ALT 88- 120

Hi Stefano,

My DNA load is 183IU only but ALT are constantly elevated. all other test normal. HBeAG Neg ofcourse. what does that mean? does that  show body immune system trying to fight the virus or what?  

[stef2011]

yes, thats a good sign it means your immune system can detect even small amounts of virus, a very good indication for immune modulators like interferon and who knows maybe ntz too

for example i have hbvdna und but my alt are flactuating according to ntz dose 40-31, they haven t yet reached 20-30 range but as long as fibrosis regresses i don t care about alt difference between 40 and 20

[hepbvictim]

Appreciate your prompt reply. So basically is it better if Viral Load is low and ALT high? this means immune system can detect small amount of Virus.

But what if DNA is und then is it better if ALT are low or high?

[hepbvictim]

and ALT high for the last 2 years (since I know) now. between 80-120

[stef2011]

So basically is it better if Viral Load is low and ALT high

it means interferon has good results, but high alt means also more liver damage

actually today we know that the only thing that matters is hbsag quantity if you want to know the number of infected cells/chances of hbsag seroconversion by interferon (i mean interferon because all other drugs are almost useless for this goal)

[hepbvictim]

ntz means alinea right?

would you go for Alinea in my situation or monitor? Interferon, too strong side effects.

[stef2011]

i'd definitely try an alinia combo with entecavir if resistance test is available or tnf if it is not available

if alinia and the other drug will not work in 2 years it is about the time for interferon lambda to be available and try with that combo

[stef2011]

of course ntz is nitazoxanide (alinia)

[hepbvictim]

Thanks. Doc has advised to monitor over six months becoz DNA came down to 183 from 11000 on its own.

[stef2011]

your doc is just a doc not a researcher or expert liver specialist, hbvdna has no meaning except for choosing if to use antivirals but if you are thinking about eradication only hbsag and interferon or ntz use matter, of course hbvdna und or close to und is good for ntz monotherapy

[hepbvictim]

I nudersatnd he wouldn't be the best Doc but he is qualified hepatologist. So are you saying that therapy should be started without delay and not to just monitor.

How about Alinia alone? Do you have Abbot Hbsag quantity test & Fibroscan available quiet commonly in Italy?

[stef2011]

I nudersatnd he wouldn't be the best Doc but he is qualified hepatologist.
yes but what he saying is valid only for etv and tnf which are only active on hbvdna.with such low hbvdna they are of course useless and dangerous because they might even suppress your immune system, i think he is talking about that type of therapy only and not immune modulators like ntz/interferon

as regards ntz and interferon thi is the best moment to start because the virus is weaker, so it is absolutely the best moment to start ntz monotherapy if you want to

[stef2011]

How about Alinia alone? Do you have Abbot Hbsag quantity test & Fibroscan available quiet commonly in Italy

yes every provincial hospital have them except extreme sothern italy, i don t know there because it is a poor and depressed area of the contry, as regards north/centre/south they are every where.
the first one were available from 2004 in main research hospitals/some private clinics

[stef2011]

alinia is not registered so available only for prassite infections and hcv inside specialized hospitals so i order generics from canadian pharmacy

it is available in swiss drugs distributors but too expensive