Hep B Blog

Which is Worse Chronic Hepatitis B or C? What Do You Think?

From HBF’s expert Guest Blogger, Dr. Thomas London

If you ask doctors in the United States, or patients with liver disease, or the average person on the street, the answer that you usually get is that Hepatitis C is worse.  Hepatitis C has a bad reputation in the media and with the public. We, at the Hepatitis B Foundation, tend to think that hepatitis B is the worse disease, but until now we have not had any basis for that answer. Now we do.

Recently a group of investigators from Johns Hopkins University published a paper with the title “Comparative Risk of Liver-Related Mortality from Chronic Hepatitis B Versus Chronic Hepatitis C Virus Infection”.  The answer from this publication is that hepatitis B is more likely to cause liver related death than hepatitis C.  It is worth dwelling on how the authors came to this conclusion: unexpectedly, the AIDS epidemic triggered the studies, which made the conclusion possible.

Acquired immune deficiency disease (AIDS) was first reported in the United States in 1981. The disease appeared to be deadly, and it was thought-to-be confined to homosexual men. In fact, it was initially called Gay Related Immune Deficiency or GRID.  Although it was soon proven that this new immune deficiency disease was not limited to gay men, it is true that men who had sex with men (MSM) accounted for most of the early cases.  In the 1970’s there were several reports that MSM had a high incidence of hepatitis B.  For the initial clinical trial of the then new hepatitis B vaccine, MSM in New York City were selected as the study population because of their high risk for hepatitis B infection. In the trial about 27% of the unvaccinated population became infected with hepatitis B virus (HBV) within 18 months, whereas less than 3% of the men who received the vaccine became infected over the same time interval.  This result proved the efficacy of the vaccine.

Fast forward to 1984 before the virus causing AIDS was clearly identified, several researchers suggested that a variant of hepatitis B was the cause. A group of investigators proposed a prospective study of MSM who had been tested for hepatitis B and a newly reported anti-HIV antibody, but who did not have immune deficiency disease.  By following the men over time, the thought was that it would be possible to observe which infection – HIV or hepatitis B or a combination of both – led to AIDS.

MSM were recruited from 4 cities in the USA (Baltimore, Chicago, Pittsburgh, Los Angeles); thereafter called the Multicenter Cohort Study (MACS).  Over four time intervals from 1984 to 2002, 6972 MSM were enrolled.  The men were followed until 2010, on average for more than 8 years. Serum samples were collected every 6 months, frozen and stored.  Although the hepatitis C virus had not yet been identified in 1984, all the samples were later tested for HIV, HBV and hepatitis C virus (HCV).  All deaths were recorded as were all liver related deaths.

The results were surprising. Comparable numbers of men were infected with HBV and HCV, but MSM with chronic hepatitis B were twice as likely to die a liver related death as the men with chronic hepatitis C.  The statistical analyses were carefully done to account for the treatments of HCV, HBV, and HIV that were used during the course of the study.  Immunodeficiency further increased the risk of liver death in the men with hepatitis B over that in the men with chronic hepatitis C.

The study showed that in the two and a half decades after 1984, hepatitis B infection was more serious than hepatitis C. Now, in 2012, this difference is even greater. Chronic hepatitis C has become a curable disease.  Chronic hepatitis B is manageable, but not yet curable.  This means that hepatitis B, which was already a worse disease than hepatitis C before the new therapies for HCV, is now a much more important unsolved health problem.

– Dr. Tom London

Comments on this blog are closed. If you have questions about hepatitis B or this blog post, please email info@hepb.org or call 215-489-4900.

85 thoughts on “Which is Worse Chronic Hepatitis B or C? What Do You Think?”

  1. Very interesting post, and thank you for sharing. I have a few questions (probably complicated answers!). As someone with chronic HBV (diagnosed 11 years ago and no complications so far – regularly monitored), it somewhat concerns me that HCV is considered a “curable disease”. I realise this may come across a bit selfish, but given HBV has been around longer than HCV, how is it that HCV has achieved this status over HBV?

    What is being done to get HBV to a “curable disease” status like HCV? I know there are lots of things that go into this (political, financial, technical, scientific etc).

    What are the new up and coming developments likely in the next 5-10 years or so that I can look forward to in treating or curing HBV?

    Thanks again
    David

    1. David,
      The answer to your question involves, science, politics and money.
      The scientific reason that HBV has been a more difficult nut to crack
      than HCV is due to the method of HBV’s replication. In the infected
      liver cell, HBV is lodged inside a structure called a mini chromosome.
      Within that structure, the template for HBV’s replication is a molecule
      called cccDNA (covalently closed circular DNA). HBV copies made from the
      cccDNA template are suppressed by treatment with the available
      anti-viral drugs, but the cccDNA is not affected.

