Hepatitus B

[N47HAN]

Eve all,

Well had better days , just been told by the doctor I have hepatitus b.

Looked through the net most of the day and reading what i can.

It would appear to be a serious liver infection although may infact be cleared by the bodys own antibody system within a few months or so?

Some straight info without the cotton wool stuff would at this time be very appreciated.

Thx in advance

[traveldog]

Whew Hep B. That is not good news. I am sure you are having a second blood test to confirm-false positives happen a lot. Also it is B? Hep A is a more common occurance and much less serious as well???? This is not the place to get serious info on such a serious disease. Depending on when you contracted the virus there are several treatment options and your virologist can give you the latest and prognosis. You should arm yourself with some basic anatomy/physiology of how your liver works and what hep B does....google and find the least "cotton" site you can find...wikipedia is a good overall start as well as Medline, CDC, WHO-if you have done so sorry for redundancy. The important thing is to get going now on your treatment options...That to me means finding a Liver specialist with lots of experience with Hep 'B. Yes if you are young and lucky the disease is often cleared/eliminated by your own immune system...but maybe not-that's why you should see a specialist about when to consider taking anti-virals such as interferon(which is a nasty drug with lots of side effects) and I believe is more sucessful the sooner it is instigated. Good luck and hope all clears soon.

[N47HAN]

Whew Hep B. That is not good news. I am sure you are having a second blood test to confirm-false positives happen a lot. Also it is B? Hep A is a more common occurance and much less serious as well???? This is not the place to get serious info on such a serious disease. Depending on when you contracted the virus there are several treatment options and your virologist can give you the latest and prognosis. You should arm yourself with some basic anatomy/physiology of how your liver works and what hep B does....google and find the least "cotton" site you can find...wikipedia is a good overall start as well as Medline, CDC, WHO-if you have done so sorry for redundancy. The important thing is to get going now on your treatment options...That to me means finding a Liver specialist with lots of experience with Hep 'B. Yes if you are young and lucky the disease is often cleared/eliminated by your own immune system...but maybe not-that's why you should see a specialist about when to consider taking anti-virals such as interferon(which is a nasty drug with lots of side effects) and I believe is more sucessful the sooner it is instigated. Good luck and hope all clears soon.

thx bud,

Reg today at bkk phuket hospital, seems like they have a specialised liver department there. Unfortunately the symptons are pretty overwhelming and the test is correct.

Interferon is to be used at the "chronic" stage should it develop that far...... for now on some liver assistance drugs, have my second blood test in 7 days so have to wait ... christ this is gonna be a bloody long 7 days...

Thx for the links

regards

[Ijustwannateach]

Apart from whatever medical advice the docs give you, you're going to want to be kind to your liver. NO alcohol or other intoxicants, very few medicines other than what the docs give ('cause things like analgesics get processed through the liver), lots of fresh fruit and veggies, lots of water, good air, low on the meat proteins)... some of the carminative teas might be a help, as healthier blood means fewer dead blood cells for the liver to take care of- get a bit of exercise when you've recovered enough.... you're going to need to take care of yourself in general if you want to give your body the best chance to get rid of this infection and not have it become chronic (i.e., eventually fatal). Good luck.

[Prakanong]

By your reference to Bangkok Phuket hospital I take it you are down south. Chula Uni in Bangkok has an excelent reputation in the liver disease department and we have used them for a lot of research into a Hep B vaccine and we still continue follow up there.

I do know they are involved in studies for Lamivudine as well as Chula - the place is well recognised for its expertise in Hep B

Thailand has a high incidence of Hep B (and of liver disease in general - often caused by flukes in raw fish and crabs.)

Have a look at this site http://www.hepb.org/patients/hepatitis_b_treatment.htm

Approved Hepatitis B Drugs in the United States

Interferon-alpha (Intron A) is given by injection several times a week for six months to a year, or sometimes longer. The drug can cause side effects such as flu-like symptoms, depression, and headaches. Approved in 1991 and available for both children and adults.

Pegylated Interferon (Pegasys) is given by injection once a week usually for six months to a year. The drug can cause side effects such as flu-like symptoms, depression and other mental health problems. Approved May 2005 for adults.

Lamivudine (Epivir-HBV, Zeffix, or Heptodin) is a pill that is taken once a day, with almost no side effects, for at least one year or longer. The possible development of hepatitis B virus mutants during and after treatment is a concern. Approved in 1998 and available for both children and adults.

Adefovir dipivoxil (Hepsera) is a pill taken once a day, with few side effects, for at least one year or longer. Kidney problems can occur while taking the drug and is a concern, but are reversible once the drug is stopped. Approved September 2002 for adults. Pediatric clinical trials are being planned.

Entecavir (Baraclude) is a pill taken once a day, with almost no side effects for up to one year. It is considered to be the most potent oral antiviral drug for chronic hepatitis B to date. Approved April 2005 for adults. Pediatric clinical trials may be planned for the future.

Telbivudine (Tyzeka, Sebivo) is a pill taken once a day, with almost no side effects for up to one year. Studies have shown that it rapidly and profoundly suppresses HBV levels. Approved October 2006 for adults.

As IJWT points out its a very good idea to keep you liver clean of any other "items" as possible - the abstract below alludes to cirrhosis being a factor "Without pre-existing cirrhosis, there may be only slight fibrosis or mild chronic hepatitis, but with pre-existing cirrhosis, further complications may ensue"

This abstract shows that in Asia the level of chronic

"Of the estimated 50 million new cases of hepatitis B virus (HBV) infection diagnosed annually, 5–10% of adults and up to 90% of infants will become chronically infected, 75% of these in Asia where hepatitis B is the leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). In Indonesia, 4.6% of the population was positive for HBsAg in 1994 and of these, 21% were positive for HBeAg and 73% for anti-HBe; 44% and 45% of Indonesian patients with cirrhosis and HCC, respectively, were HBsAg positive. In the Philippines, there appear to be two types of age-specific HBsAg prevalence, suggesting different modes of transmission.

In Thailand, 8–10% of males and 6–8% of females are HBsAg positive, with HBsAg also found in 30% of patients with cirrhosis and 50–75% of those with HCC.

In Taiwan, 75–80% of patients with chronic liver disease are HBsAg positive, and HBsAg is found in 34% and 72% of patients with cirrhosis and HCC, respectively. In China, 73% of patients with chronic hepatitis and 78% and 71% of those with cirrhosis and HCC, respectively, are HBsAg positive. In Singapore, the prevalence of HBsAg has dropped since the introduction of HBV vaccination and the HBsAg seroprevalence of unvaccinated individuals over 5 years of age is 4.5%. In Malaysia, 5.24% of healthy volunteers, with a mean age of 34 years, were positive for HBsAg in 1997. In the highly endemic countries in Asia, the majority of infections are contracted postnatally or perinatally.

Three phases of chronic HBV infection are recognized: phase 1 patients are HBeAg positive with high levels of virus in the serum and minimal hepatic inflammation; phase 2 patients have intermittent or continuous hepatitis of varying degrees of severity; phase 3 is the inactive phase during which viral concentrations are low and there is minimal inflammatory activity in the liver.

