Patient's question:
Mother, 58 years old, 7 years post-heart valve replacement surgery, taking warfarin sodium tablets indefinitely, 12 years post-gallbladder removal, taking Bystolic one tablet daily for hypertension, hepatitis B surface antigen positive for 10 years, liver function tests have always been normal. Recently, her ALT and AST levels were found to be 60-70, with a DNA copy number of 10^5, accompanied by symptoms of bitter taste, stomach discomfort, and nausea. Other liver function tests are normal, and ultrasound shows diffuse liver parenchymal damage. Should she be prescribed antiviral medication? However, she is already taking so many medications, and her body is very sensitive to drug side effects. What should I do?Doctor's answer:
Patients with "minor triple positive" should first undergo liver function tests, detect the level of HBV-DNA in the blood, and check for pre-C gene mutations. Additionally, a necessary liver biopsy should be performed to accurately determine how this "minor triple positive" condition requires treatment measures. Generally, if liver function is normal and HBV-DNA is negative, treatment is not needed, and annual follow-up tests are recommended. If liver function is abnormal and HBV-DNA is positive, treatment is necessary. Since patients are directly affected by liver disease, we should actively adopt treatment measures and avoid delaying medical visits. If the liver disease does not improve with treatment, the treatment plan should be adjusted promptly.