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[QUOTE=AlanPi;3619171]I was apparently exposed to Hep B at birth. 1973. Apparently back in the day they don't have vaccinations of Hep B for babies yet.

Currently the virus is not active. What is the chance of it becoming active again in life term? I don't know what I can do, if any?[/QUOTE]
Hi, this is also a very good question. (see my answer to your first question in the previous thread).

Assuming you are a chronic carrier (which is a good bet because 90% of babies who are exposed at birth and do NOT get the HBIg, become chronic carriers) there are a few different patterns to how your liver reacts.

So first off, it's not the virus itself that damages your liver--it's your immune system fighting the virus which is what causes the damage.

From birth to about 20 years of age, chronic carriers of hepatitis B have high levels of virus in their liver, but their liver remains healthy and NOT inflamed because the immune system has not decided to attack yet.

At some point in one's 20s, the immune system decides it's going to attack the virus and try to rid the body of it. At this point the liver becomes inflamed (the person may become jaundiced) but the amount of virus drops to undetectable levels. From here you can go a number of ways:

#1. The inflammation continues firing on, the liver gets really really ill and you end up getting permanent liver damage and failure and need a liver transplant. Fortunately this is relatively rare.

#2. The inflammation settles down and the amount of virus STAYS undetectable, and it continues like this forever. This is the best situation.

#3. The inflammation settles down and the amount of virus stays undetectable, but you have periods where your immune system gets revved up again for a few weeks, causing damage to your liver over time. THESE ARE THE PEOPLE LIVER SPECIALISTS WANT TO CATCH BECAUSE YOU NEED TO TREAT THEM WITH MEDICATIONS

#4. There is also the people in whom the liver inflammation settles down, but the viral load stays medium to high. If there is no inflammation, you don't necessarily need to treat these people, but you have to watch them closely.

As you can see, this is somewhat complicated because, #3 can easily masquerade as #2, because a lot of the time the inflammation is happening, there are no symptoms. It is very important to follow every chronic carrier of Hepatitis B with serial blood examinations to make sure there is no asymptomatic inflammation happening.

Finally, the last VERY VERY VERY important thing. All chronic active carriers of Hepatitis B are at risk for liver cancer even in the absence of liver cirrhosis or liver inflammation (which is in contrast to infection with Hepatitis C). As a result, it is recommended that, after the age of 40, every single person who is a chronic carrier of Hepatitis B start getting abdominal ultrasounds every 6months for the rest of their lives.

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