      The political/financial reason is HCV research has received much more
      funding in the US than HBV research. And the reason for that is that is
      that government data implied that HCV disease was more common and more
      severe than HBV liver disease. That view can now be put to rest.
      I am optimistic about the future. Scientists at the HBF have some good
      leads on how to attack HBV cccDNA. If they prove to be right, then a
      curative therapy might be available in less than 5 years.
      Thomas London

  2. Thanks for the great blog entry, Dr. London. This is very well explained and very informative. Wishing HBF and all HBV researchers around the world all the very best as they seek a cure for HBV.

  3. Thanks to Dr. London, for highlighting this problem, and to the Hopkins researchers, for their enlightening publication. We understand that both hepatitis B and hepatitis C can be devastating diseases, and cause significant suffering and death. My own family is still recovering from the death of my husband’s Mom from hep-C related liver cancer. As a public health community, we all celebrate the success of the new hep C curative medications – it is truly wonderful for those suffering from hep C, and makes me so happy that fewer families will have to deal with the devastating loss that we did.

    What we can’t ignore, however, is the disproportionate amount of attention and funding that hep C gets versus hep B. Hepatitis B continues to be under-recognized and under-prioritized in the U.S., while millions of families are still waiting for their cure. It is critical that hepatitis B be given the funding necessary to move our own cure research into the realm of cure, and to provide more “on the ground” public health programming to get people tested and into care.

    People seem to think that hepatitis B is a fading problem – maybe it is because there is a vaccine, maybe we just haven’t made enough noise. It is time that everyone understands just how bad hepatitis B can be. So, not only do we need more studies like this one done at Hopkins, but we need to give way more attention to these publications when they do come out.

  4. Thank you so much Dr. Tom London for the valuable information.
    I am anxiously looking forward to the cure for Hepatitis B since I have been on Viread for over 5 years. I was on Interferon (Pegasys) treatment for 7 months recently but it didn’t work so I was put back on Viread again.
    Please keep us updated as you normally would and I will look forward to the good news.
    Thank you so much.

    Sean

  5. hello…heppB i was reading and thinking about my problem im a victim of HepaB- antigen the doctor told me when im going to medical..he said im going to whole body medication but im not going becouz im scared to know everything…its is a nessesary to do..if im not going im died how long my life when im carried this HepaB- antigen…im so curious and scared ….what i should do? you have a medication this HepaB -antigen..how ? then im pregnant if possible my baby carry also in HepaB….now my babay is 5mos.. then i have a bf im leave in now..when he do medical the doctor said he got also a HepaB….if possible my HepaB thrue w/ him he take my Hepa or he got already …becoz he always drunk and he take to much cigarrete i dont knw f he take my HepaB- antigen or becoz hes to much drinking alcohol….please give me some adise i want to know thank you and im waiting to your reply…………

    sincerly: jane

    1. Please do not avoid learning about HBV because you are scared. It is important that you see a liver specialist who can talk to you about your hepatitis B infection. It is important to learn how HBV is transmitted so you can prevent transmission to others. HBV positive mothers should have their newborn receive the first dose of the HBV vaccine and a shot of HBIG within 12 hours of birth in order to prevent transmission from mother to baby. There are good treatments for those who would benefit from treatment, but you need to be thoroughly evaluated with blood work and a physical examination and health history. Remember to take care of your general and liver health, by avoiding alcohol, avoiding cigarettes and eating a healthy diet.

  6. A year or so ago, my doctor told me that HBV has a curable rate of about 10% with Viread treatment. Is this opinion still correct?

    1. Assuming conversion to HBsAg negative is a “cure”, the occurrence is very uncommon, and is only 3% to 5% with long-term treatment with Viread/tenofovir. However, 75% to 80% will develop very low or undetectable HBV DNA levels.

  7. Dear Dr. Tom London,
    I have a question:
    The government’s view on HCV previously as a more epidemic and more common disease so they spent more money on the research but HCV has now become curable so the previous view can be put to rest as you stated.
    At this point, is the government beginning to view HBV as a very common disease as they did to HCV?
    If not, when?
    Any advice will be appreciated it.
    Thank you.
    Sean

  8. Thank David, Sean, and Chari. All of your inputs are accurate. I am chronic HBV carrier since childhood (I do not know when started). I had flare since 2010. I have been taken Baraclude since then. It costs around $900 a month. I cannot aford if I do not have medical insurance with full time work.

    As most of HBV carriers, I pray the Federal Government or drug manufacturers to treat HBV as same as HCV or other dieases. Maybe we (HBV carriers) have not made big noise!!! But there are many carriers in the world.

  9. Thank you for your input as well Sherry.
    I totally agree with you that the government needs to be heard our voice out and loud.
    My understanding is, Hep C was quite common in the military back then, a lot of soldiers got contracted from one to another so it spread out pretty fast so that caught the government’s attention. So they spent money on it.
    At this point, I don’t know if the government would care about the civilians who have Hep B.
    I think they would rather care about their soldiers who have Hep C than the civilians who have Hep B.

