Q. Is hepatitis B curable?

 

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Hello doctor,

I am hepatitis B patient. My current status is as follows. HBeAg – negative (0.010), HBV E antibody or Ag – positive (0.031) and HBV DNA quantitative (PCR) less than 17.1 IU/mL. Please advise whether this can be cured to become negative as it is affecting my career.

 

 

Answered



Hello,

Welcome to dr.sitehome.info.

  • When both anti-HBe (anti-hepatitis B E antigen) and HBsAg (hepatitis B surface antigen) are positive (HBeAg – negative), there is reduced infectivity and the patient is expected to resolve the infection spontaneously.
  • The Anti-HBe antibodies may be detectable in a chronic carrier but in that situation the HBe antigen will be negative.
  • The presence of anti-HBe does not imply immunity to HBV infection.
  • I would need antibody to Hepatitis B core (Anti-HBc both IgM and IgG) to determine whether the patient is in window period (IgM) and his viral load is suspected to go higher. Do you have it? If yes please share.
  • This antibody appears during the first few weeks after infection and rises to high levels during the remission. Levels remain high in patients who have progressed to the chronic carrier state (IgG).
  • In shot I would have to determine if the patient is in window period versus chronic carrier versus progression to chronic hepatitis B.

  • Investigations to be done:

    Anti-HBc (both IgM and IgG), Liver panel, ultrasound of the liver INR/PT and serum albumin if not part of the liver profile.

  • Differential diagnosis:

    1. Chronic hepatitis B.

    2. Chronic carrier state.

    3. Acute infection in window phase (with less infectivity).

  • Treatment plan:

    Yes, it is treatable, but I would be able to give you a better answer once I have the complete set of blood work and ultrasound results.

  • Regarding follow up:

    Revert back with the investigation reports to an internal medicine physician online.—> https://www.dr.sitehome.info/ask-a-doctor-online/internal-medicine-physician



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