Should I Consider Antiviral Medication for Chronic Hepatitis B? - Gastroenterology and Hepatology

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When considering antiviral medication for chronic Hepatitis B, it is essential to weigh the potential benefits against the risks and current health status. As a 26-year-old who has been a carrier of Hepatitis B since high school, and with regular monitoring showing mostly normal liver function, your situation requires careful evaluation.

Firstly, it is important to understand the nature of chronic Hepatitis B. This viral infection can lead to liver inflammation, fibrosis, and potentially cirrhosis or liver cancer over time. Regular monitoring through blood tests (like GOT, GPT, and AFP) and imaging (like ultrasound) is crucial in assessing liver health. Your current practice of monitoring every six months is commendable and allows for timely intervention if any issues arise.

Your doctor’s advice to avoid antiviral medication at this stage, given your normal liver function, aligns with current medical guidelines. Antiviral medications, such as lamivudine, entecavir, and tenofovir, are typically recommended for patients with significant liver inflammation or elevated viral loads that pose a risk for liver damage. The goal of these medications is to suppress the virus, potentially leading to a decrease in viral load and, in some cases, seroconversion (the transition from HBsAg positive to HBsAg negative). However, the likelihood of achieving this seroconversion is relatively low, especially in certain populations, as your doctor pointed out regarding the statistics in Taiwan.

The concern about developing drug resistance is valid. Long-term use of antiviral medications can lead to the emergence of resistant viral strains, particularly if the medication is not effective in fully suppressing the virus. This could limit future treatment options. Therefore, initiating treatment when liver function is stable and normal may not be advisable unless there is a clear indication of disease progression.

Your mention of feeling fatigued and experiencing changes in your physical stamina could be related to various factors, including lifestyle choices like late nights and stress from academic pressures. While these symptoms can be concerning, they do not necessarily indicate worsening liver disease. It might be beneficial to explore lifestyle modifications, such as improving sleep hygiene, managing stress, and maintaining a balanced diet, which can positively impact your overall health and energy levels.

In summary, based on your current health status and the advice from your healthcare provider, it may be prudent to continue monitoring your liver function without initiating antiviral therapy at this time. If your liver function tests begin to show significant abnormalities or if you experience symptoms indicative of liver disease progression, then reconsidering antiviral treatment would be appropriate. Regular follow-ups and open communication with your healthcare provider will ensure that you are making informed decisions regarding your health. If you have further concerns or if your symptoms persist, seeking a second opinion or consulting a specialist in hepatology could provide additional insights tailored to your specific situation.