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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is HBV Mutations And Medicine To Prevent Chirrosis In Kids?

Respected Sir. I am from India. I am 34 years old. HBV carrier. Incidentally by blood was diagnised and found screening test hbsag-positive. SGPT-18 Imeediately Doctor advised to check my hbcab and hbeag they were positive and negitive respectively. When my wife(30) and children (9-f, 8-f) were checked for hbsag screening test they all negitive and their LFT are also normal but my child isolated ALP alevated (20 points) . My wife previously did not take any HBV vaccination but my children got vaccination after theri birth during the routine vacination schedule. Are they infected with hbv? what is the mean of hbv mutations? Every one those who have hbsag will suffer from liver cancer and chirrhisis?. Any medicine is available to prevent chirrosis and liver cancer Please explain . What is the clinical research of this medicine? is it better of HBV eradication? Recently I feel pain at right abdomin and the hole right abdomin feel wighty.
Mon, 15 Feb 2016
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Pediatrician, Infectious Diseases 's  Response
Hello and welcome.
Thank you for your queries. I have read your questions and understand your concerns.
With the information you have provided, if HBsAg screening test is negative, and if your wife’s testing was negative, and the children received their Hepatitis B vaccine series, then the chances of infection are very low, likely negligible.
HBV mutations refer to the changes in the genome/genetic composition of the virus occurring naturally or as a response to antiviral treatment. The mutations usually depend on the viral genotype (that can be tested by a blood test, mostly done if treatment is contemplated).
Not everyone with positive HBsAg will suffer from cancer or cirrhosis, however, up to about 25% of patients with a positive HBsAg will develop these complications. Risk factors for cirrhosis or cancer are very high viral loads in the blood (tested by HBV DNA PCR in the blood) and abnormal liver biopsy findings. So as an Infectious Diseases doctor, whenever I see patients with similar presentations, I would advise close follow up and monitoring of liver tests and Ultrasound of the liver at least annually with your treating doctor and if possible, also an evaluation by a liver specialist (Hepatologist).

There is research going on for Hepatitis B medications. All medications are being studied and a few are approved for treatment,however, the indications for treatment would be a high viral load in the blood (>20,000IU/ml, if HBeAg negative), elevated liver enzymes (ALT) for more than 6 months or abnormal findings on liver biopsy. Therefore, most doctors treat patients only if they meet the above mentioned indications. None of the approved medications causes Hepatitis B eradication but all are only suppressive for the virus.
If you are having pain and heaviness in your right abdomen, please get an Ultrasound of the liver and liver function tests (ALT, AST, Bilirubin), and I would also suggest seeing your local doctor.
I hope to have answered your questions. Please do write to us if you have any further questions and I would be happy to help.
Best wishes.
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What Is HBV Mutations And Medicine To Prevent Chirrosis In Kids?

Hello and welcome. Thank you for your queries. I have read your questions and understand your concerns. With the information you have provided, if HBsAg screening test is negative, and if your wife’s testing was negative, and the children received their Hepatitis B vaccine series, then the chances of infection are very low, likely negligible. HBV mutations refer to the changes in the genome/genetic composition of the virus occurring naturally or as a response to antiviral treatment. The mutations usually depend on the viral genotype (that can be tested by a blood test, mostly done if treatment is contemplated). Not everyone with positive HBsAg will suffer from cancer or cirrhosis, however, up to about 25% of patients with a positive HBsAg will develop these complications. Risk factors for cirrhosis or cancer are very high viral loads in the blood (tested by HBV DNA PCR in the blood) and abnormal liver biopsy findings. So as an Infectious Diseases doctor, whenever I see patients with similar presentations, I would advise close follow up and monitoring of liver tests and Ultrasound of the liver at least annually with your treating doctor and if possible, also an evaluation by a liver specialist (Hepatologist). There is research going on for Hepatitis B medications. All medications are being studied and a few are approved for treatment,however, the indications for treatment would be a high viral load in the blood ( 20,000IU/ml, if HBeAg negative), elevated liver enzymes (ALT) for more than 6 months or abnormal findings on liver biopsy. Therefore, most doctors treat patients only if they meet the above mentioned indications. None of the approved medications causes Hepatitis B eradication but all are only suppressive for the virus. If you are having pain and heaviness in your right abdomen, please get an Ultrasound of the liver and liver function tests (ALT, AST, Bilirubin), and I would also suggest seeing your local doctor. I hope to have answered your questions. Please do write to us if you have any further questions and I would be happy to help. Best wishes.