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Have acute Hepatitis B and Jaundice. Prognosis? When will ALT and AST get normal?

My age is 25, height - 190cm, weight - 76kg, I am from Ukraine. Starting from Dec.24 I noticed flu simptomes, that grew till Dec.29 (cold, cough, weakness, 37.2-37.5 Celsium temperature). Than nausea, vomiting once per day and dark urine added. On Jan.1.2013 my eyes begin to turn yellow. On Jan.2.2013 my skin also began to turn a bit yellow. I thaught that it could by hepatitis and went to a doctor. My HBSAg test turned to be positive and anti-HBc igM also turned positive, hepatitis A (negative), C (negative), D (negative). My ALT on Jan.3.2013 was 3000 and AST was 1900, total bilirubin - 216, conjugated bilirubin - 164. So doctor said I have acute hepatitis B with jaundice . He also said that I need to lie in hospital bed (contagious isolation ward), do not carry anything heavy, do not go for a long walks and eat according to Pevzner diet (eat 5-6 times a day small portions of food, drink around 2 liters of liquid, no alcohol, anything fat, spicy, fried or cold, no coffee, no preserved or marinated food etc... only light dishes that support my liver and do not harm it). He also prescribed daily dropper with the next medicaments (1 bottle of dextrose 5% 200ml mixed with vit.C 10% 2ml + vit.B6 1ml + asparcamum 10ml + cocarboxylase, and 2-nd bottle - reamberini 400ml). Plus daily sorbate pills 1 hour prior taking food. Doctor said this treatment is prescribed in order to lower body intoxication and to protect my liver. Now on 24.Jan.2013 I have the next analysis results (total Bilirubin - 79, conjugated bilirubin - 59, ALT - 331, AST - 138, no jaundice, no temperature). So, based on what I have wrote, could you please answer my questions: 1. Do I really needed to stay in bed, no long walks, no big physical activity, stay isolated in a hospital, eat special food according to diet ? When can I go to work ? 2. Was that prescribed medicaments correct ? I see on many medical web-sites, that acute hepatitis B doesn t need to be treated such way. 3. Can bilirubin level get higher again after it got lower (216 -- 79) and is it possible for me to become yellow-colored again ? 4. What is my prognosis according to current analysis result ? 5. When I need to repeat my HBSAg analaysis to see If i still have virus or not ? I read, that I must repeat analysis after 6 monthes (is it after 6 monthes since infection, or since first analysis). What other analysis must I do ? 6. Do I have acute or chronice hepatitis ? I read that if I have such big ALT and AST plus jaundice - it is likely to be acute infection ? Maybe I am wrong ? 7. When ALT and AST would become normal ? Thanks in advance. If you need any questions - please say to me, I have some additional analysis results (CBS, for example)
Asked On : Mon, 28 Jan 2013
Answers:  1 Views:  254
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM

I,ll answer your queries in chronological order:
1. It has been a month since you got diagnosed with acute hepatitis B. It will be good if you take rest and avoid strenuous activities. Start with your activities slowly as hepatitis is associated with weakness. Light food will be good even after a month of diagnosis. Fatty and spicy foods put a strain on the liver so best avoid them. Stick to light freshly prepared food, plenty of fluids in the form of water, fresh fruit juices and soups. You can go to work from next month but if the work involves stress, physical or mental best avoid for few days more.
2. The medications prescribed are basically energy providing dietary supplements and preparations aiding in digestion.
3. There is decrease in level of bilirubin ans liver enzymes (ALT and AST). This decrease signifies an improvement. A relapse or recurrence can cause an increase of both bilirubin and liver enzymes.
4. Prognosis is good as there is response to treatment given.
5. You need to get the tests repeated six months after the first test. This is to rule out chronic infection. A substantial number of cases of hepatitis B go to chronicity so it is important to rule out chronic hepatitis.
6. On the basis of the serum markers- HBsAg and anti HBc Ig M, it is an acute infection.
7. AST and ALT levels will come back to normal over 4-12 weeks.

I hope I have answered all your concerns.
Please add your review if you are satisfied with the answer.
Thanks and take care
Dr Shailja P Wahal

Answered: Tue, 29 Jan 2013
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