23. Do HBV carriers need monitoring?

So what should every hepatitis B carrier need to do for monitoring? What I recommend is you screen for liver damage every six months with a simple ALT or SGPT. You need to screen for liver cancer. If your doctor won’t ask for it, you ask him for it. And if he doesn’t do it, switch, go and see another doctor. You need an AFP blood test every six months, an ultrasound of the liver once a year. And if you have family history, we recommend twice a year screening with ultrasound, for those who have family history of liver cancer and if you have cirrhosis. Because once you have a family history of liver cancer and cirrhosis, your risk of developing cancer is much higher than if you don’t have a positive family history of cirrhosis. If the ultrasound is not satisfactory, (some people when you do an ultrasound it is difficult to interpret because you might have a fatty liver or a very fibrotic liver), the ultrasound will look like a piece of swiss cheese. You don’t know which hole has cancer. Then in those cases you need to do a triphasic CT scan of the abdomen. You cannot just do one test alone because you can miss the cancer. AFP will only pick up about forty to fifty percent of the liver cancers.