Hepatitis B Carriers: Health Implications and Pregnancy Concerns

Hepatitis B carrier

Three years ago, I was diagnosed with hepatitis B through a blood test, and in September of the 89th year, I had a blood test for the E antigen, which indicated that I do not have hepatitis B.
However, in June of the 89th year, I underwent a premarital health check: Hepatitis B surface antigen: abnormal (positive); Hepatitis B E antigen: normal (negative); Hepatitis B surface antibody: negative.

1.
What is the status of my liver function based on the above report?
2.
I am currently married and overweight.
I have heard about the "cocktail diet" that emphasizes natural foods with no side effects.
Since I have hepatitis B, I am unsure if this is suitable for me and whether it would affect my liver.

3.
What tests should be included in the liver function tests that I undergo every three months? Besides hospitals, what other institutions can provide these tests? What is serum alpha-fetoprotein?
4.
If I become pregnant, will it have a significant impact on my child? Is breastfeeding not allowed?

Yiru, 20~29 year old female. Ask Date: 2000/11/21

Dr. Yang Guojun reply Internal Medicine

As a carrier of hepatitis B, the severity of your liver disease needs to be assessed through tests such as GOT, GPT, and ultrasound examinations.
There are various methods for weight loss, and obesity is primarily related to genetics, with a smaller portion influenced by dietary habits and lifestyle.
Therefore, pharmacological weight loss is usually considered an adjunct to behavioral therapy and should only be used short-term, in conjunction with diet and exercise.
The use of combination therapy is currently controversial, with many reported side effects; the impact on liver and kidney function depends on the specific components used.
A mother with hepatitis B should ensure that her child receives the vaccine after birth.
The likelihood of transmitting hepatitis B through breast milk is very low, especially since all newborns are now routinely vaccinated against hepatitis B, so there is no need to worry about breastfeeding transmitting the virus.
Breastfeeding is generally acceptable, and routine liver function tests, serum alpha-fetoprotein levels, and abdominal ultrasound examinations should be conducted to prevent progression to hepatitis and subsequently cirrhosis.
Dr.
Yang Guojun, Gastroenterology and Hepatology Specialist, responds.

Reply Date: 2000/11/21

More Info

Hepatitis B is a viral infection that affects the liver and can lead to both acute and chronic diseases. As a carrier of the Hepatitis B virus (HBV), it is crucial to understand the implications of your condition, especially concerning your health and potential pregnancy.

1. Understanding Your Liver Function Tests: The results you provided indicate that you are a Hepatitis B carrier, as evidenced by the positive Hepatitis B surface antigen (HBsAg) and negative Hepatitis B surface antibody (anti-HBs). The negative E antigen (HBeAg) suggests that you may have a lower level of viral replication, which is generally a favorable sign. However, the interpretation of liver function tests (LFTs) such as SGOT (AST) and SGPT (ALT) is essential. Elevated levels of these enzymes can indicate liver inflammation or damage. Regular monitoring is crucial, and your healthcare provider will guide you on the frequency and necessity of these tests.

2. Diet and Weight Management: Regarding your concerns about weight management and the "cocktail diet," it is important to approach any weight loss plan with caution, especially as a Hepatitis B carrier. While natural foods are generally safer, any drastic dietary changes should be discussed with a healthcare professional. The liver is a vital organ for metabolism, and maintaining a healthy diet is crucial for liver health. Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while avoiding alcohol and processed foods high in fats and sugars.

3. Regular Monitoring: For someone with Hepatitis B, routine blood tests every three months should include liver function tests (SGOT, SGPT), Hepatitis B viral load (HBV DNA), and Alpha-fetoprotein (AFP) levels. AFP is a tumor marker that can indicate liver cancer, which is a risk for chronic Hepatitis B patients. These tests can be performed at hospitals, specialized clinics, or laboratories that offer liver health assessments.

4. Pregnancy Considerations: If you are considering pregnancy, it is essential to consult with your healthcare provider. Hepatitis B can be transmitted from mother to child during childbirth (vertical transmission). However, with proper medical management, the risk can be significantly reduced. Infants born to Hepatitis B-positive mothers should receive Hepatitis B immunoglobulin (HBIG) and the first dose of the Hepatitis B vaccine within 12 hours of birth. This intervention can reduce the risk of transmission to less than 5%. As for breastfeeding, it is generally considered safe for mothers with Hepatitis B to breastfeed, provided the infant has received the appropriate vaccinations.

In summary, being a Hepatitis B carrier requires regular monitoring and a proactive approach to health management. Weight management through a balanced diet is important, and any weight loss strategies should be discussed with a healthcare provider. If you are planning to become pregnant, ensure you have a thorough discussion with your doctor about the necessary precautions to protect your child’s health. Remember, many individuals with Hepatitis B lead healthy lives with appropriate medical care and lifestyle choices.

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