the Risks of Reactivation in Chronic Hepatitis B Carriers

Q: the Risks of Reactivation in Chronic Hepatitis B Carriers

Hello： (1) The activation of hepatitis B virus is usually associated with a decline in immune function, such as excessive fatigue, or the use of corticosteroids, immunosuppressants, undergoing chemotherapy, alcohol consumption, etc. <br>In some cases, the activation may occur for

Questions about asymptomatic carriers?

Hello Dr.
Tsai, I have been a carrier of hepatitis B since I was in my specialty training.
I found out during a health check at work when I was about 27 years old that my HBeAg was negative.
I have also had two or three HBV viral load tests, and if I remember correctly, the values were all below 200 IU/ml, with one instance where the virus was not detected at all.
However, I recently had blood tests and an ultrasound that revealed an AST of 45 and an ALT of 64, and the ultrasound showed severe fatty liver.
Dr.
Tsai, is it possible that I am entering a phase of HBV reactivation? Could I transition from an inactive carrier to an active carrier? What is the likelihood of this happening? I would appreciate your clarification on this matter.
Thank you.

u8970014, 30~39 year old female. Ask Date: 2016/01/19

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: (1) The activation of hepatitis B virus is usually associated with a decline in immune function, such as excessive fatigue, or the use of corticosteroids, immunosuppressants, undergoing chemotherapy, alcohol consumption, etc.
In some cases, the activation may occur for unknown reasons.
(2) Essentially, if there is severe fatty liver, the likelihood of inflammation being caused by fatty liver is higher.
It is recommended to maintain a light diet, exercise more, and lose weight (if overweight).
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2016/01/19

More Info

Hello! Thank you for your question regarding the reactivation risks associated with chronic Hepatitis B (HBV) carriers.
As a chronic HBV carrier, you are indeed at risk for reactivation of the virus, especially if you have previously been in a low-viral-load state. Reactivation can occur due to various factors, including immunosuppression, concurrent infections, or even certain medications that affect your immune system. The fact that you have had low HBV viral loads in the past is reassuring, but it does not eliminate the risk entirely.

Your recent lab results showing elevated AST and ALT levels indicate liver inflammation, which could suggest that the virus is becoming active again. The presence of elevated liver enzymes, particularly when combined with other risk factors such as fatty liver disease, can be a sign that the virus may be reactivating. Fatty liver disease itself can contribute to liver inflammation and may complicate the clinical picture, making it essential to manage both conditions effectively.

In your case, transitioning from a non-active carrier to an active carrier is a possibility, especially if your liver enzymes continue to rise or if you experience symptoms such as fatigue, jaundice, or abdominal pain. The likelihood of reactivation can vary based on individual factors, including your overall health, lifestyle, and any medications you may be taking.
It is crucial to monitor your liver function closely through regular blood tests and imaging studies. If you notice a significant increase in your liver enzymes or if you develop any symptoms, it is essential to consult your healthcare provider promptly. They may recommend antiviral therapy to manage the reactivation if necessary.

In addition to monitoring your liver health, lifestyle modifications can also play a vital role in managing both HBV and fatty liver disease. This includes maintaining a healthy diet, engaging in regular physical activity, avoiding alcohol, and managing any other underlying health conditions, such as diabetes or high cholesterol.

In summary, while you are at risk for reactivation of Hepatitis B, the actual likelihood depends on various factors, including your current health status and lifestyle. Regular follow-ups with your healthcare provider are essential to ensure that any changes in your condition are addressed promptly. If you have any further questions or concerns, please do not hesitate to reach out to your healthcare team. They can provide personalized advice and treatment options based on your specific situation. Thank you for your inquiry, and I wish you the best in managing your health!

Similar Q&A

Understanding Hepatitis B Virus Reactivation in Carriers Over 60

I am a carrier of hepatitis B. I undergo ultrasound and blood tests every six months, and my indices are normal, so I do not need medication and must return for regular check-ups every six months. I have heard that after the age of 60, when the body's immune system weakens, ...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello, sir. As long as you have regular follow-ups, you can lead a normal life. Changhua Hospital cares about your health. Chen Shidian

Understanding the Risks of Reinfection in Chronic Hepatitis B Carriers

Hello, Doctor: Taiwan is an endemic area for hepatitis B, and many people are unaware of how they became infected. If a healthy carrier of hepatitis B is unknowingly infected by another hepatitis B carrier, will there be any adverse effects? Or does it not matter since they alrea...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: As a carrier of hepatitis B, since you are already infected, further exposure to other strains of hepatitis B will not have additional adverse effects. Wishing you good health. Sincerely, Dr. Chi-Feng Chen, Taoyuan General Hospital, Department of Health.

Understanding Surface Antibodies and Relapse Risks After Hepatitis B Treatment

Hello: Four years ago, I started taking entecavir due to acute hepatitis. In January of this year, my E antigen turned negative, and the other day, my surface antigen also turned negative, with a surface antibody level of 861 IU/L. Since my health insurance coverage will expire i...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: Currently, the National Health Insurance recommends that patients with e-antigen positive hepatitis B who turn negative require one year of consolidation therapy. The presence of S-antigen turning negative and the production of S-antibodies in patients infected with hepati...

Understanding Hepatitis B Antibody Changes: Risks and Implications

Hello Dr. Hong: I would like to ask you about the issue of hepatitis B antibodies. I am currently 60 years old. When I was younger, I was positive for hepatitis B surface antigen (HBsAg+) and negative for hepatitis B surface antibody (anti-HBs-). At the age of 45, I transitioned ...

Dr. Hong Yuanbin reply Internal Medicine
Hello, the presence of surface antibodies typically indicates that your body has cleared the hepatitis B virus. As long as these antibodies are present, the risk of reinfection is relatively low. However, if the antibodies disappear, there is indeed a risk of infection. Additiona...