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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Are The Chances Of Acute HVB Converting Into Chronic HVB?

I am suffering from Acute hepatitis B with symptoms shown in Dec 2009. My Bilirubin went as high as 14 and SGPT went as high as 1385. Now in the month of Feb 2010 all has become normal. My bilirubin as on March 2010 was 0.9. But HbsAg is weakly reactive (2.34) & it has not got eliminated. When can it be eliminated or Is there any chance of converting this Acute HVB to Chronic HVB. My age is 32 years

                                                  
Fri, 13 Oct 2017
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Internal Medicine Specialist,  's  Response
hi I read your question thoroughly.

HBV infection has many outcomes:

In majority of patients(approximately 80 to 90 %) human immunity will eradicate the infection. In which case serology tests will only show Anti-HbsAg and Anti HbeAg(IgG).

Normaly it takes 5 to 6 month for the immunity of human body to eradicate HbsAg from the blood. so in your case you still need to wait 2 to 3 months to see if your infection gets completely eradicated or not. So, regular follow up with serology tests for HbsAg and Anti-HbeAg is strongly advised.

In a minority of patients( approximately 5 to 10 %) it may get converted into chronic infection. In which case there are two possibilities:

1) The infection might develop into a chronic carrier transmissible disease( Anti HbeAg-IgM and HbsAg +ve in blood) in which case there is high replication of virus and it causes damage to the liver, therefore, it has to be considered for further evaluation that is repeating the tests such as Alt( SGPT ) levels and a PCR for HBV DNA and a liver biopsy(in selective cases). Depending on the outcomes of the mentioned tests, treatment can be considered for a duration of 1-year.

2) The infection might develop into a chronic carrier non transmissible disease(Anti HbeAg-IgG and HbsAg +ve in blood) in which case there is low replication of virus and it causes minimal or no damage to the liver, however, it should also be followed with regular tests such as ALT(SGPT) levels and viral load(PCR) for HBV DNA. Mostly in this scenario treatment is not often required.

I hope you find this helpful.
Regards
Dr. Abdur Rehman Alozai.

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What Are The Chances Of Acute HVB Converting Into Chronic HVB?

hi I read your question thoroughly. HBV infection has many outcomes: In majority of patients(approximately 80 to 90 %) human immunity will eradicate the infection. In which case serology tests will only show Anti-HbsAg and Anti HbeAg(IgG). Normaly it takes 5 to 6 month for the immunity of human body to eradicate HbsAg from the blood. so in your case you still need to wait 2 to 3 months to see if your infection gets completely eradicated or not. So, regular follow up with serology tests for HbsAg and Anti-HbeAg is strongly advised. In a minority of patients( approximately 5 to 10 %) it may get converted into chronic infection. In which case there are two possibilities: 1) The infection might develop into a chronic carrier transmissible disease( Anti HbeAg-IgM and HbsAg +ve in blood) in which case there is high replication of virus and it causes damage to the liver, therefore, it has to be considered for further evaluation that is repeating the tests such as Alt( SGPT ) levels and a PCR for HBV DNA and a liver biopsy(in selective cases). Depending on the outcomes of the mentioned tests, treatment can be considered for a duration of 1-year. 2) The infection might develop into a chronic carrier non transmissible disease(Anti HbeAg-IgG and HbsAg +ve in blood) in which case there is low replication of virus and it causes minimal or no damage to the liver, however, it should also be followed with regular tests such as ALT(SGPT) levels and viral load(PCR) for HBV DNA. Mostly in this scenario treatment is not often required. I hope you find this helpful. Regards Dr. Abdur Rehman Alozai.