    Any comments are welcome.

    Sean

  10. Hi, I totally agree with theses responses from affected patients around the world who have been living with Hepatitis B all there lives or who have aquired the disease at a later stage it doesn’t matter how you got it. We are all in the same boat and we all need to keep sending our voice into this fearful disease that most of us hve been to afraid TO talk about about in the past. I am from Australia and it shows that we are all the same all over the world, the fear the shame. I think you never really accept it but live with it and you have no choice. It’s true that Hep C has always been the focus and not hep B because of vaccincatoin. But that is all changing know thanks to people around the world speaking up. I pray for everyone around the world that all that fear will disappear. That it was all just a BAD DREAM>>>> A CURE IS ON THE HORIZON.

  11. Hi, I have had hepB since childhood. My liver count was very high and now I am on Baraclude for about a month. Could some please advice how long will I need to be on Baraclude for…? Any side effects of Baraclude?

    1. Baraclude is an excellent antiviral used to treat chronic HBV. There are typically few or no side effects, but talk to your doctor if you experience any. Treatment with an antiviral is often for years or even for life. Please take baraclude daily, as directed. Stopping baraclude may result in flares that can result in liver damage. Please discuss this with your doctor.

  12. Dear Dr. Tom London,
    Thank you for your educative narration about HBV and the insight provided. I’am a HBV victim with no information about when or how it started. Though i can recall that i was treated with Hepatitis about 15 years ago but the Dr. then did not explain further especially about the fatality or it being incurable, which made me continue to live my life unchecked until about 8 years ago when i was diagnosed. However, though diagnosed and have been doing health check 1 to 3 times yearly since over 5 years my Dr. has not prescribed any HBV related medication. Due to language issues in this part of the world i am sometimes concerned whether there are things i should know or be doing that i am not doing about it. Therefore, i would appreciate some kind of clarification about this virus from a specialist like you.
    Is there any kind of HBV that could be there though high than normal but stays there for life time ?
    The scary part is that i do drink alcohol sometimes perhaps because of the way i feel.
    To be honest i do not feel anything different other than some minor fever or headaches when i have cooled. I still play football though i gets tired faster than before which i thought could be related to my age. By the way, i am 36 years old going to 37.
    Please let me know if there’s anything i need to know to about this that would ensure i continue to live a normal life.
    Sincerely,
    Iyke.

    1. Dr. London is on vacation. Yes, chronic HBV is not uncommon and at this time there is no complete cure.There are good treatments, but not everyone needs treatment. I would encourage you to see a liver specialist to learn more about your HBV infection and your liver health, and whether or not you need treatment at this time, or in the future. HBV and drinking is a dangerous combination. Lifestyle changes can make a big difference in your liver health so consider changes that are good for your liver: do not drink alcohol, do not smoke and maintain a healthy weight by eating a well balanced diet and getting plenty of exercise. Most importantly be sure you are evaluated and regularly monitored by a liver specialist. These are all very important and certainly help you live a long, full life filled with work, love, family and friends.

  13. Dear Dr. Tom London,

    Thank you very much for all the inputs you gave us but i have another question. My question is, How long a person with Hepatitis B on treatment will live?

    with regards,

    GKHN

    1. Having HBV should not be a barrier to marriage. We are so fortunate to have a safe and effective vaccine so your future spouse and children can be protected against HBV!

  14. Hi doctor,, i wanna clarification for the answer which one is much worser hepatitis B and hepatitis C

    1. I believe Dr. London stated that HBV is worse than HCV for a number of reasons. At this time HCV can be completely cured nearly every time versus HBV which can be controlled but not cured. Hopefully we will soon see a cure for hepatitis B.

  15. hello Everyone
    I am Tina,I live in Rwanda-Kigali.on 18th October night my mother started vomiting much blood,when she went to the Doctors they gave her tablets for ulcers,but I insisted they do more tests,and with that hospital they found out that she had hepatitis C,she got transferred to Kanombe hospital where they did the first test and found her negative but because her tummy had increased in sice they took more tests and said that she had Hepatitis B.
    I have been trying to think that everything will be ok.i am the first born,still job hunting,she is the only parent i am left with,i am not ready to lose her at all.unfortunately the hospital has not even told her what 2eat n what not to eat and if i tell her sometimes she takes it the wrong way,yet am trying to help bse am scared for her life.my qn is how affordable are the medications?how long can my mother live?

    1. I am sorry to hear of your mother’s viral hepatitis infection and the impact it is having on you. This is a difficult time for both you and your mother. I would encourage you to have your mother see a liver specialist – perhaps at a larger medical center or teaching/research hospital to learn more about her HBV and liver health. What are her doctors indicating at this time?

