Life after Hepatitis B

[Sharma45]

I am a 37 yrs old man, I had Hepatitis B at an age of 20 some 17 years ago. It was cured then and since then I have never had health problems related to liver. Should I be worried about future liver problems? What can I do to prevent these.

[AyrshireK]

britishlivertrust.org.uk/in...

[Sharma45 in reply to AyrshireK]

Thanks, it doesnt say much on post Hepatitis conditions though. I have had several full body examinations after getting cured from HBV and never even once doctor askes me if I had HBV or told that I still have it. I am just worried as I dont know if having the infection once can harm you even after serveral years.

[mantana in reply to Sharma45]

Most adult people infected with hepatitis B virus (HBV for short) fully recover.

Those who don't - they have chronic hepatitis B which stays with them for the rest of their lives, their immunological system is impaired, they are much more likely to die of liver cancer and some other cancer types, especially if not treated. Medicines available today do not fully treat hepatitis B (but still considerably reduce cancer risk) - for most patients, they need to be taken for life and just knock down the virus.

I was one of these who was infected during an operation in a hospital in my late teens and didn't recover to this date, i.e. I have chronic hepatitis B.

If you're worried - not sure what you mean by a full body examination, but it is not the way to find out if you're infected with HBV or not.

To determine if you're indeed hepatitis B free, you would need to take these blood tests:

- HBV DNA - should be undetectable or 0 for healthy, but also should be 0 for those infected, and treated with medicine, like etecavir or tenofovir

- HBsAg - hepatitis B surface antigen - if it's undetectable or 0, together with undetectable HBV DNA - it means you're PROBABLY free of hepatitis B; current treatments knock it down, but not to 0 / undetectable levels for most people

- HBsAb (hepatitis B surface antibody) - if you had an infection in the past, or HBV vaccination - you should have hepatitis B antibodies in your blood - this is what you want to have and it gives you protection from the virus

Note - there are several other hepatitis B antibodies which may be detectable in your blood, but they should not be confused and they don't give protection: HBeAb and HBcAb.

How to understand the above?

If you have HBV DNA and HBsAg undetectable / zero, and you have HBsAb (antibodies) positive - this is very good, you have antibody protection and it is very unlikely you would get an infection in the future, or any liver problems.

If, however, after recovering, your HBV DNA and HBsAg are zero, but also HBsAb (antibodies) are zero - this would be a suspicious state. Why wouldn't your body produce antibodies after fighting the infection? In that case, get a series of hepatitis B vaccinations, and then (a few months later) get tested for antibodies again. If they still are not found, it can mean you have the so called occult hepatitis B infection - virus is almost undetectable, but it's still in your liver, and prevents proper immune response, can turn in the future into something more nasty.

There is one more thing you need to remember. Hepatitis B virus is very good at integrating into our genome and hiding from our immune system. Even if it's undetectable and we have antibodies - for those of us who were ever infected in our lives, it can come back under some circumstances.

Current guidelines in some countries, for people who were infected in the past, even those who fully recovered and produced antibodies - is to take an antiviral like entecavir or tenofovir to prevent HBV reactivation for cases like:

- undergoing a transplant

- undergoing a cancer disease

- undergoing any other disease or treatment which impairs the immune system

[LittleShrew in reply to mantana]

I have a similar journey.. I am still hoping that cure one day will be available

[yspex777 in reply to mantana]

I think it is very important also for people with Hepatitis B to be tested for Hepatitis Delta. That type of Hepatitis only occurs in people with Hep B. The two types together are very severe and can progress to cirrhosis in a short period of time.

[AyrshireK]

I take it you had an acute version of Hep B which you cleared. In which case you should have life long immunity according to the BLT page.

People with the acute phase of hepatitis B, do not require treatment. For the majority of people, the symptoms resolve and the person can ‘clear’ the infection, usually within six months, meaning they are no longer infectious; their blood will always show the hepatitis B antibodies but they should never be infected again (they are considered ‘immune’).

If you had chronic Hep B then treatment is usually for life as it isn't curable but is possible to be kept under control with anti-virals.

[Sharma45 in reply to AyrshireK]

Thanks for your reply ans advice. Not sure, as it was such a long time ago. However, I wasnt prescribed any continued treatment and have been living a healthy life since. So I believe it was acute Hep B only.