Hepatitis B positive disease control before marriage

Hi,
Welcome to Doctor Spring Forum.

Let me know the associated details along with mentioned.
Do you have any recent history of blood transfusion, intravenous injections?
Do you have positive family history of hepatitis B in parents and other siblings?
Do you have positive family history of liver cancer or significant liver damage?
What is the level of SGOT/ SGPT yet now?

Hepatitis B is caused by a virus Hepatitis B virus.
It could cause acute Hepatitis B or chronic hepatitis B.

Acute Hepatitis B may be acquired after blood transfusion, organ transplantation,
hemodialysis, and intravenous injection as it is blood born disease.
95% cases of acute hepatitis B are self limiting, 4% cases are converted into chronic
hepatitis and 1% cases are fulminant means life threatening.

Chronic hepatitis has been labelled when hepatitis B surface antigen (HbsAg) is found to be
positive for more than 6 months. This is acquired from mother while birth (majority of cases),
exposure of cuts with blood contacts in childhood.
So in case of chronic hepatitis, there could be positive family history of hepatitis B as it
may be acquired from mother or other siblings. Other siblings may also get infection from
mother.

Now comes to your query.
As you have positive HbsAg, there appears to be high chances of chronic hepatitis B, with
virus appears to be in inactive form. You have very less HBV DNA quantitative values as
suggested by blood reports but it may become active at any time of life. There could also be
possibility of negative HbsAg in future as virus may be cleared by body.
Sometimes virus gets cleared from body but its DNA may get integrated with Human DNA and may
cause liver cancer in future.

Chronic Hepatitis B has four stages:
1) Immune Tolerance Phase- body doesn't act against the virus.
2) Immune clearance phase- body tries to clear the virus
3) Immune Control Phase- body controls the virus.
4) Immune Escape phase- virus may be reactive.

Treatment of Hepatitis B is decided by HBV DNA level, HbeAg, Anti Hbe and SGOT/ SGPT status.
You should go for remaining investigations for further decisions.
SGOT/ SGPT normal values for a male is 30 U/L.
When HbeAg gets positive and Anti Hbe gets negative with SGOT/ SGPT level more than
twice(means >60 U/L in case of male), then only treatment should be considered.
There are few cases, in which precore mutant/ core mutant virus may be present.

You should consult with internal medicine specialist/ gastroenterologist and should go for
thorough check up.
You should remain in touch with your treating doctor and should go for repeat SGOT/ SGPT at
interval of 3-6 months.

There is high chances of Spread of Hepatitis B by sexual contact to your better half.
She should get vaccinated properly by 3 doses of Hepatitis B vaccine available easily in each
hospital.


Take care,
Get well soon,
Let me know your other query if you have,
Dr. Mayank Bhargava

Actually my dad died 4months ago because of liver cancer, he was HCV patient while there is one more thing i would like to tell that i was a bodybuilder and i used supplements and steroids also. On the day my dad died, he needed blood so i went for exchange my blood and from there i got to know that i m HBV. Is there any kind of medication dat i can start for this virus to be removed from my body. And do tell me test that i should get done.

Thanks

Hi,
As you have positive HbeAg with SGPT in between 1-2 times (30-60) of normal, you should go for Liver biopsy.
There appears to be high chances of Precore mutant virus in your case as HbeAg is getting positive while HBV DNA is very low.
You should also consult with hepatologist for further treatment.

Take care,
DR. Mayank Bhargava