Dr. Sultan Zeb Khan
Medical Gastroenterology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My husband had his blood test taken six months back and his HPV DNA level was 777 IU/ml. We went back for another blood test seven months later and it went down to 267 IU/ml. Is this good or bad? He has no scarring or damage to his liver and is not on any medications. He only found out he had hepatitis B a year back.
Hi,
Welcome to icliniq.com.
I think you mean HBV DNA (hepatitis B virus DNA) rather than HPV (human papilloma virus). I would want to know about the ALT (Alanine Transaminase) level of the patient as well as HBeAg (hepatitis b e antigen) and anti-HBe (hepatitis b e antigen). After that, the exact phase of hepatitis B could be identified.
Patient's Query
Thank you doctor,
Yes, I meant HBV DNA. He is HBsAg positive A. And it says chronic hepatitis B e-antigen negative. His ALT lvl is 50 U/L. Let me know if the details sound correct.
Hi,
Welcome back to icliniq.com.
Yes, this information is enough. He is having e antigen negative chronic hepatitis B infection which was previously known as inactive carriers. At the moment he does not need any treatment. He just needs to follow up every three months with HBV DNA, ALT level and ultrasound of the liver. If the level of HBV DNA becomes more than 2000 and ALT raises more than two times, then he will need treatment with oral medication.
Patient's Query
Hi doctor,
Thank you very much for your help that answers my question. I was also wondering is it normal for the HBV DNA level to fluctuate? Since it is lower than the previous, is this a good sign or does it fluctuate often?
Hi,
Welcome back to icliniq.com.
Yes, it can fluctuate. It is good that it is lower than previous. Sometimes body automatically clears hepatitis B virus. Let us hope it does not fluctuate much and remains below 2000. Monitoring is very important as I mentioned earlier. Take care and have a nice day.
Patient's Query
Hi doctor,
Thank you so much. Is it possible to stay under 2000 for years forever? Or will it definitely go over 2000 eventually and require treatment?
Hi,
Welcome back to icliniq.com.
No, it may stay under 2000 for life and as I mentioned it may be cleared by the body automatically but there are chances of it going up. That is why we advise continuous monitoring.
Patient's Query
Thank you doctor,
Could it take longer than six months to clear up though? I thought it had to clear up before six months otherwise you have it for life?
Hi,
Welcome back to icliniq.com.
Yes, in 90 percent cases it is cleared up in first six months but in patients who develop chronic hepatitis, there is a chance of becoming HBsAg negative and developing anti-HBs antibodies although in very little percentage. Even with treatment it is not eliminated from the body but suppressed to a level where it can cause no damage. You need not worry much at this stage.
Patient's Query
Hi doctor,
Thank you so much. It has cleared lots of things up for us. We really appreciate your help. Take care and thanks again.
Hi,
Welcome back to icliniq.com.
You are welcome. Take care.
Patient's Query
Thank you doctor,
When you said his ALT levels would have to rise more than double to qualify for treatment, do you mean it would have to be 100 more or 150 or more? We are planning to get his blood taken again in a weeks time so it will be interesting to see if the levels have changed.
Hi,
Welcome back to icliniq.com.
The normal levels are 30 to 40. More than two times means more than 80 to 90. But HBV DNA has to be more than 2000 to qualify for treatment.
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