it is also vital that you continue to minimize or avoid alcohol use and make sure that you are hepatitis A immune (either by natural immunity or immunization). You should also do everything possible to avoid infection with hepatitis C virus if you are not already infected.

I would strongly suggest that you see a qualified hepatologist with experience treating HBV infection. If you are also HIV-infected an HIV specialist should also be part of the team. The good news is that there are several other drugs available that may be well tolerated and active against your HBV, such as entecavir, recently approved for treatment of HBV, and tenofovir which is not yet approved for HBV infection but clearly active. Make sure you discuss all of these options with your primary provider and hepatologist.

Best, Eric


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