In general, patients who clear HBeAg have a better prognosis than patients who remain HBeAg-positive for prolonged periods of time. The outcome after anti-HBe seroconversion depends on the degree of pre-existing liver damage and any subsequent HBV reactivation. Without pre-existing cirrhosis, there may be only slight fibrosis or mild chronic hepatitis, but with pre-existing cirrhosis, further complications may ensue. HBsAg-negative chronic hepatitis B is a phase of chronic HBV infection during which a mutation arises resulting in the inability of the virus to produce HBeAg. Such patients tend to have more severe liver disease and run a more rapidly progressive course. The annual probability of developing cirrhosis varies from 0.1 to 1.0% depending on the duration of HBV replication, the severity of disease and the presence of concomitant infections or drugs. The annual incidence of hepatic decompensation in HBV-related cirrhosis varies from 2 to 10% and in these patients the 5-year survival rate drops dramatically to 14–35%. The annual risk of developing HCC in patients with cirrhosis varies between 1 and 6%; the overall reported annual detection rate of HCC in surveillance studies, which included individuals with chronic hepatitis B and cirrhosis, is 0.8–4.1%. Chronic hepatitis B is not a static disease and the natural history of the disease is affected by both viral and host factors. The prognosis is poor with decompensated cirrhosis and effective treatment options are limited. Prevention of HBV infection thorough vaccination is still, therefore, the best strategy for decreasing the incidence of hepatitis B-associated cirrhosis and HCC.

[Ijustwannateach]

That's another good reminder- get your Hep.A and Hep.B vaccinations pronto!!!

[Prakanong]

Here are the cost comparisons for Hep B treatment too - not cheap!!

http://www.hepb.org/pdf/HBV_Drug_Comparison_Costs.pdf

I know its too late for the original poster but please anyone reading this go and get yourself vaccinated - three shots and you are covered for life

Engerix for Hep B alone and Twinrix for Hep A and B

I pay about 80 SGD in Singapore per shot for Twinrix but thats at a private clinic - in Pattaya the ex paid 2300 THB per shot for Engerix - A recent thread on here i pointed a guy to the Thai Red Cross - less than 70THB

I get all these for free of course but never bothered until recently - what a fool I was but luckily i am OK. Its just a coincidence but my GP rang me this morning to say come in for my 3rd and final engerix shot.

I started on Twinrix but I proved to already be immune to Hep A after I had a medical - must have had it and not known!

Edited May 14, 2007 by Prakanong

[Ijustwannateach]

Some doctors have told me that there is "background exposure" here to a lot of diseases, including typhoid, which eventually obviates the need for vaccination as long as you have a healthy immune system and fight them off as you go.

[Prakanong]

Some doctors have told me that there is "background exposure" here to a lot of diseases, including typhoid, which eventually obviates the need for vaccination as long as you have a healthy immune system and fight them off as you go.

Do you mean as there is a lot of the disease about some of the locals become immune after exposure as kids etc?

Yeah I think that happens - Dr I know says most Thai's have Dengue antibodies and the malaria vaccine is really aimed at protecting kids for the first year or so till they build up their own defences though.

Then there are others like Rotavirus - every kid in the world gets it at least once before age 5. Problem though it does not kill us in the west as its usually the dehydration and other side affects that kill you - we need to vaccinate for that as it can kill in developing countries before the immune system is strong enough against it.

I will ask my pal at work - he knows a bit about childhood vaccines in Asia if you get my drift ;-)

[N47HAN]

thx for your input guys,

anyone know anthing about a tablet(capsule) called hepacap?

Doctor put me straight on them after the blood test?

[drenoi]

The truth is Hep B isn't that serious, if you've done alot of reading you will know the approx. 85% of people clear the virus and are then immune to it for life. Whilst approx 15% will go on to get Chronic Hep B and eventually liver cirrocis.

My advice to you: Dont drink alcohol, eat lots of salads, avoid fatty/oiliy foods, drink lots of fluids, quit smoking for a while if you smoke but the most important this is don't drink!! If you do this you will be fine. From my experience not drinking or eating fatty food reduces the symptoms 100 fold. Basically, just give your liver a break for a few weeks...

Hep C is the one to watch out for with the odds reversed, that is 15% clear it and 85% go on to get chronic hepatitis.

As far as I know there is no treatment for Hepatitis but did a quick search for Hepacap and it looks like an alternative treatment? Anyway everything I've ever read says no treatment.

Yes I've had hep b also, yes it was a scary as <deleted> but supprisingly it cleared very quickly (2-3 weeks), oh and congratulations!! You've joined the short list of people to actually get something back from the Thais!