      There is no HBV specific diet, but your mother wants to be sure to eat a healthy, well balanced diet filled with colorful vegetables, fruit, whole grains and ask her doctor about protein sources and amounts since I am not sure of her situation. She should avoid all fast foods or processed foods. She should NOT drink alcohol and she should avoid smoking and environmental toxins. Getting moderate exercise is also important – basically just walking regularly is typically very good for your mom unless she is told by her doctor that she should avoid even limited exercise.

      Hopefully you are able to find a good liver specialist for your mom who can offer you good advice. Please be sure to check out our website at http://www.hepb.org

  16. I think hepatitis B more serious than hepatitis C in general population but hep C more risk on health worker because vaccination not available yet Thanks for all

  17. Dear DR
    am a humanitarian worker in south Sudan , I was diagnose with HBV 2yrs ago and I also diagnose with fatty liver , and at one year time my virload was reading ,20 iul but the last test in April my viraloads increase to 411 iul and I supper a lot with the fatty liver I don’t have any pain in the rest of my body but the side of the liver ,when ever I go for scan they told me fatty liver , and always they told e to reduce weight , so am trying to do exercise and to avoid other foods, am not drinking what could be the Couse of fatty liver hepb or not ? and what will my future be am I going to die soon for all this two liver disease please I need your advice if I can start medication at that viraload
    thank you
    Jodephine

    1. Hello: Unfortunately, some people genetically have a predisposition for non-alcoholic fatty liver disease, and as you know, being overweight worsens that condition. Many people with fatty liver disease have liver damage even if they are not infected with hepatitis B. As you accurately point out, you are facing two problems in your liver–fatty liver, which causes the pain in your right side, and a hepatitis B infection. I very much agree with your doctor that the best things you can do is exercise more, eat fewer fatty foods, and definitely stay away from any alcoholic drinks and smoking. I believe if you can reduce your weight, you can be healthy despite the hepatitis B infection.
      I don’t think you’ve provided the correct reading for your viral load, is it possible for you to provide more of your test results? The ALT or alanine aminotransferase reading is important too, because it shows the health of your liver. An antiviral treatment will lower your viral load if it is very high, your doctor will provide you with advice. What I can suggest is to concentrate on what you can control — eating a healthy diet, and staying away from fatty foods and alcohol. If you can do that, the health of your liver should improve. Good luck.

  18. dear Dr thank you for your respond the scan was done and they told me my liver function was fine but my liver is a bit enlarge because of the fats I could not remember well the medical documents are not with me here , but there is some thing that they wrote 18 and the other one 23 I don’t know which one is ALT but viro load is 411iu/l my kg from 83 is now 77 kg but my question remain may I start treatment for hepb and what is the treatment for fatty liver ?

    1. Hello: From the information that you provided, your liver condition (function) is fine and your ALT is within the normal range. Your viral load, if I’m interpreting your results correctly, is also fairly low, which is good, so there appears to be no reason for hepatitis B treatment at this time. Of course you should discuss this with your liver specialist and follow his or her recommendations. Again, the main problem is your fatty liver, so exercise and a healthy diet will do more at this time than treatment for hepatitis B. Good luck.

  19. Dear Doctor my fatty liver have improved according of the scan result and HBV virus are 451 ul so is it possible for me to start treatment , my liver function is normal, secondly I read from the web site the cure for HBV has been found from Australia , is the combination of Cancer drug and HBV drug please tell me

    1. Hello: Not all people with hepatitis B require treatment, if you have a low viral load and your liver function is normal, according to current medical guidelines, you may not require treatment. It is important to discuss this with your liver specialist who is familiar with treating hepatitis B. Currently, there is no cure for hepatitis B. There are several good medications available to lower your viral load, but no cure. To find out about promising drugs now under development, including the one you referred to, visit our Drugs in Development webpage at http://www.hepb.org/professionals/hbf_drug_watch.htm
      Thank you

  20. dear doctor i have two people in the family who have been diagnosed of hepb positive
    the viral loads have been done but the doctor says they are within the required range
    so the medication has not yet started i am from Ghana.I have two questions
    1. Is it true that the combination of Birinapant and entecavir gives 100% eradication of
    hepatitis b?
    2. Please what is the life expectancy of hepatitis b patience if all medical advises are obeyed.

    1. Hello: There is no drug or drug combination that guarantees 100% eradication of hepatitis B. There are drugs under development that are very promising, and a cure should be developed in the next few years, but currently a cure isn’t available. There are effective drugs that can help stop the virus from reproducing and lower viral load and the risk of liver disease. Many people live full, long lives with hepatitis B. As long as you eat healthy foods, avoid alcohol and smoking, and get regular check-ups, most people have normal life spans. Good luck.

