the Risks of Hepatitis in Families with Liver Disease History

A GPT index exceeding 1000 may indicate a severe liver condition, such as acute hepatitis. It is important to consult a healthcare professional for proper evaluation and diagnosis?

Hello Doctor: My family has a history of liver disease that has persisted for four generations.
Almost all of my mother's relatives have died from liver disease.
My uncle, who was very strong and ran 3,000 meters daily, did not live past 50 due to fulminant hepatitis.
Six months ago, I went to a health check-up center and received the following results: GOT: 250, GPT: 230, AFP: 30, with mild fatty liver and no jaundice.
My white blood cell count was slightly low.
In March of this year, I went to the hospital for further tests, and the results were: Glucose (AC): 80 mg/dL, GOT: 649 U/L, GPT: 1154 U/L, HBsAg: positive.
An ultrasound only showed splenomegaly.
The doctor recommended that I take Tenofovir.
If my condition is caused by fatty liver, will taking Tenofovir be effective? Do I need to undergo a liver biopsy? Will my health insurance cover Tenofovir? I had a liver cancer screening at Hsinchu Hospital a year ago, and there were no issues at that time.
Does taking Tenofovir affect fetal development in males? Thank you.

homa, 30~39 year old female. Ask Date: 2008/04/09

Dr. Li Xuanshu reply Gastroenterology and Hepatology

1.
Indeed, if the hepatitis is caused by fatty liver, the use of干安 (干安 is likely a medication name, please provide the English name for accurate translation) would be ineffective.

2.
Is your E antigen positive or negative? Do you have E antibodies? If your E antigen is positive, a liver biopsy is not necessary, and health insurance will cover it.
However, if it is negative, a liver biopsy must be performed to determine eligibility for coverage based on the pathological report.

3.
Currently, there is insufficient research data to confirm any impact on fertility, but it is generally recommended to avoid it if possible.

Reply Date: 2008/04/09

More Info

Hepatitis B is a significant public health concern, particularly for individuals with a family history of liver disease. Given your family's history of liver disease, it is essential to understand the risks associated with Hepatitis B and the implications for your health.

Firstly, Hepatitis B is caused by the Hepatitis B virus (HBV), which can lead to chronic liver disease, cirrhosis, and hepatocellular carcinoma (liver cancer). The transmission of HBV can occur through several routes, including vertical transmission from mother to child during childbirth, horizontal transmission through blood, and sexual contact. Given your family history, it is plausible that your infection could be hereditary, particularly if your mother was a carrier of the virus.

Your recent lab results indicate elevated liver enzymes (GOT and GPT), which suggest liver inflammation. The presence of HBsAg (Hepatitis B surface antigen) confirms an active infection. The elevated AFP (alpha-fetoprotein) level can be concerning as it is often associated with liver cancer, although it can also be elevated in other liver conditions. The ultrasound revealing splenomegaly (enlarged spleen) further indicates liver dysfunction.

Regarding your question about the use of antiviral medication like Tenofovir (干安能), it is crucial to determine the underlying cause of your elevated liver enzymes. If your liver dysfunction is primarily due to fatty liver disease (non-alcoholic fatty liver disease or NAFLD), antiviral treatment may not be effective, as these medications specifically target viral replication. In such cases, lifestyle modifications, including weight loss and dietary changes, may be more beneficial.

As for the necessity of a liver biopsy, it is often recommended to assess the degree of liver damage, especially if there is uncertainty about the cause of liver enzyme elevation. However, the decision to perform a biopsy should be made in consultation with your healthcare provider, considering the risks and benefits.

Regarding the insurance coverage for Tenofovir, it typically requires specific criteria to be met, such as elevated ALT levels and positive e-antigen status. If your liver enzymes are significantly elevated and you meet the criteria, you may be eligible for coverage. It is essential to discuss this with your physician, who can provide guidance based on your specific situation.

Concerning the potential impact of Tenofovir on future pregnancies, current evidence suggests that Tenofovir is generally considered safe during pregnancy. However, it is always advisable to consult with your healthcare provider regarding any medications you are taking and their potential effects on fertility and pregnancy.

Lastly, regarding the expired Tenofovir, it is generally not recommended to take expired medications, as their efficacy may be compromised. If you have concerns about your medication or its expiration, consult your healthcare provider for guidance.

In summary, given your family history and current health status, it is crucial to work closely with your healthcare provider to monitor your liver health, consider appropriate treatments, and make informed decisions about your health and future family planning. Regular follow-ups, lifestyle modifications, and adherence to medical advice will be key in managing your liver health effectively.

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