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Suggest Treatment For Chronic Hepatitis B Infection

Posted on Tue, 31 Mar 2015

Question: One of my family member found reactive with Australia Antigen,Actully it was reactive in 2001 but never treated.When we tested same in 2014 its again reactive. Now the patient is suffering from stomach ache and acidity problems and discomfort.Now treatment is antacids and Hepakind tablets.What do you suggest.Is the condition treatable, what precautions and treatment should be taken and for how long?
Hi Doc..As per your suggestions i have got some test done regarding Recurrence of HBV infection,the report of which are attached herewith..kindly give your expert opinion..

Answered by Dr. Dr.P.Ratnakar Kini (1 hour later)

Brief Answer:
Periodic follow up

Detailed Answer:
Hi,
Thanks for getting back to me with the reports.
As per the reports attached -
1. HBeAg - Negative
2. Viral load- 309 IU/ml
3. LFT - Within normal limits

He is having chronic hepatitis B infection.
He is in the inactive carrier state.
He does not need any treatment for hepatitis B as of now.
Only periodic follow up should be done.

He is more prone of liver cirrhosis and liver cancer. He needs to undergo ultrasound scan of the abdomen and serum alpha feto protein test for screening of the above conditions every 6 months.
I have mentioned about these tests in our previous conversation also.

If he is married, his spouse should be screened for HBsAg. If negative should be vaccinated and if positive all these tests should be done.

Let me know if you have any more questions.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (13 hours later)

Thanks a lot Doc.I will get back to you with remaining reports .Meanwhile can you please suggest what should be done to avoid risk of liver cirosis and cancer. What precautions should be taken for that.?

Answered by Dr. Dr.P.Ratnakar Kini (10 hours later)

Brief Answer:
Avoid alcohol

Detailed Answer:
Hi,
To prevent damage to liver , he needs to avoid alcohol.
And weight reduction if obese and check his blood glucose and cholesterol levels.
As mentioned in my previous post, periodic monitoring is the most important thing.

Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (41 hours later)

please find attached USG report.

Answered by Dr. Dr.P.Ratnakar Kini (9 hours later)

Brief Answer:
No evidence of cirrhosis and liver cancer

Detailed Answer:
Hi,
In the USG, there is no evidence of wither cirrhosis or cancer of liver.
The mildly increased echogenicity could be due to fatty liver. Since the liver function test is normal, there is no need to worry.

Regards,
Dr.R.K

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr.P.Ratnakar Kini (2 days later)

Hello Doc,
please find attached AFP report also the lipid profile. If no medication required for patient for HBV ,but the patient is suffering from stomachache and sometimes feeing like stomach is hard. can you please suggest.The patient was on librax tablet and razo D .So what should be taken to minimise this stomachache

Answered by Dr. Dr.P.Ratnakar Kini (5 hours later)

Brief Answer:
AFP is within normal limits

Detailed Answer:
Hi,
The AFP is within normal limits.
The lipid profile also looks absolutely fine.

For the stomach ache he can continue taking Librax and Razo -D

Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (9 hours later)

Hi Doc,

Thanks a lot for your quick responses. Much appreciated.
Can the patient resume the work, The patient is farmer and sometimes need to lift the things. Can you please suggest the guidelines for the work related precautions.

Thanks in adv.
Best regards.
XXXXXX

Answered by Dr. Dr.P.Ratnakar Kini (2 hours later)

Brief Answer:
There is no work related precautions needed

Detailed Answer:
Hi,
There is no work related precautions needed.
He can resume work.
Review every 6 months is what is required.

Regards,
Dr.R.K.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar