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How to manage Chronic Active Hepatitis B?

Q: I am a 32 years old, male, patient of Chronic Active Hepatitis B. HBV was detected 7 years ago. Had undergone haemodialysis 6 months before that. Before dialysis, HBV tests were negative so supposedly got this infection during dialysis only. Kidney tests show normal functioning. My SGOT and SGPT are slightly elevated (50-60). HBsAg is positive and HBeAg is positive. Took Interferon for 4 months (56 injections of 5 MIU) following which HBeAg tested negative for few months but again became positive. Have been taking Lamivudine 100 mg daily for the last 5 years. What is advisable now?Should I continue taking Lamivudine? What is likely to be the condition of my liver at this stage? What precautions and care to be taken? I am not married so far. Is it advisable to go in for marriage in my situation?

A:Best way to look at the condition of the liver is to do a liver biopsy. If the tests done after being on Lamivudine still show Hep B DNA to be positive, and HBe antigen to be positive. Trial of adefovir dipivoxil can be given by your doctor. It can cause renal (kidney problems) so your doctor will have to decide. Regarding marriage, if the above tests are positive there is a high chance of you passing the virus to your partner. Barrier precautions should be used.


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