  21. I am 28 and was diagnosed of hepatitis b. Testing positive to me tested like death. I don’t have any symptoms of the disease currently though my two tests confirm am positive. I’ve decided to visit a liver specialist who recommended liver tests to see of it functions normally. He says he will do more tests as Time goes on. Through counselling and reading about the virus I feel better now and looking forward to live a normal full life

    1. Thanks for your comment, when first diagnosed many of feel like we’ve been handed a death sentence. In reality, many people live long and healthy lives with hepatitis B. It’s important to be monitored regularly, and there are very effective drugs if we ever need treatment. Experts predict a cure in a few years, so we are optimistic! Good luck.

  22. Dear Dr I have a concern am 3 yrs tested HBV positive before the fatty liver as well as my husband but the kids are all negative have already vaccinated and we are still look healthy so doctor are we to have sex with condom or without since we are all infected please advice

    1. Hello: Because you have both already been exposed to each other’s hepatitis B infections for years, you may not have to use a condom at this stage, as long as both of you are monogamous. However, ask your doctor about this to make sure. And, great job having your children vaccinated! Thank you.

  23. Dear DR I just want to know as the researchers are working hard , they have already get the cure for HCV ,only that the price is still not affordable , so am asking is there any hope for the cure of HBV? or it will continue to be manageable

    1. Hello: I am happy to report that experts predict that they expect to develop a cure for hepatitis B in the next few years. Until then, we have effective antivirals that reduce our viral load and risk of liver damage. We are hopeful and optimistic! To monitor what new drugs are in development, please visit our Drug Watch webpage at http://www.hepb.org/professionals/hbf_drug_watch.htm
      Thank you.

  24. Dear DR
    I just want to find out why is it that when the Viroload is abit low one cannot benefit from the treatment , for me I was thinking that it would have been oke to managed the virus when is not yet darmage the liver , especially when it has staredt mutflying

    1. Hello: You ask a great question. Because we have no treatment today that is able to totally gets rid of the virus, doctors don’t want to use antivirals or interferon unless a patient really needs it and is experiencing liver damage. It’s sort of the “if it’s not broke don’t fix it” approach. Also, interferon that boosts the immune system doesn’t work unless the immune system is already fighting the infection. Doctors also don’t want to put anyone who doesn’t need treatment on antivirals, because the virus can sometimes develop mutations to the drug and doctors don’t want to run out of treatment options. Good luck.

  25. Dear Dr. I am 30 yr male diagnosed with chronic Hep B in mid 2015. It came as a shock as even though I had more than one partner at different times I never engaged in unprotected penetrative sex, unprotected oral yes. After the depression and nightmares I went through I am now dealing with it as best as I could. My viral load and LFT results put me in the range for treatment. My problem is no pharmacy in my country has nor seem willing to source the drug Tenofovir which my doctor prescribed. I believe its because of the cost, even though I am willing to pay they dont want to take the risk. What other drug, or drug combinations, do you recommend I can use that works best to combat mutation of the virus.

    1. Hello: I am surprised, as tenofovir is used to treat HIV as well as hepatitis B. What country to you live in? If you visit the website of the World Hepatitis Alliance (www.worldhepatitisalliance.org) and look at its member countries, you may find the country where you live. There should be a list of organizations that work on hepatitis-related issues. Perhaps they can tell you how to get tenofovir. Good luck.

      1. Hi doctor, I live in the Eastern Caribbean. Hep B infections arent common here. I have even been to the government body responsible for HepB/HIV medication. What I am hearing is that due to cost, they do not source the pure Tenofovir medication anymore. What is being used are combination pills i.e. Tenofovir mixed with something else. I have taken to sourcing the medication from an online pharmacy. That seem to be my only hope now.

        1. Hello: There is an antiviral used for HIV that combines tenofovir with another antiviral called emtricitabine (brand name Truvada). This combination has been used effectively against hepatitis B, so if it is the only antiviral with tenofovir available to you, it will work against hepatitis B, especially if it is more affordable than purchasing tenofovir overseas. Good luck.

  26. hi doc,being infected for the past ten year now,looking for a proper management.i have access to germany and italy were do you think i can get proper care?and my partner is negative since we are planning making baby soon,how do I protect her?

    1. Hello: Before you have unprotected sex, you must make sure she is immunized with all three doses of the hepatitis B vaccine, and a blood test shows she has enough hepatitis B surface antibodies, also called titers, to protect her from infection. She should have at least a 10 mIU/mL level of surface antibodies. Both Germany and Italy have hepatitis B experts. If you visit our liver specialist directory page at http://www.hepb.org/resources/liver_specialist_directory.htm you can find hepatitis B experts around the world. Good luck.

  27. i got to italy as asylum seaker,they have done the comfairmation test and not attending to me again,the manager in my camp told me its no big deal having the vairus,that almost everybody has it makin me feel its no problem at all.it really make me sick ,being feeling this consistent pain in the rigt side of my abdome its by the grace of God i sleep and wake up the next day.i got infectrd when i was working with a medical laboratory as a lab asistant ,when i remember this i feel so miserable and i feel like giving up.am considering moving to germany finding help.need your advise.

    rking as lab
    attendant,when i

    remember this i feel so miserable i feel like endiing my live

    1. Hello: I am so sorry to hear about your circumstances and your medical condition. You clearly are receiving less than ideal care in the refugee camp, and are under tremendous stress that can lead to a variety of medical problems that are not related to hepatitis B. Please do not give up, keep trying to get healthcare and if/when you are resettled in a new community, see if you can get tested for liver damage (an ALT test) as well as gallbladder and other tests to identify the source of the pain. Our thoughts are with you, good luck.

  28. thank you very much doctor,planing my way to germany.hope to get a better care there by the grace of God.

  29. Hi Doctor,
    My wife is infected with chronic HBV . 1.5 year ago during the blood test we have informed about it. Gave a blood test for FIBROMAX and result was: there is no Fibrosius. Alt/Ast is normal/ liver scan shows that there are no problem.
    During this 1.5 year we have visited 4 times our doctor and gave a blood tests and liver scan. But virus load for the first time was 6.0 x 10*2 after 3 month 2.9 x 10*3 after next 3 month HBSAG is positive but viral loads are not shown. But the last month we gave again blood test and results are : Hbsag -positiv 4.6 x 10*3 Iu/ml, Hbeag -negativ 0,04 and anti Hbe is positiv. ALT 21/AST 29 and other test is normal/ Liver scan shows that there are no any problem just a small fatty of liver.
    Could you give me a little information about virus load. Why virus load was lost and after 5 month later shown again and a little more than first time taste? Does she need to start for treatment with the taste results mentioned above?
    Also I want to know a little more information about chronic HBV and your advice to live long and healthy life. She don`t drink and smoke and eats normally also drinks minimum 2 litres of water daily.
    Thans in advance dear Doctor

    1. Hello: Our viral loads can fluctuate depending on the strength of our immune system. So if she was sick with the flu, or stressed etc., her viral load may increase in one test and decline in the next test. What is important is her ALT level of 21 shows there is no liver damage occurring, which is excellent, and she tests positive for the hepatitis B “e” antibody. As long as she eats healthy foods and does not drink or smoke, she may lead a long and healthy life, as long as she is monitored regularly by her doctor. This may not be an issue for you, but if and when she has children, it is very important that the baby is vaccinated with the first dose of the hepatitis B vaccine within 12 hours of birth. Also, I assume you have been tested and vaccinated also? Thank you.

  30. dear Doctor thank you very much for great information and reply. Yes me and my son vaccinated allready, but my doughter`s test result for Anti HBSag was positive and because of doctor told me that she don not need to vaccinate. Doctor told me that maybe your doughter got the virus but with the strength of her immune system she had an anti Hbsag. Is it true? And one question more please/ If I am vaccinated can i get that virus from my wife from the sex or any kisses?
    Thanks in advance

    1. Hello: Yes it is possible your daughter was infected with hepatitis B, but her immune system was able to get rid of the virus, which is very good. If you have been vaccinated, and you have hepatitis B surface antibodies, then you can safely have unprotected sex with her. It is always safe to kiss someone with hepatitis B unless you have mouth sores. Good luck.

  31. DR I have HBV with low viroload and I have scan ever three months reads normal and I was having fatty lever I have beaten it off , but I still have pain in my upper abdomen at right hand side it started two years ago since the time I was having the fatty liver when I went to my DR he said it may be nerves and he gave me the medicine but still the pain is there what could that one be ?

  32. Dear DR I just want to find out the clear limit of the treatment of HBV especially when ones viroload has reached to the extend of benefiting from the medicine for how long will the person continue to take the drugs ? is it for life or has time limit?
    thanks

    1. Hello: Doctor generally prescribe treatment if your viral load (HBV DNA) is elevated and you have signs of liver damage, such as an elevated ALT/SGPT liver enzyme. If your doctor has placed you on treatment, that probably means you had some liver damage. Usually, doctors treat you until you have produce the “e” antibody and you no longer have a high viral load or signs of liver damage. Ultimately, treatment can stop if you have lost the hepatitis B surface antigen for several months and have no signs of liver damage.
      This is a hard question to answer because stopping treatment depends on your overall health, gender, age, and history of infection. For more information about when you can stop treatment if you have lost the HBeAg, please see: http://hepbblog.org/2016/01/27/thanks-to-antivirals-youve-lost-the-hepatitis-b-e-antigen-so-when-can-you-stop-treatment/
      If you were HBeAg-negative when you started treatment, and now have normal ALT and low viral load, please read this: http://hepbblog.org/2016/02/03/can-people-with-hbeag-negative-hepatitis-b-ever-stop-taking-antivirals/
      Good luck.

