Din pacate acum pare mai clar, mult mai clar. Totul se reduce dupa parerea mea la : hepatita cronica activa cu virus mutant (AgHbe-, AntiHbe+, HBV DNA pozitiv, transaminaze peste limita normala). Nu stiu insa de ce au ajuns la asemenea valori. E posibil sa fi trecut din nou intr-o faza replicativa, de fapt e cel mai posibil. Ce sa iti zic... nu stiu cati ani ai, de cand ai hepatita, acum... dc mama ta are ciroza hepatica de 18 ani (presupun ca in urma unei hepatite cronice?) ma gandesc sa nu fi luat si tu la nastere sau la alaptare virusul... In acest caz, ar fi bine sa te apuci cat mai repede de tratament. Oricum dc vrei sa fiu sincer: hepatita cronica cu virus mutant are forme mai grave si mai rapide decat cele cu AgHbe+. Nu incerc sa te sperii ci sa te conving ca nu e de stat degeaba... ce-i drept insa intr-o luna nu se intampla cine stie ce asa ca prinde forte proaspete de Sarbatori si fa-ti curaj sa termini toate analizele si sa iti faci dosarul. Probabil ca o sa ti se aprobe. E de cercetat de ce ai atat de mari transaminazele deodata. Eu cred ca are loc o reactivare a virusului si o mutatie precore (repet ca nu sunt medic dar ceva asemanator am citit), altfel nu imi explic. Cel mai bine un medic specialist bun iti poate explica si pune un diagnostic. Nu te lua dupa nimic de pe forum, doar ca titlu de informare. Adevaratul diagnostic ti-l pune un medic specialist BUN.
Sanatate.
"Patients with HBeAg negative chronic hepatitis are usually older than
patients with HBeAg positive chronic hepatitis and the age ranges between
36 and 45 years (median 40); males largely predominates and the reported
male/female ratio ranges from 3.9 to 17 (26, 48-51). Current available data
indicate that the clinical profile of HBeAg negative chronic hepatitis
differs from that seen in patients with HBeAg positive chronic hepatitis.
Indeed minimal or mild chronic hepatiits at histology is infrequent and
severe necroinflammation is seen in more than 50% of HBeAg negative cases at
diagnosis (26, 48, 51, 52). In large series of patients from the
Mediterranean area from 29% to 38% had cirrhosis already developed at the
time of their first presentation (25, 26, 51, 52). The older age and the
high rate of advanced liver damage at presentation of HBeAg negative as
compared to HBeAg positive patients suggest that HBeAg negative chronic
hepatitis represents a late phase in the natural history of chronic HBV
infection. To further support this concept a recent long term study has
reported that HBeAg negative chronic hepatitis accumulated over time after
HBeAg seroconversion with a cumulative incidence of approximately 25% at 16
years of follow-up (31). Thus the increasing prevalence of HBeAg negative
chronic hepatits may be only the reflect of the increased duration of
infection in chronic HBV carriers and long term monitoring of patients.
Moreover the clinical course of HBeAg negative chronic hepatitis differs
from the HBeAg positive forms in relation to large fluctuations over time of
viremia and transaminases, with relapses of hepatitis alternate to periods
of biochemical remission in most patients and a much lower rate of
sustained spontaneous remission. During follow-up three main biochemical
profiles are observed, namely recurent flares of ALT with (pattern 1) or
without (pattern 2) spontaneous ALT normalization between flares, and
persistently increased ALT without tendency for spontaneous remission
(pattern 3). In a recent longitudinal study approximately two-thirds of
patients showed recurrent ALT flares and the frequency of patterns 1,2 and
3 was reported to be 45%, 20% and 35%, respectively (51). Flares of
hepatitis may be severe and disease exacerbations correlate with progression
to end stage complications of cirrhosis (51). Periods of remission with
normal ALT and low serum HBV-DNA levels (< 105 copies per ml) may be long
lasting, but usually the disease recurs and sustained spontaneous remission
of disease activity is uncommon (6). The incidence of delayed spontaneous
HBsAg clearance has been estimated to occur at a low rate of 0.5% per year
(31, 52)."
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