Hepatitis B: Risks, Treatments, and Myths Explained

Hepatitis

I am 29 years old and recently discovered that I am a carrier of hepatitis B, with a positive HBeAg.
My liver function tests are normal; total bilirubin is 1.3 mg/dL, direct bilirubin is 0.3 mg/dL, and an ultrasound showed a rough texture of the liver.
The lab technician mentioned that being positive for both hepatitis B and HBeAg is very concerning, with a 90% chance of progressing to liver cancer and cirrhosis.
He suggested seeking traditional Chinese medicine to improve my HBeAg status, claiming that there is a high chance of success and that the rough texture of my liver could become smooth.
Is this true? Should I consult traditional Chinese medicine or Western medicine? Is the 90% progression rate to liver cancer and cirrhosis really that high?

A Lun, 20~29 year old female. Ask Date: 2004/02/05

Dr. Liang Jiade reply Gastroenterology and Hepatology

Hello, it is recommended to regularly monitor liver function and undergo ultrasound examinations.
Your liver function is currently normal.
Although HBeAg is positive, antiviral medication treatment is not advised.
To date, there is no research or literature in traditional Chinese medicine that has identified a method or medication capable of eliminating HBeAg.

Reply Date: 2004/02/05

More Info

Understanding Hepatitis B: Risks, Treatments, and Myths Explained
Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic diseases. It is crucial to understand the implications of being a carrier of the virus, especially when HBeAg (Hepatitis B e Antigen) is positive, as this indicates active viral replication and a higher risk of liver damage.
Firstly, it is essential to clarify the statistics regarding the progression of chronic Hepatitis B to more severe liver conditions. While it is true that chronic Hepatitis B can lead to complications such as cirrhosis and hepatocellular carcinoma (liver cancer), the risk is not as high as 90% for all patients. The actual risk varies significantly based on several factors, including the individual's age, sex, the presence of co-infections (like Hepatitis C or HIV), lifestyle factors (such as alcohol consumption), and the degree of liver inflammation or fibrosis. Generally, studies suggest that about 15-40% of individuals with chronic Hepatitis B may develop cirrhosis over a period of 20-30 years, and a smaller percentage may progress to liver cancer.

Regarding treatment options, it is important to note that while some patients may seek alternative therapies, such as Traditional Chinese Medicine (TCM), the most effective and evidence-based treatments for chronic Hepatitis B are antiviral medications. These include nucleos(t)ide analogs like entecavir and tenofovir, which have been shown to effectively suppress viral replication, improve liver function, and reduce the risk of liver-related complications. Interferon therapy is another option, but it is typically reserved for specific cases due to its side effects and the need for injections.

The notion that herbal medicine can "cure" Hepatitis B or significantly alter the course of the disease is a common myth. While some herbal remedies may support liver health and improve symptoms, they should not replace conventional antiviral treatment. It is crucial to consult with a healthcare professional who specializes in liver diseases to determine the best course of action.
In your case, with normal liver function tests but the presence of HBeAg, it is advisable to undergo regular monitoring, including liver ultrasounds and blood tests to assess liver function and fibrosis. If liver inflammation is detected or if there are signs of significant liver damage, antiviral therapy may be recommended even if you are asymptomatic.

In conclusion, while being a carrier of Hepatitis B with a positive HBeAg status does carry risks, the actual likelihood of developing severe liver disease varies widely among individuals. Evidence-based antiviral treatments are available and should be prioritized over unproven alternative therapies. Regular monitoring and consultation with a healthcare provider specializing in liver diseases are essential for managing your health effectively.

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