Managing Hepatitis B Treatment Challenges: A Family's Journey

Hepatitis B treatment issues?

Dear Vice President,
Our family does not carry the virus but lacks antibodies.
My father (51 years old) was diagnosed with hepatitis B on April 19.
To keep it brief, my question is that the doctor mentioned on that day that my father's liver enzyme levels were 20 times higher than normal, and the ultrasound showed no signs of liver inflammation.
The diagnosis on the prescription included HBV Carrier, GERD, and Primary Insomnia, and he was prescribed Sirin 35 mg to be taken three times a day, two tablets each time.
However, after taking the medication for a day or two, he started experiencing skin itching, which even affected his sleep.
On the night of April 22, he went to the emergency room and was temporarily advised to continue this medication.
During a follow-up on April 26, the doctor discontinued this medication and prescribed allergy medication to be taken in the morning and evening.
The itching has slightly improved, but he still experiences it.
Vice President, should we consider switching to another hospital for treatment, or should we continue to follow the doctor's advice? My father needs to go out to work every day, but he has been feeling very drowsy and fatigued lately, and now with the skin allergy, he can only take allergy medication, which is making him a bit anxious.
(ㅜ_ㅜ)

tata, 30~39 year old female. Ask Date: 2021/04/29

Dr. Chen Shidian reply Gastroenterology and Hepatology

The symptoms initially do not seem to be clearly related to elevated liver function.
However, it is advised to monitor for hepatitis B with an ultrasound every six months, and if liver function abnormalities occur, monthly follow-ups may be necessary.
Additionally, allergy medications could potentially cause drowsiness or affect liver function, so caution is advised.

Reply Date: 2021/04/29

More Info

Managing Hepatitis B can be a complex and challenging journey, especially when it involves family members. In your father's case, it appears that he has been diagnosed as a Hepatitis B carrier, which means he has the virus in his body but may not necessarily show symptoms or have significant liver damage at this time. However, the elevated liver enzymes and the symptoms he is experiencing, such as itching and fatigue, warrant careful management and monitoring.

Firstly, it is important to understand that Hepatitis B can lead to chronic liver disease, including cirrhosis and liver cancer, particularly if the virus is active and causing liver inflammation. The fact that your father's liver enzymes are elevated indicates that there is some level of liver inflammation, which could be due to the virus itself or possibly a reaction to the medication he was prescribed.

The itching and skin reactions he is experiencing could be an allergic reaction to the medication (Sirin tab) or could be related to the liver's inability to process certain substances due to inflammation. It is crucial to communicate these symptoms to his healthcare provider, as they may need to adjust his treatment plan. If the itching persists or worsens, it may be necessary to consider alternative medications or therapies.

Regarding whether to switch hospitals or continue with the current treatment, it is essential to weigh the benefits of continuity of care against the need for effective management of his symptoms. If you feel that your father's concerns are not being adequately addressed or if you are not satisfied with the current treatment approach, seeking a second opinion from another hepatologist or a liver specialist could be beneficial. A fresh perspective might provide new insights into his condition and treatment options.

In terms of managing his Hepatitis B, regular monitoring of liver function tests, viral load, and liver imaging (such as ultrasound) is critical. This will help assess the activity of the virus and the health of the liver over time. If his liver enzymes remain elevated or if there are signs of liver damage, antiviral therapy may be warranted. Medications such as entecavir or tenofovir are commonly used to suppress the virus and reduce liver inflammation.

Additionally, lifestyle modifications can play a significant role in managing liver health. Encouraging your father to maintain a balanced diet, avoid alcohol, and manage stress can help support his liver function. Regular follow-ups with his healthcare provider will ensure that any changes in his condition are promptly addressed.

Lastly, it is important for your father to be educated about his condition. Understanding Hepatitis B, its transmission, and the importance of adherence to treatment can empower him and alleviate some of the anxiety he may be feeling. Support from family members, including open discussions about his health and treatment, can also be beneficial in managing his emotional well-being during this challenging time.

In summary, managing Hepatitis B requires a comprehensive approach that includes regular monitoring, appropriate medication management, lifestyle changes, and emotional support. If there are ongoing concerns about his treatment or symptoms, seeking a second opinion may provide additional clarity and options for his care.

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