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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Hepatitis B Infection While Suffering From High Th1 Level

I am a 31 year old female married for last 1 year. I am HLAB27 positive and my disease diagnosed is Undifferentiated Spondyloarthropathy since 6 years. I got inflammation attack in 1 knee everytime and was injected local steroid. I also underwent arthroscopy for detecting any other possibility. I was taking Indomethacin-75 mg (ONCE A DAY), Indocap SR-25 mg (ONCE A DAY) and Sulfasalzine 1gm (ONCE A DAY) at that time. Then Methotrexate 17.5 mg/week was started for me. It was started 2years before and then i was perfectly fine. I took it for 1 year and 8 months. I wanted to start my family so i stopped Methotrexate and had plans to conceive after 6 months, so that i am out of its effects. Then i went for all checkups including ESR, CRP, Serum creatinine, TLC, DLC, ALT, AST so as to be assured about my health. But to my misery i discovered that i had raised ALT (198) & AST (168). I showed to a gastro Doctor and i got done Hepatitis B&C. I was positive for Hepatitis B surface ag as well as hepatitis B "e" antigen. I also got done ultrasound which reflected slightly coarsened echotexture & suggested Hemangioma. No antibodies was found against Hepatitis B "e" antigen. I also got done my Viral load which showed HBV DNA titre to be 7.98x107 IU/ml. Right now i am taking Indocap-75mg and Indocap SR - 25mg, as i do feel some pain in few joints. I wanted to ask you what course of treatment should i undergo for Hepatitis B as I have higher proliferation a Th1 in my body because of Autoimmune response.
                                                                 
Thu, 27 Apr 2017
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Gastroenterologist 's  Response
hi.
thanks for posting query at HCM.

HBsAg can not be completely eradicated in a patient suffering from HepB.
however, complications maybe prevented if proper medication is taken and proper diet plan is followed.
Treatment is advised if AST and ALT are > ULN and HBV DNA count on PCR is very high.

Liver enzymes and HBsAg status and HBV DNA PCR maybe done regularly every 6 to 12 months,
As per your current presentation, treatment maybe initiated. Consult hepatologist or gastroenterologist.

even if HBV DNA count in PCR are not high,
Liver enzymes should be monitored regularly while HepB markers maybe checked every 6 to 12 months.

hope to answer your concern.
wish you good n sound health.

regards
Dr Tayyab Malik
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Suggest Treatment For Hepatitis B Infection While Suffering From High Th1 Level

hi. thanks for posting query at HCM. HBsAg can not be completely eradicated in a patient suffering from HepB. however, complications maybe prevented if proper medication is taken and proper diet plan is followed. Treatment is advised if AST and ALT are ULN and HBV DNA count on PCR is very high. Liver enzymes and HBsAg status and HBV DNA PCR maybe done regularly every 6 to 12 months, As per your current presentation, treatment maybe initiated. Consult hepatologist or gastroenterologist. even if HBV DNA count in PCR are not high, Liver enzymes should be monitored regularly while HepB markers maybe checked every 6 to 12 months. hope to answer your concern. wish you good n sound health. regards Dr Tayyab Malik