Second Opinion Regarding HBV?
I would like to ask for a second opinion regarding my case. 6 months ago I tested positive for HBsAg and then further tested with normal AST and ALT, non-reactive HBeAg, and reactive AntiHBe. The internal medicine doctor that I met said there was no need to take medicine and was told to live a healthy life and then check again for 6 months. Yesterday I consulted again and checked AST and ALT were normal while HBsAg was still positive and AntiHBs were non-reactive (2 mIU / ml). The doctor again suggested that there was no need for therapy and continued to live a healthy lifestyle while having regular checks for the next 6 months. I want to ask for a second opinion. Do I really not need therapy or what? thank you
Hello, andrew123, thanks for asking HealthReplies.com.
Hepatitis B is inflammation of the liver due to hepatitis B virus infection. In general, this infection can be acute or chronic. In the course of hepatitis B, there are signs of immunity that must be checked to monitor hepatitis B infection, such as HBsAg, HBeAg, AntiHBe, AntiHBs, and others. Each of these indicators indicates the immune condition against hepatitis B virus infection. In addition, the state of liver function (liver) must also be monitored by checking liver function (eg AST and ALT).
Here's how to read the lab results on your case:
1. HBsAg reactive indicates the presence of hepatitis B infection (either acute or chronic). However, there is usually another test to determine whether a hepatitis B infection is acute or chronic, namely by checking IgM antiHBc.
2. HBeAg indicates active hepatitis B virus replication / multiplication, so a non-reactive (negative) result indicates that no active hepatitis B virus replication is detected in your body.
3. Reactive AntiHBe (positive) indicates low viral transmission.
4. AntiHBs indicate the body's immunity against hepatitis B virus so that the patient is "immune" to hepatitis B infection in the future. For example, antiHBs will be positive in people immunized against hepatitis B.
5. Normal AST and ALT indicate that your liver function is still within normal limits.
According to the test results you presented, you are infected with the hepatitis B virus but the virus has a low replication rate and has little potential to transmit hepatitis B. Liver function within normal limits means that the virus has not caused liver function disorders. In cases like this, in theory from the literature there is no proven therapy to change HBsAg status. So, what can be done is monitoring the patient's health condition in general (physical examination, consultation on patient complaints), periodically checking for indicators of hepatitis B infection as is done by your internal medicine specialist, and if necessary, other examinations like an ultrasound or fibroscan. Regular monitoring is carried out to see if there is a risk of increased viral activity, other infections, new infections, and to confirm the condition of your immunity. If there are signs of virus activity during monitoring, further treatment will be taken.
Follow the treatment advice from the doctor who treats you because he will immediately examine you. Periodically control according to the doctor's recommendation or if there are complaints, avoid things that can transmit the hepatitis B virus, and maintain a healthy lifestyle.
That's all, hopefully it's useful.
Greetings, dr. Sarah Rizqia.