[N47HAN]

The truth is Hep B isn't that serious, if you've done alot of reading you will know the approx. 85% of people clear the virus and are then immune to it for life. Whilst approx 15% will go on to get Chronic Hep B and eventually liver cirrocis.

My advice to you: Dont drink alcohol, eat lots of salads, avoid fatty/oiliy foods, drink lots of fluids, quit smoking for a while if you smoke but the most important this is don't drink!! If you do this you will be fine. From my experience not drinking or eating fatty food reduces the symptoms 100 fold. Basically, just give your liver a break for a few weeks...

Hep C is the one to watch out for with the odds reversed, that is 15% clear it and 85% go on to get chronic hepatitis.

As far as I know there is no treatment for Hepatitis but did a quick search for Hepacap and it looks like an alternative treatment? Anyway everything I've ever read says no treatment.

Yes I've had hep b also, yes it was a scary as <deleted> but supprisingly it cleared very quickly (2-3 weeks), oh and congratulations!! You've joined the short list of people to actually get something back from the Thais!

like your quip at the end !

Still curious about hepacap though, scoured the net as most no doubt but really cant find anthing except the companies own description, no affects reasons etc....

[drenoi]

I would say looking at what websites have any info on hepacap that it is a liver detox type of treatment, you could compare the ingredients in it with more mainstream liver detox treatments and see if they have the same ingredients. Although it seems to be solely a herbal treatment.

Also when i type hepacap into google alot of results come up in Thai, that gives a good indication that it's made in Thailand or only sold in Thailand?

Anyway, good luck!

[Prakanong]

And no vaccine for Hep C yet do watch out and be careful

Vaccine for Hep "E" is in trials - yes there is an E too

[Sheryl]

Most cases of Hep B will clear up on their own without sequelae and actually no treatment is necessary for the acute phase of the illness unless it is very severe (which yours does not sound like), otherwise it is a matter of just avoiding things that will further stress the liver (alcohol, just about any medication, recreational drugs), eating a good balanced diet, getting enough rest and letting nature do the rest. Some people advise high potency B complex supplements, which is what the Hepacap is. May help and can't hurt.

The problem is that 10-15% of people become chronic carriers and that carries with it a risk of liver cancer later on. If you do develop the carrier state then the various expensive new drugs may be warranted but cross that bridge if and when you come to it.

You should know that you can transmit the virus to a sexual partner and take precautions (condoms) accordingly. If you have a regular partner they should be tested and if they are negative for both the antigen (current infection) and antibody (immunity do to past infection) then they should get the Hep B immunization.

Many Thais have already acquired immunity to Hep B so it is customary to check first for that (by testing for antibody) before incurring the expense of vaccination. Unfortunately some Thais have acquired a chronic carrier state, and it is quite possibly intimate exposureto one of them through which you acquired the disease.

[N47HAN]

visited bkk phuket today,

good news in the fact that my g/f is clear and has had the first vaccination today and the rest to follow accordingly.

have a liver scan booked for next week, this is looking like its gonna cost a few quid , todays visit was nearly 7000 Baht.

Have now also been prescribed LEGALON.

News from the doc seems to be a mid to high infection looking at the numbers from the test.

All the reading up ive done does indeed look positive , but , to be honest seeing yourself turn yellow gradually from head to toe is bloody scary!

Thanx to all whove responded to this thread, I appreciate this is not a medical forum but reading the responces so far certainly helps to put my mind at rest.

On a lighter note...... had to order UBC today for the first time in 3 years of being here , as staying at home the amount of time i am is to say the least bloody boring! ( probably had longer off in the last 2 weeks than ive had away from work in the last 3 years!)

[Prakanong]

Great news you GF is clear and getting the jabs

There is a newly approved by the FDA accelerated route even though Dr's have been doing that for years

Instead of day 0 - day 30 then circa day 180

The accelerated schedule is

Day 0 - day 30 then 8 weeks after the day 30 dose

I can not remember if this needs a booster at a year with the accelerated schedule but something is sticking in the back of my mind but that could well be a recent Twinrix study I read

Get her on the accelerated dose!

