ALT level rising - Hepatitis B positive. PLEASE ADVISE

Question

Dear Doctor,

Please help us as we are very scraed. My boyfriend is a Hepatitis B carrier with viral load of 270 IU/ml. His ALT level constantly rising: ALT (LFT) was 94 IU/L 3 months ago. Now it is 108. In previous years it was 2007: 29 IU/L, 2008: 53 IU/L. We do not know how and when he was infected. We only know that he has been positive for 4 months. He guesses he was born with it or infected when he was a child. Does he need to start getting treatment? What is the chance for him to get liver disease? Are there any hopes to get an efficient drug in the future to cure him?

His other results are: anti-HBc: positive HBsAg: positive anti-HBs: negative Anti-HBCore IgM (HBVSC): not detected HBe Antigen (HBVSC): not detected Anti-HDV: not detected Anti-HBe (HBVSC): positive

Please help!

Thank you.

Answer

I don't consider that a major change. I would follow his HBV DNA serially about every 3 to 6 months. I would also follow his LFTs about every 3 months.

I would also be certain he has been checked for HCV in the past as part of his original evaluation.

I would also see if his body weight is normal. You can check body mass index on line at this website: http://www.nhlbisupport.com/bmi/

to be certain that he is not overweight...Obesity can cause fatty liver and abnormal LFTs.

I hope this is helpful.