Should You Continue Taking Interferon for Hepatitis B After Recovery?

Should I take Gan An Neng?

Hello Doctor: A year ago, I tested negative for Hepatitis B during a health check.
On February 14 of this year, I ate seafood and had raw oysters (I do not drink alcohol, and I was not taking any medications at that time; my lifestyle was normal).
On February 16, I felt dry mouth and loss 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 over 3000 and GPT over 2000.
I was admitted to the hospital and discharged on March 6, with GOT and GPT 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 GOT was 31 and GPT was 43.
The doctor informed me that the application criteria for "interferon" have been relaxed and would help me apply for it.
On April 27, I returned for a follow-up, and my blood tests showed GOT and GPT reduced 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 those with Hepatitis B need to have an abdominal ultrasound and blood tests every three months.
If the doctor does not arrange this for me in three months, can I request him to conduct the tests? I appreciate your time in answering my questions.
Thank you.

A-Yun, 30~39 year old female. Ask Date: 2004/05/07

Dr. Chen Jianhong reply Gastroenterology and Hepatology

Hello Ayun!
1.
Your latest tests show that your liver enzyme levels are normal, so there is no need for you to take Tenofovir.
However, it is still best to have your medical history for reference.
Additionally, we suspect that 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 history to confirm this.
2.
As for how long you need to be monitored, it will depend 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 hepatitis B 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: 2004/05/07

More Info

When it comes to managing Hepatitis B, particularly after an acute infection, the decision to continue antiviral therapy such as "干安能" (entecavir) hinges on several clinical factors. Based on your situation, here are some insights and recommendations.

1. Continuation of Antiviral Therapy: After your liver enzyme levels (GOT and GPT) have normalized, the question of whether to continue antiviral therapy is crucial. Generally, the standard practice is to continue antiviral treatment for patients with Hepatitis B until certain criteria are met. In your case, while your liver enzymes have improved significantly, the presence of Hepatitis B surface antigen (HBsAg) and the risk of viral replication must be considered. If HBsAg remains positive, it is typically recommended to continue antiviral therapy to prevent potential liver damage and complications, including cirrhosis or hepatocellular carcinoma. The goal is to achieve a functional cure, which is defined by HBsAg negativity and the presence of Hepatitis B surface antibodies (anti-HBs).
2. Concerns About Drug Resistance: It is true that long-term use of antiviral medications can lead to drug resistance, particularly if the virus mutates. However, entecavir is known for its high barrier to resistance compared to other antiviral agents. If your liver function tests are stable and you are not experiencing any side effects, continuing entecavir may be beneficial. Switching to "肝福" (a herbal supplement) without proper medical guidance is not advisable, as it may not provide the necessary antiviral effects to control the Hepatitis B virus. Regular monitoring of liver function and viral load is essential to ensure that the virus remains suppressed.

3. Monitoring and Follow-Up: It is indeed recommended for patients with a history of Hepatitis B to undergo regular monitoring, including blood tests and abdominal ultrasounds. The frequency of these tests can vary based on individual risk factors, but a common practice is to perform these evaluations every three to six months. If your physician does not schedule these follow-ups, you have every right to request them. Regular monitoring helps in early detection of any potential complications, including liver cancer, especially in patients with chronic Hepatitis B.

In summary, while your liver function tests have improved, it is crucial to continue antiviral therapy until you achieve a functional cure. Regular follow-ups and monitoring are essential components of managing Hepatitis B effectively. If you have concerns about your treatment plan or the frequency of monitoring, do not hesitate to discuss them with your healthcare provider. They can provide personalized recommendations based on your specific health status and the latest clinical guidelines.

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