Impact of Night Shifts on Liver Metabolism in Hepatitis B Patients

Q: Impact of Night Shifts on Liver Metabolism in Hepatitis B Patients

Hello, sir： Belarck has good long-term safety, but there are contraceptive considerations. <br>As long as the virus is well-controlled, working night shifts is not a major issue, but it should not be done for an extended period to avoid impacting immune function. <br>Changhua Hos

Does working night shifts affect liver metabolism?

Hello, doctor.
I am a carrier of hepatitis B.
About four years ago, my GPT levels were over 600.
Following my doctor's advice, I took Tenofovir for more than two years and then stopped the medication.
At that time, I had just changed jobs, and my new job requires shift work.
About six months after stopping the medication, my condition relapsed.
I asked my doctor if the night shifts could be the cause, but he said it’s not necessarily the case, and that the relapse rate for Tenofovir is already high.
I then switched to Baraclude (entecavir), and I have been on it for a year and a half, during which I only worked morning and afternoon shifts (I gave up my supervisory position).
Recently, my supervisor mentioned that there are still a few supervisory positions available in the company and asked if I would be interested.
This has put me in a dilemma because taking a supervisory position would require me to work night shifts.
Therefore, I would like to ask you about the potential negative effects of night shifts on the liver.
Additionally, I have been paying out of pocket for Baraclude (0.5 mg) for the first year, but due to recent changes in the national health insurance system, my doctor said I could switch to insurance coverage and continue taking it for another two years.
He suggested that I take it as long as I need until it is no longer covered by insurance, which means I could end up taking it for three years.
Is long-term use of this medication appropriate?

LEE, 30~39 year old female. Ask Date: 2010/07/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir: Belarck has good long-term safety, but there are contraceptive considerations.
As long as the virus is well-controlled, working night shifts is not a major issue, but it should not be done for an extended period to avoid impacting immune function.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2010/07/06

More Info

The impact of night shifts on liver metabolism, particularly in patients with Hepatitis B, is a complex issue that intertwines various factors including circadian rhythms, liver function, and the effects of antiviral medications. As a Hepatitis B carrier, your concerns about the potential repercussions of night shifts on your liver health are valid and warrant careful consideration.

Firstly, it is essential to understand that the liver plays a crucial role in metabolism, detoxification, and the synthesis of various proteins. The liver's functions are influenced by the body's circadian rhythms, which are biological processes that follow a roughly 24-hour cycle. Disruptions to these rhythms, such as those caused by rotating night shifts, can lead to metabolic disturbances. Studies have shown that shift work can alter liver enzyme levels, potentially exacerbating pre-existing liver conditions, including Hepatitis B.

In your case, you mentioned that after stopping the antiviral medication (干安能), your liver enzymes (GPT) spiked again, leading to a recurrence of your condition. While your doctor indicated that the recurrence might not be solely due to night shifts, it is important to recognize that stress, irregular sleep patterns, and lifestyle changes associated with shift work can contribute to liver health deterioration. Night shifts can lead to poor sleep quality, increased fatigue, and altered eating patterns, all of which can negatively impact liver function.

Moreover, the antiviral medication you are currently taking (貝樂克) is crucial in managing your Hepatitis B. Long-term use of antiviral medications is often necessary to maintain viral suppression and prevent liver damage. The recommendation to continue taking the medication for an extended period is based on the need to keep the virus under control, especially since Hepatitis B can have a high rate of recurrence after stopping treatment. It is essential to follow your doctor's advice regarding the duration of treatment, as the benefits of maintaining viral suppression often outweigh the risks associated with long-term medication use.

In terms of your work situation, if you are considering taking on a role that requires night shifts, it is advisable to weigh the potential risks to your liver health against the benefits of the position. If possible, discuss with your employer the option of maintaining a schedule that minimizes night shifts or allows for a more stable routine. Additionally, implementing lifestyle changes such as maintaining a balanced diet, regular exercise, and ensuring adequate hydration can help mitigate some of the negative effects associated with shift work.

In conclusion, while night shifts can have adverse effects on liver metabolism, particularly in individuals with Hepatitis B, the relationship is multifaceted. It is crucial to maintain regular follow-ups with your healthcare provider to monitor your liver function and adjust your treatment plan as necessary. If you decide to take on a position that involves night shifts, consider strategies to manage your health proactively. Your liver health is paramount, and making informed decisions regarding your work and treatment can help you maintain a better quality of life.

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