HBeAg Reactive

[Mars86]

what time does it take for HBeAg to be seroconverted and body develops HBeAb while keeping treatment with etv (baseline viral load is more than 170,00,000 iu/ml ?

[stef2011]

i use vit d3 quantity to ensure my optimum blood levels, heptech dose was too low for my serum levels to normalize, with less than 10.000iu daily my levels drop

you have to make oxidative stress tests to tell

[ggtm]

And is heptech, vit d, c, e sufficient to ensure a high level of antioxidants? Would vegetables be good as well?

[stef2011]

So even if hbv DNA is und, still possible for liver damage by own immune system?

no, not on chronic hbv but hbvdna in the millions/billions can have no liver damage too

the damage is due to our immune attack but the liver ususally is able to regenerate itself, if/when this balance is broken you develop liver damage.a good antioxidant status should be able to prevent this

most hbv carriers have no severe liver damage but just very mild or no liver damage, fibroscan monitoring will ensure this to every carrier

[ggtm]

So even if hbv DNA is und, still possible for liver damage by own immune system? If this is so, how can we prevent liver damage with hbv dna und/low DNA?

[stef2011]

Stef, after hbeag seroconversion, and still continue on nucs with hbv und, would you still recommend alinia add on?

i d not consider hbeag but only follow hbsag quantity and stop if it reaches low levels below 500iu/ml
alinia did not work with nucs i d consider it with intf if intf doesn t work just to boost it

Can I also ask you another qn. I know hbv dna cause damage to liver. But does high hbsag cause damage to liver?

none of these make liver damage, it s our immune system to make the damage and values of hbvdna, hbsag are not correlated with liver damage (only in some stages/staus of immune clearance are)

[stef2011]

first of all immune tollerant should not be treated, especially with antivirals that can have resistance, 9 months with hbvdna so high in thousands is too much i d go with tenofovir add on

it makes no sense to keep etv mono just in the hope of getting und but risking resistance mutations.i d keep the combo as long as hbvdna stays und and then make intf add on if the antivirals have no hbsag decrease in 1-2 years

[Mars86]

stef ,
what do you think about my status now ? since 3 month DNA was 4000 iu/ml , HBsAg was 89000 iu/ml ... now DNA is 5800 iu/ml and HBsAg is 133000 iu/ml *CMIA* , bothe are increased... I am on etv mono since 9 months , ALT/AST never flucuated ... I got treated in the immune tolerance phase .... I'd like to ask abou the large increase in HBsAg !!

[ggtm]

Stef, after hbeag seroconversion, and still continue on nucs with hbv und, would you still recommend alinia add on?

Can I also ask you another qn. I know hbv dna cause damage to liver. But does high hbsag cause damage to liver?

Thanks Stef. You are really the light for us hbvers. Drs cannot be trusted fully. I have experienced that myself.

[stef2011]

hbeag and hbeab are pretty useless to define hbv infection and hbv clearance (same thing hbvdna), the only thing to follow is:
hbsag quantity, if hbsag goes down you are clearing hbv from the liver
hbvdna, must be und as soon as possible otherwise you may develop resistance

etv is not good for hbeag pos because the rate of hbv clearance is very low, about 5% in 5years and more while tenofovir has 11% hbv clearance at 3 years already

[Mars86]

Thanks dear so much :)
but unfortunatley it increases to 5800 iu/ml after the proceeding  2 months
:(

I think this because I didn't be careful enough to take etv in an empty stomach >> I'll keep it in mind :)

about ur case what is going on after e antibody appeared ?

[ggtm]

My answer may be a bit late.
My hbeag went neg in about 1 yr on etv. Hbeab appeared 2weeks after that detection. Your decrease looks good. You are getting there!

[Mars86]

6 month treatment has lowered DNA to 4000 iu/ml , how much does it take for HBeAg to be seroconverted ?