  33. Dear DR I read a lot of journals of product from the internet , some of them claimed that they can cure HBV some of them said when you drink coffee regularly it will reduce liver damages for 50% some of them contradict, so am confused , pleas help me out of this internet match , and tell me the truth about the cure of chronic HBV whether is near or whether death will be the cure , because we will waste a lot of money , for nothing , may be one can
    keep the money to take care of the children when your death ,

    1. Hello: Coffee provides some protection to your liver against infections and damage. However, the best thing you can do is eat healthy food and avoid alcohol and cigarettes. Many people live long and healthy lives with hepatitis B. You need treatment only if you are experiencing liver damage, indicated by a blood test for ALT or SGPT. Take care of yourself, be sure to practice safe sex, and have your family tested and vaccinated if needed. Good luck.

  34. I need to ask a question. I am silent carrier of Hepatitis B virus. How can i prevent this disease from transfering to my wife and then to my childrens. Are there any safety measures so that diseases is prevented and my wife also get safe from this disease.? How many chances are there.?

    1. Hello: Great question, there is a very safe and effective vaccine that protects against hepatitis B. It is given in three doses. After the first shot, the second shot is given 30 days later, and then the third is administered five months after the second dose.
      First, have your wife tested for hepatitis B and vaccinated as soon as possible. About one or two months after her third shot, have your wife tested for hepatitis B surface antibodies (anti-HBs). If she has at least 10 iu/ml of anti-HBs, she will be protected for life. Until she is vaccinated and found to have immunity, you must practice safe sex to avoid infecting your wife. The same immunization process needs to occur with any children you may have.
      This is very important as hepatitis B is easily spread sexually. Good luck.

      1. Could you please tell me the name of that vaccine.?

        Is it fully confirmed that it will protect my wife from having hepatitis B infection.

        Secondly, if anti Hbs is less than 10iU/ml, what to do next.?

        I donot want to transmit my infection to my wife. I want her to be protected. But I also want to have children. In this regard how would you guide me.? What should i do? What measure should i take.?

        1. Hello: Any clinic will have hepatitis B vaccines that are effective. Have your wife tested for hepatitis B, and if she has not been exposed, she needs the three vaccine doses. After the first dose, the second is administered 30 days later, and the third is administered five months after the second. About one or two months after the third dose, have her tested for hepatitis B surface antibodies. If they are 10 mIU/mL or higher, then she is protected from hepatitis B, and you can have unprotected sex and have children. If she has not produced that level of antibodies, you can have the vaccine series repeated. As long as she is not infected, she will not spread hepatitis B to your children. Just make sure your children are vaccinated within 12 hours of birth, and then make sure they get the next two doses on time and they will be fine. Good luck.

          1. Hello: Engerix-B is a vaccine for adults that prevents hepatitis B. Yes, it is approved by the U.S. FDA and is effective. Good luck.

  35. My Recent HBV DNA PCR Quantitative Result is Detected 12 IU/mL.
    Serum Bilirubin (Total): 0.37
    SGPT (ALT) : 25 U/L
    Alkaline phosphatase: 88 U/L
    Gamma GT: 22 U/L

    Anti HDV Result: Negative 1.43

    Is any thing to worry.?
    I have been treated with Entecavir for 6 months in 2011

    1. Hello: Your liver enzyme (called SGPT or ALT) is an important indicator of whether you are experiencing liver damage. Your ALT level, at 25, is in the healthy range. Healthy ALT levels range up to about 19 for women and 30 for men. The numbers can vary, based on what each individual lab considers normal. Your test results also show you have tested negative for hepatitis D (HDV), which is also good news. Good luck.

  36. I came to this page by accident as someone who has Hep C. I am aware that I can be cured, but my viral is low, and as I understand only 1/3 of those with Hep C progress to serious liver damage, so I am forgoing treatment. Am I correct?

    What I want to ask is how often chronic Hep B progresses to serious liver damage? I understand it is at a higher rate than Hep C? Also, I am confused as to how anyone even HAS chronic Hep C in this day and age. I have been vaccinated for Hep B since I was a young teenager, and I was under the impression this was common practice? I am just confused….

    1. Hello: Thank you for your follow-up post clarifying that you have hepatitis B not C. About 10-15% of adults with chronic hepatitis B develop serious liver damage, such as cirrhosis or liver cancer. If you avoid alcohol and cigarettes and lead a healthy lifestyle, your risk of liver damage decreases markedly. The hepatitis B vaccine is very effective, but when people are infected at birth or during early childhood, before they are immunized, then the vaccination will not protect them.
      It’s difficult to compare liver damage rates between hepatitis B and C, because so much depends on a person’s overall health, lifestyle, gender, age and other factors.
      Should you ever need treatment for hepatitis B, be assured there are effective antivirals available that can lower viral load and reduce the risk of liver cancer. Good luck.

