Q: While in India two years ago, I was found to have Hepatits-B, A-symptomatic. My earlier blood report results were HBsAg (Australia antigen): +ve, ANTI HBc(Total): +ve, HBeAg:-ve, ANTI HBe:+ve, ANTI HBs: -ve. I was told by the doctor that I am asymptomatic. He gave me the first dose of vaccination for Anti HBs level immunisation (for 10 IU/L). I came to US and I had consumed alcohol but in very limited quantities. I could not get the second and third doses(10-100 I/U and 100-1000 IU/L) and it lapsed. After joining work here, I went to a doctor and requested Hep-B vaccination. I had the first dose and after a month the 2nd dose. Off-late I feel I have a slightly reduced appetite and my digestion and bowel activity are somewhat low. I consulted a Gastroenterologist and my latest hepatic panel blood test results are as follows: . Protein, Total: 7.1 g/dl; Albumin : 4.2 g/dl; BILI, TOTAL: 0.3 mg/dl; BILI, Direct: 0.2 mg/dl; Alk. Phos: 123 U/L; AST:24 U/L; ALT (SGPT) : 64 U/L; HBe Ag: negative; HBe Ab: positive; HBs Ab: negative. He suspected I had Hepatitis C and liver cirrohsis. What should these values be in a normal person and what do they signify? Acute Hepatitis panel: HBc Ab, IgM: negative; HBsAg: positive. HA Ab, IgM: negative; HC Ab (3RD GEN EIA): negative; HC VIRUS RNA, QUANT : < 615 IU/ mL. Now my doctor says I'm still a carrier and dont have Hep. C. My abdomen ultrasound and esophago-duodenal endoscopy (done to diagonose my gas, bloated stomach, indigestion and bowel problem) were all normal except slight irritation due a bacteria in my stomach. I was prescribed PREVPAK for treating stomach bacteria. My questions are: 1) Is there no cure to Hep B carrier state? Will I ever get Hep. C? What are the symptoms? Are my liver test results ok? 2) Is there some other Hepatitis infection I am suffering from? 3) Has the PREVPAK resulted in any increased liver enzymes or deterioration of liver? What healthy food do I have to eat to keep my digestive system ok? 4) My 3rd shot of Hep B vaccination is due in Nov. Do I need to take it? If I dont, will there be any problem?

A:The response to your questions is as follows: 1) Is there no cure to Hep B carrier state? You have normal liver tests and you are hepatitis B e AG -ve. The need for any treatment is quite low. About 5-10% patients lose their HBsAg spontaneously per year. So there is a chance you will get rid of the infection. 2) Will I ever get Hep C? What are symptoms? Hep C is acquired by some form of blood contact with a person with Hep C such as blood transfusion, sharing needles, razors etc, sexual contact. If you avoid such risk factors you should not get Hep C. 3) Are my liver test results ok? Your ALT is slightly elevated, but the rest of the liver tests are OK. 4) Is there any other Hepatitis infection I am suffering from? It does not look like you have any other infection. 5) Has the PREVPAK resulted in any increased liver enzymes or deterioration of liver? What healthy food do I have to eat to keep my digestive system ok? This is a short course of treatment and should not harm your liver. Eat a normal diet. There is no need to go for special diets because of your hepatitis B infection. 6) My 3rd shot of Hep B vaccination is due in Nov. Do I need to take it? If I don't, will there be any problem? There is no need for taking your vaccinations because you have already been exposed to the virus. You are not likely to benefit from the vaccination.