Is It Necessary to Continue Taking Hepatitis B Medication After Recovery?

Is it suitable to take Gan An Neng?

Hello Doctor: A year ago, I tested negative for Hepatitis B during a health check-up.
On February 14 of this year, I ate seafood and consumed raw oysters (I do not drink alcohol and was not taking any medications at that time; my lifestyle was normal).
On February 16, I began to feel dry mouth and lack of appetite.
Initially, I thought it was just stomach discomfort and did not pay much attention to it.
By February 20, I could not tolerate it any longer and went to a large hospital for a check-up.
Blood tests revealed that I had Hepatitis B, with GOT and GPT levels over 3000 and 2000, respectively.
I was admitted to the hospital and discharged on March 6, with GOT and GPT levels reduced to around 200.
The doctor prescribed "Hepatitis B medication" for me to take at home.
On March 23, I had another blood test, and my GOT was 31 and GPT was 43.
The doctor informed me that the application criteria for "interferon" had been relaxed and would help me apply for it.
On April 27, I returned for a follow-up, and my GOT and GPT levels had dropped to 20.
The doctor still prescribed "interferon" for me.
I have a few questions: 1.
Since my levels are normal, do I still need to take "interferon"? 2.
I read some medical reports online stating that long-term use of "interferon" can lead to drug resistance.
Since my levels are normal, can I just take "Hepatitis B medication" and not "interferon," or is it sufficient to have regular check-ups and maintain a normal lifestyle without medication? 3.
I heard that individuals with Hepatitis B should have an abdominal ultrasound and blood tests every three months.
If my doctor does not arrange for these tests in three months, can I request them? Thank you for taking the time to answer my questions!

Xiao Yun, 30~39 year old female. Ask Date: 2004/05/01

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello, Xiaoyun!
1.
Your latest tests show that your liver enzyme levels are normal, so there is no need for you to take Danazol.
However, it would be best to have your medical history for reference.
Additionally, we suspect you may have acute hepatitis? It is possible that you have chronic hepatitis B with a recent acute flare-up, but we need to review your medical records to confirm this.
2.
As for how long you need to be monitored, it depends on the diagnosis.
Currently, we cannot confirm whether you are a carrier of hepatitis B (the definition of a hepatitis B carrier is having a positive surface antigen for more than six months, but according to the information in your letter, your previous test for the surface antigen was negative).

Reply Date: 2004/05/01

More Info

When it comes to managing Hepatitis B, especially after an acute infection, the question of whether to continue medication after recovery is crucial. Based on your situation, it appears that you had a significant acute Hepatitis B infection, which required hospitalization and treatment. Your liver enzyme levels (GOT and GPT) have improved significantly, which is a positive sign. However, the management of Hepatitis B is not solely based on liver enzyme levels; it also involves monitoring viral load and the presence of hepatitis B surface antigen (HBsAg) and antibodies.

1. Do You Need to Continue Taking "干安能" (entecavir) After Normalizing Liver Enzymes?
Yes, it is generally recommended to continue antiviral therapy like entecavir even after liver enzymes have normalized. This is because normalization of liver enzymes does not necessarily mean that the virus is eradicated from your system. The hepatitis B virus can remain dormant in the liver, and stopping antiviral therapy prematurely can lead to a resurgence of the virus, which could result in liver damage or complications. The goal of treatment is not just to normalize liver enzymes but to achieve sustained viral suppression, which is typically monitored through regular blood tests for HBsAg and HBV DNA levels.

2. Concerns About Drug Resistance and Alternative Treatments:
While it is true that long-term use of antiviral medications can lead to drug resistance, this is more of a concern when the medication is not taken as prescribed or if the virus mutates. If you are compliant with your medication, the risk of developing resistance is significantly reduced. Switching to a different medication like "肝福" (which is likely a supportive treatment rather than an antiviral) is not advisable without consulting your healthcare provider. Supportive treatments can help with liver health, but they do not replace the need for antiviral therapy if the virus is still present. Regular monitoring is essential to determine the best course of action.

3. Monitoring and Follow-Up:
It is indeed recommended to have regular follow-up appointments, including blood tests and abdominal ultrasounds, especially after a Hepatitis B infection. The typical recommendation is to have these checks every three months for at least the first year after diagnosis. If your doctor does not schedule these tests, you should feel empowered to request them. Regular monitoring helps to ensure that any potential complications, such as liver cirrhosis or hepatocellular carcinoma, are caught early.

In summary, while your liver enzymes have improved, it is crucial to continue antiviral therapy and regular monitoring to ensure the virus is adequately controlled. Discuss your concerns with your healthcare provider, who can help tailor a management plan that considers your specific situation and needs. Regular follow-ups are essential in managing Hepatitis B effectively and preventing long-term complications.

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