  37. Hello Dr, see the result below! And dr say no need treatment! Does that means no need treatment forever? And any risk in this results?
    Hbv DNA below 20ui, Log value says Not Applicable, Cutoff Value Says 4107, Hdv says Negative, Hbsag Positive, Hbsab Negative, Hbeag Negative, Hbeab Positive, Hbcab Positive, Hcv Negative!

    Thanks

    1. Hello: I am glad you hear you have an “inactive” infection and that your immune system is strong enough to suppress the virus to very low levels. However, I do not see any results indicating whether your liver is healthy. An ultrasound and/or a blood test for the liver enzyme ALT (also called SGPT) will indicate if the infection is harming your liver.
      Even though your infection is “inactive” and your liver is healthy, it is still important to continue to be monitored in order to catch any problem that can arise. And of course avoid alcohol and cigarettes, and eat healthy foods. Good luck.

  38. Hello Dr, see the result with ultrasound and ALT AST below! And dr say no need treatment! Does that means no need treatment forever? And any risk in this results? Can my body would be able to get rid of it?

    
Hbv DNA below 20ui, Log value says Not Applicable, Cutoff Value Says 4107, Hdv says Negative, Hbsag Positive, Hbsab Negative, Hbeag Negative, Hbeab Positive, Hbcab Positive, Hcv Negative!

    Liver Uss
    The Liver measures 14.4cm, its has a smooth manyin with regular outline, it’s has parenchyma echotexture is homogenous and Preserved. The intrahepatic ducts and vascular channels are sonographically within normal limits, the Gall Bladder is seen, its has a clear sonolucent contents. The walls and outlines is Preserved.
    AST is 26 lab Range 35. ALT is 0-35 Lab Range 0-45

    Thanks

  39. Hello Doctor…. My father had Valley fever in 1978. At that time, the treatment was surgery. He had 1/2 of his left lung removed and during the surgery he hemorrhaged which necessitated a blood transfusion. The blood he was transfused with was hepatitic and he was infected with the B virus. I have two questions actually…. I was reading above about a medication Baraclude, my father was not prescribed that and I wonder if you might know why that would be. Additionally, Id like your thoughts on why hospitals were not screening blood at that time? It just seems like such basic hygiene and common sense. Its still very hurtful to me. We live in Phoenix, which in 1978 was quite unsophisticated. He and my mother were able to live a nice life, traveling etc. but his last years were awful and I’m still angry because it was so senseless and preventable. I would also like to ask any healthy people to please donate blood, angry as I still am, I’m O- ( universal donor) and I donate whenever I’m called because it’s important to me to try and make sure what happened to my Dad doesn’t happen to others. The ascites at the end was awful, he would get drained, then two days later he was like a balloon… graphic I know, but if people can avoid his fate through vaccines and medications, please get tested and follow your Dr’s direction. My thoughts are with all of the commentators and may you have a long and happy lives.

    1. Hello: Thank you for sharing your father’s story. Unfortunately, hepatitis B has historically been spread through improperly sterilized medical equipment, and many years ago through blood transfusions. Even today, there are hepatitis B outbreaks in nursing homes and other places where healthcare workers do not practice universal precautions. Thank you for your endorsements of both blood donation (which is perfectly safe now) and immunization. Hepatitis B is easily prevented. Good luck.

  40. hello doc, I’ve read a lot of article on this but am still scared. My fiancé just told me he has hapB virus and he has been carrying it for years now, although he feels no symptoms but that each time he goes for checkup he keeps testing reactive and his doctor told him not to worry that his immune system is fighting the virus . our wedding is in a month time, and am really scared. he sleeps a lot for like a whole day if given the opportunity. am soo confused on whether to proceed with our plans or to back off. I will like to know if with this status we are on a safe side or whether there could be complications in the future

    1. Hello: If you love him, marry him. The majority of people with hepatitis B never need treatment, especially if they eat healthy foods and avoid alcohol and cigarettes. There are no guarantees in life, any of us could become sick or injured in an accident at any time.
      It sounds like your boyfriend’s infection is “inactive” and his immune system is doing a good job at controlling the infection.
      Have you been vaccinated against hepatitis B? That is very important before you have unprotected sex with him. Once you are vaccinated with all three doses, get tested to make sure you have at least 10 mIU/mL of hepatitis B antibodies. If you do, you are forever protected from infection. Good luck.

      1. thanks doc, I really appreciate. I wish I could convince my parents cos they feel it a death sentence and that marrying him would be my worst decision ever in life

        1. Hello: Marriage should be your decision, not theirs. Just try to educate them about hepatitis B, and explain that you will not become infected and that many, many people live long, full and healthy lives with hepatitis B. Good luck.

  41. Hello Dr please i want to ask one question which is very vital to my whole being.How soon can mankind have cure for this hopeless disease
    will it be within 5year time or more.

    1. Hello: We don’t know exactly, but researchers predict a cure will be developed in the next few years. We remain hopeful. Good luck.

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