HepB re-activating Post Hep C treatment

[LifeIsGood]

Hello to All, 

My name is Mara, and I am 64 years old. 
I really have no idea where to ask this question--as far as which Board or Topic to enter it into. I apologize!  But as this is happening to me Post-Treatment with Harvoni, I am tucking it in here.

Here is my question:

Does anyone have any info or experience with Occult HepB (undetectable surface antigens) re-activating after DAA treatment?   I am awaiting blood work results to see if in fact this is what is happening to me.  The only info I can find is regarding Hep B reactivation during Chemo for Cancer, or from drugs to do with Transplant.  There is very little info that I can find out there addressing OBI after DAA drugs....but it can happen, i did find a PubMed tiny document about it.....

I started Harvoni 10/2/15 and ended 12/24/15.   At EOT I was undetected.  My dr. did not repeat a VL @ 4 weeks EOT---opting to wait on 12 EOT for that.  However he did do some Liver tests and my ALT and AST are not co-operating by coming down...they are in the 70's. They started in the 150's.   He is now doing a VL for C and also 3 tests to do with HepB., one DNA...

I probably posted for help too soon, because my mind is mush about this.  I was just thinking I would 'clear', or 'relapse' from C. Pretty straightforward.    I never imagined that HepB would rear it's head. And as you all probably well know...waiting for answers and blood work is the hard part.

Thank you in advance for any info anyone can think of or point me to.
I will update as I learn also.   I do not think i will be the last to find HepB waiting in the wings after clearing (possibly) Hep C.  I had HepB 45 years ago, and was always told that because I had anti-bodies I was "cured".  Evidently it can revive in the right circumstances...

I am sure my Dr. will have a plan of action in due time after he sees the BW...I am just trying to get a grip on what that plan may be, if it has happened to anyone else....I am not great at waiting thru a weekend.....:-)

Kind Regards to you all, and thanks for reading this far!

[lporterrn]

If you have hep B antibodies (HBsAb) then you aren't a carrier, and there is nothing to activate. It's kind of like looking at a photo of a car and wondering if you could drive it. As for the elevated enzymes, there are a number of possibilities (and not usually call for alarm), and your instinct to let the doc work it out is a good one.

Waiting is hard; it is also an art. It is so hard to wait calming, that many of Hep's bloggers have written about it. Here's one post: https://www.hepmag.com/blog/hepatitis-c-and-wait

[LifeIsGood]

Lucinda,
Thank you so much for the Tips on Patience article!  It is very helpful :-) 

I see what you are saying about  there being nothing to reactivate if  one has antibodies.   So i dug out my pretreatment BW and what is seen is HepB Core AB IGM  nonreactive

and HepB Core AB   reactive.

I do not know exactly what this signifies.....

Maybe it is more accurate to state that I am CO-infected....but that the virus was undetectable via usual tests? Because it was Replicating so incredibly slowly as to be 'forgotten about' in my over-all treatment pic.  I think that is what Occult means....under the radar and needs sensitive tests to find it.

http://www.ncbi.nlm.nih.gov/pubmed/25830779

http://www.jcancer.org/v04p0473.htm

looked high and low for a HepC / HepB co-infection forum the quality of this one to join, but came up empty-handed.
The above links are a window into what I believe my Dr. is looking at as at staying on top of,  but as you say he is looking at other reasons for continued elevated enzymes also. 

I am in the care of a Transplant Hepatologist in Wash. DC.  I was sent there after my trusted local GI got a look at my AFP marker and MRI results.....AFP was into triple digits, and a very small lesion on my Liver was seen.   I am very pleased to report that the AFP marker has plummeted---here at 5 weeks EOT---to 8.  EIGHT.  Maybe transplant oriented Dr.'s are prone to examine even remote possibilites.
Anyway...follow-up MRI this Monday, and BW answers looking at HepB due this week.

Thank you for your input!

I wish i could figure out how to do a 'footer', i know it would make life easier for people to see my situation and numbers.

Also, I want to say, and this goes along with the Tips for calmness....I have learned that some things just have to happen in their own time...some situations have to reveal themselves at their own pace, and one just cannot rush them.  Some things just have to be Gone Through...we all know that feeling!

Mara 

[lporterrn]

Hi Mara,
You need more info - this is so complicated, and although the charts look straight-forward, there is a chance of false results. Your doc is the best possible person to interpret this. Honestly, if I could give you an educated guess based on what you are sharing, I would, but I know enough to know that there isn't enough info for a good guess.

[lporterrn]

PS - Do keep us in the loop when you know more.

[LifeIsGood]

Thank you Lucinda Porter, I will.

and, Thank you for reading and weighing in

Mara

[FutureThinker]

The process for dealing with this disease is already so complicated, so I am sorry to hear you're having even more questions/concerns post successful HCV treatment.  Keep us posted and fingers are crossed -- FT 

[lporterrn]

Mara - have you seen this? http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Direct-acting_antivirals_for_hepatitis_C_20/Procedure_started/WC500204893.pdf