Hepatitis B and Fatty Liver: Your Concerns Addressed

Hepatitis B

Hello Doctor: I apologize for bothering you again, but I would like to discuss the following issues and hope you can spare some time to help me.
Thank you.

1.
I had an ultrasound examination that showed my liver appearing hyperechoic, and the examining physician diagnosed me with fatty liver.
Additionally, my blood tests indicated that I am positive for Hepatitis B.
I have never had this condition before.
Here are my examination results: I am really very worried!
- Liver: diffuse increased echogenicity of liver parenchyma with smooth surface and dull edges without detectable hepatic lesions
- Spleen: Negative
- Portal vein: normal and patent
- Diagnosis: moderate fatty liver with hepatomegaly
- Acute biochemical test report:
- Sample: BLOOD (green cap)
- 01012 GOT (AST) 530
- 01013 GPT (ALT) 140
- Serum test report:
- Sample: SERUM
- 02005 Anti-HBc-IgG + (0.080) S/CO
- 02010 Anti-HCV - (0.43) - S/CO
- 02014 AFP (alpha-fetoprotein) 2.66 (0~10.9 ng/ml) Normal
2.
I am really very concerned about the possibility of transmitting this to my family!
3.
Should I get vaccinated? Is it necessary to receive the vaccine if I do not have Hepatitis B antibodies?
4.
I was vaccinated in the past; why do I no longer have antibodies now? Thank you for your help, Doctor.

A Miao, 20~29 year old female. Ask Date: 2004/09/16

Dr. Chen Zhiping reply Gastroenterology and Hepatology

Hello,
1.
Your test report shows elevated liver enzymes with Anti-HBc IgG(+) and HCV Ab(-), but it does not include HBsAg and HBsAb (Hepatitis B surface antigen and antibody), so we cannot determine if you are currently a carrier or if you have antibodies.
Anti-HBc IgG(+) only indicates a past infection with the Hepatitis B virus, but it does not reflect your current status.
Please have HBsAg and HBsAb tested.
2.
The transmission routes for Hepatitis B, aside from vertical transmission during childbirth, include horizontal transmission through contact with blood or bodily fluids.
Therefore, routine daily activities and diet do not pose a risk of transmission, but sexual contact may still carry a risk.
3.
There is no need for vaccination, as Anti-HBc IgG(+) indicates a past infection with Hepatitis B.
You may either be a carrier (HBsAg(+)) or have developed immunity (HBsAb(+)), and vaccination is intended for those who have never been infected.

Wishing you good health,
Dr.
Chen Zhi-Ping, Department of Internal Medicine, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2004/09/16

More Info

Understanding Hepatitis B and Fatty Liver: Your Concerns Addressed
Hello! Thank you for reaching out with your concerns regarding Hepatitis B and fatty liver. It’s completely understandable to feel anxious about these health issues, especially when faced with new diagnoses. Let’s break down your questions and provide clarity on each aspect.

1. Fatty Liver and Hepatitis B Diagnosis: Your ultrasound results indicate moderate fatty liver (steatosis) with hepatomegaly, which means your liver is enlarged due to fat accumulation. This condition is often linked to factors such as obesity, high cholesterol, diabetes, and excessive alcohol consumption. The elevated liver enzymes (GOT and GPT) suggest liver inflammation or damage, which can be exacerbated by the presence of Hepatitis B. The positive Anti-HBc-IgG indicates a past or ongoing infection with Hepatitis B, while the negative Anti-HCV suggests you do not have Hepatitis C. It’s crucial to monitor your liver function regularly, as chronic Hepatitis B can lead to more severe liver conditions over time, including cirrhosis or liver cancer.

2. Transmission Concerns: Hepatitis B is primarily transmitted through blood and bodily fluids, not through casual contact such as sharing meals or living in the same household. However, it’s important to practice safe measures, such as not sharing personal items that may have blood on them (like razors), to prevent transmission. If your family members are concerned, they can get tested for Hepatitis B and consider vaccination if they are not already immune.

3. Vaccination: If you have tested positive for Hepatitis B and do not have protective antibodies (Anti-HBs), vaccination is typically recommended for those who are at risk of infection. However, since you already have Hepatitis B, the vaccine would not be appropriate for you. Instead, your healthcare provider may discuss treatment options to manage your Hepatitis B infection and monitor your liver health.

4. Loss of Antibodies: It’s possible for the antibodies from a previous vaccination to diminish over time, especially if you were vaccinated many years ago. The presence of Anti-HBc-IgG indicates that you have been exposed to the virus, but the absence of Anti-HBs suggests that you do not have immunity. This is why regular monitoring of your liver function and viral load is essential, as it helps determine the best course of action for your health.

In summary, your current health situation requires careful monitoring and management. It’s essential to work closely with your healthcare provider to develop a plan that includes regular blood tests to assess liver function, potential imaging studies, and discussions about lifestyle changes that can help manage fatty liver, such as dietary modifications and increased physical activity.
Additionally, consider discussing the possibility of antiviral therapy for Hepatitis B if indicated, as this can help reduce liver inflammation and prevent further liver damage. Remember, you are not alone in this, and there are effective strategies to manage both fatty liver and Hepatitis B. Please feel free to reach out with any further questions or concerns. Your health is important, and staying informed is a key part of managing your condition.

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