Hello and thank you for the question.
Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.
You need to answer a few questions first which will help me assist you in a better way.
Can you tell me what was the referance range for HBsAg (you have only written the value 1351.66 s/co)? Did it mention positive or negative?
Have you been getting these sores in the past as well?
the sores around my genetal area i have never experienced before. it is just 10 days back and then i got it tested.
the reference range for HBsAg non reactive: < 1.00 S/CO
reactive : >= 1.00 S/CO
Thank you very much for the valuable information Ariz.
As per the reports you have mentioned, you are positive for Hepatitis B infection. However this is a screening test (HBsAG) and we need to have a number of other tests as well to determine whether this needs treatment or not. These include viral load, ALT levels, and HBeAG.
Not all the people infected from hepatitis B require treatment, rather a vast majority of patients clear the infection from their body spontaneously.
In remaining patients (who do not clear off the virus) the above mentioned tests determine if treatment is required or not, because in some patients the virus may remain inside the body with out affecting your liver and for that no treatment is required. Only the patients who suffer liver damage due to Hepatitis B virus (determined by high ALT levels and liver biopsy) need treatment for this, which is very effective these days (in the form of oral drugs) and provide excellent results.
So for hepatitis B you need further evaluation by a Hepatologist or Gastroenterologist.
As far as the HSV 1 and HSV 2 results are concerned, these tests are done for Herpes Simplex virus, which has two types (1 & 2). These herpes virus give you genital as well as oral lesions (like the one you have).
The test results (positive IgG for both HSV1 & 2) means you have been infected with both of these viruses in the past (at least more than 2-3 months ago or more than that).
IgM if turns out to be positive means a recent infection or a recurrent infection by the Herpes virus.
The herpes virus remains in your body once you are infected and can give you lesions in the genitals as well as around mouth any time (especially during stress, concurrent illness, poor immunity). These attacks of herpes are treated with antiviral drugs, which reduce the pain as well as severity of the attack.
Once an attack is treated, you no longer require the drugs for herpes until the next attack (which may take months or years to happen again).
If some one gets frequent attacks of herpes lesions, then the doctors prescribe drugs against the herpes virus for a long duration to reduce both the frequency as well as severity of the herpes attacks.
You should discuss this with your treating doctor to chalk out further management plan that suits best to your needs and visit the hepatologist as well for hepatitis B evaluation in detail.
I would have been worried too if I were at your place, but let me reassure you that this is not something very serious or life threatening. It is a treatable condition and carries a good prognosis with appropriate management.
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should i abstain from sexual activity even if there is no lesion of any sort?
how long do these lesion take to go away and what kind of anti viral drug is to be taken for these?
also in order to further evaluate about the hep b virus what all other test is recommended....my Sgot result is 45 u/l and sgpt is 80 u/l. also i was wondering if this is necessarily due to the hep b virus? as i had started taking body building supplements of different kinds on a daily basis as well as testoboosters....is there any possibility that these supplements have anything to do with these results?
Thank you very much for getting back.
You should discuss this with your partner in detail and practice safe sex (using condoms will be most helpful for your partner). You have to follow this even if there are no lesions present.
And whenever you get the herpes outbreak (lesions) try to abstain from intercourse (even protected) as the chances of transmission are highest whenever you have active lesions/outbreaks.
Acyclovir, Famciclovir, and Valaciclovir are the drugs usually employed to treat this condition.
For further evaluation of hepatitis B following tests will be required;
Complete liver panel (including sgot/sgpt/alp/bilirubin/albumin)
Coagulation profile (PT/INR)
PCR for Hep B DNA (quantitative as well as qualitative)
Once you have results of all these tests, your doctor will be in a much clear position to determine whether the virus inside your body is affecting you adversely and requires treatment or not.
Raised sgot/sgpt are suggestive that the virus is affecting you liver, but this rise can be due to many other factors as well such as;
fatty liver (in obesity)
over the counter supplements (which you are using)
any other drugs (such as paracetamol)
Its advisable to stop taking any kind of drugs/supplements and getting the test repeated after a week or two to be absolutely sure about the levels of sgot/sgpt.
Moreover, albumin levels, bilirubin, PT/INR are more sensitive tests of liver function which need to be done.
I hope this clarifies and answers you.
Kindest Regards XXX XXXXXXXX.
hmy results for some of those tests are as follows:-
Bilirubin(total)- 0.40 mg/dl
. . . . . . . . 6.84 umol/L
My bilirubin(total), bilirubin(direct); albumin; gamma gt; prothrombin time; INR, all are well within the reference values.
My bilirubin(total); bilirubin(direct); albumin, prothrombin time; INR are all well within the reference values as per my bloodd reports.
Does this mean the virus is not causing damage to my liver?
This means that your liver is not significantly damaged to result in derangement of these tests.
However, the decision to treat the virus will depends upon other factor also, such as ALT, liver fibrosis (detected by liver biopsy) and the viral load.
The decision to treat Hep B is not easy and the expert physician has to balance the benefits and risks before initiating a specific treatment, and also the timing to initiate treatment is most important (depending upon the test results).
I start treatment to my patients if they have significant viral load, HBeAG positive, and have persistently raised ALT (2 to 3 times the upper limit of normal).
There may be little case to case variations to this decision depending upon the particular patients.