Good to see you are keeping your spirits up - I like staying in but I get better telly in Singapore and I bet its cheaper! ;-))

[Prakanong]

Legalon

Its another herbal drug - its milk thistle. Its a called a dietary supplement in many markets as its illegal to call it a medicine - ask youtrself why?

Ask your Dr to point you to any clinical trials run under GCP which have proved these work - ever wonder why these drugs are not FDA approved?

Please get up to Chula and see an expert there

[cathyy]

I had hep B about 15 years ago, and actually never knew it at the time. I found out later when I went to donate blood that I had had it and cleared it. I've been tested several times by different docs to make sure I knew what I was talking about when I told them I have antibodies but no virus, i.e. no chronic infection. My case was obviously less severe as I never progressed to jaundice.

I thought you might like to know what the permanent effects have been for me, as you are likely to end up in similar territory.

My liver is best described as "delicate." It works just fine, causes no trouble, but I cannot add to its work load. If I do, my liver enzymes skyrocket to truly alarming levels, enough to merit an emergency phone call from the doctor's office.

My liver enzymes are always somewhat elevated on liver blood tests, but not alarmingly so. They also fluctuate. I dare not take Tylenol, nor statins for cholesterol, nor Lamisil for nail fungus nor Accutane for acne (if I had need for those last two). I use my nurse's drug guide to check how drugs are metabolized and excreted before I take them as the Thai docs I have had seem oblivious to my limitations there. I do not drink alcohol, and you are really, really advised to not drink alcohol, either. Well, maybe 1 beer every year or two.

[N47HAN]

Well Good news!

Just came back from PhuketBkk Hospital.....

Although my counts are not quite normal , the doctor has told me that I will make a full Recovery with NO lasting adversities.

Have to take a few tablets a day for the next 3 months or so , lay off the beer and fatty foods but thats about all !

Thanks to all who posted replies and PMd me especially prakanong for his educated advice.

GOD IT REALLY DOES FEEL GOOD TO BE WHITE !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[jdinasia]

I had HepB subclinically as a teenager! Yeay! (not good for the folks I came into 'contact' with whilst it was active since i had no clue that I had it though!

[Prakanong]

Well Good news!

Just came back from PhuketBkk Hospital.....

Although my counts are not quite normal , the doctor has told me that I will make a full Recovery with NO lasting adversities.

Have to take a few tablets a day for the next 3 months or so , lay off the beer and fatty foods but thats about all !

Thanks to all who posted replies and PMd me especially prakanong for his educated advice.

GOD IT REALLY DOES FEEL GOOD TO BE WHITE !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Great news - a few months off the beer is not much to ask ;-)

[francois]

hi'

my 2cts worth here ...

I have hepatitis C since 13 years now ... no fun at all

this sh** washed out the hepatitis B vaccine and the doctors said that I must have

contracted one without knowing ... and it appeared to be true

I was nearly alone for years ... common medications, no improvement, blood analysis up and down.

and then I was in Thailand for a few years, nearly ran to see a Chinese Doctor

I went to Mangkala clinic(Chiang Mai), and within 6 months my blood analysis went back to normal, just as a teenager

since this treatment, everything is a lot better.

still avoid to drink alcohol, eat not too fat, and use only olive oil to cook.

drink some green tea and life ain't this bad

so, my adivice is, go to see a serious Chinese Doctor (ask about before, if a lot of Thai's go, you can go) ...

it's cheap and work wonderfuly on this disease

and if you have a good immune system you might get the chance to be ummunized by the way

francois

Edited May 25, 2007 by francois

[francois]

re ...

btw, hepatitis D, E, and F are mutants from the C one ....

no vaccine for C, no working stuff and it's valid for the rest of them.

francois