Oh my. Trying to figure out how to even explain this is hard. But I will try.
When I was pregnant with Sydni I found out that I had Hepatitis B. The general consensus is that I contracted from my birth mother, and since it's so common in Asian countries, this all makes sense. If the disease is contracted from mother to child and there are no interventions (immune globulin [given to babies born from mothers who have HepB] or vaccinations) then that likelihood that a newborn with an immune system of....well a newborn, can fight it off is unlikely. So, as of present day I still have it and that's why.
Now it sounds selfish....why would I choose to get pregnant again if I know that my new baby can contract the disease? Well after speaking with my OB and my Hepatologist it was made clear that if I wanted to have another baby, the younger I am and the less active my disease is, the better. Well it happens to be that my disease was at a low level of activity (I'll explain later) and that the time seemed like the best. When a baby is born to a mom of HepB, the baby receives a special shot called Immune Globulin. This shot reduces the likelihood of the baby contracting HepB (along with the first shot of HepB vaccincation at birth) to 1-5%. The sooner they get the shot (literally from 30 minutes to 5 minutes, makes a huge difference. However, the higher the viral load (or count) of the HepB in the mother, the more it matters about how quickly the shot is given. And, with that said it also matters because the higher the viral load, the higher the percentage that the baby will contract the disease even if they get those shots.
So....my predicament? Well since I found out I have it, and started getting my viral load checked, as well as my liver enzymes (which kind of gives a quick glimpse of whether or not the disease is damaging your liver) and other antigen and antibody tests, my overall results have been between an inactive carrier and an active carrier. The difference between the two is that an inactive carrier shows positive for the disease, but has a low viral load, regular liver enzyme counts, and the bad antigens are negative or nonreactive. I've had a liver biopsy to check my liver quality (in 2009) and it was healthy.
Well, I now get checked every 6 months. I got checked in June of this year and my viral load went down from 12000 to 6000. At first I thought those numbers were high, but I was told by my doctor that high numbers are in the millions and that my numbers were nothing to really worry about especially since my liver enzymes were in normal range and that all of my antigens weren't positive. Well, I just got bloodwork done last week and got my results last night and I was crushed. My viral load was 2,941,107....yes that's right, that number is in the millions....My liver enzymes were 128 and 130......whereas my last count was 16 and 18. High is considered above 30. My antigen that has been negative for a few years is positive.
Not only am I concerned about my life, but also my babies. I feel guilty. I just pray that he will respond to the shots even though my count is against him. Now, let me also say that my hepatologist warned me that my hepatitis could react in many different ways to being pregnant. It could stay the same, lessen or rise. So Maybe it just started rising because of the pregnancy? On top of all of this, there are other factors that can play a role now, too. Something called ICP, which occurs in 1% of pregnancies, but the 1% mostly consists of people with liver diseases, and Acute Fatty Liver which occurs in pregnancy, mostly to women with liver disorders.
So now I just wait. I am waiting to hear from my OB about what I should do.....induce or c-section because of possibility of ICP or Acute fatty liver, or c-section because it's less transmittable, or c-section because of placental contraction of the disease.....
And waiting to hear from my hepatologist.....did the levels go up because of pregnancy? Should I start an antiviral treatment for the next 4 weeks to decrease my viral load so that it's less likely for him to contract it from me? Should I come see him sooner than my scheduled appt? How can I make it known how incredibly urgent it is that he get the immune globulin shot ASAP when he's born to the pediatrician on staff at the hospital? Should I be worried about myself? Will I need to go on treatment after he's born, or get another liver biopsy (worse than labor, I swear)?
And the icing on the cake.....I won't be able to find out whether he is hep b free until he is a year old.
