— Christine M. Kukka, Project Manager, HBV Advocate
Current medical guidelines suggest doctors wait three to six months before prescribing antivirals to patients with high ALT levels, which indicate liver damage. The delay is suggested because sometimes spontaneous HBeAg seroconversion (loss of HBeAg and development of "e" antibody) occurs during these ALT spikes.
However, a new study published in the December 2014 issue of the journal Clinical and Molecular Hepatology finds that seroconversion is unlikely to occur when patients have HBV strain or genotype C. Experts say doctors should treat these patients immediately to avoid more liver damage.
Researchers in South Korea followed 90 HBeAg-positive patients with elevated ALT levels for six months without initiating treatment. During that time, only one patient (1.1%) achieved spontaneous HBeAg seroconversion. In the meantime, half of the patients experienced deteriorating liver health with one requiring a liver transplant due to liver failure.
Instead of waiting, researchers noted, "Immediate antiviral therapy should be considered, especially in patients with high ALT and HBV DNA levels in endemic areas (with) genotype C infection."
Labels: Genotype C, treatment
