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About blood test indication
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About blood test indication

Hi folks,

Entecavir treatment against chronic Hep B:

What will be the result on blood test a patient can stop Entecavir treatment

HBV DNA   ? copies/ml or  ? IU/ml

ALT level ?

HBsAg negative/non-reactive

HBsAb positive/reactive

What other indication level need to be considered.  TIA

B.R.
satimis
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Avatar_m_tn
after stopping entecavir treatment for 6 months
3% of the patents has seroconvert
hbsag - negative
hbsab>10miu/ml

absolutely not, antivirals cannot be stopped, only if hbsag becomes negative and hbsab>10 you can stop but not immediately you have to keep taking drug at least 6 months even after hbsag is neg


I might be in that 3%.  If my understanding is wrong please correct me.  TIA
yes but you musy keep taking drug anyway and not seroconverted yet because your hbsag is still positive

If hbsab > 10 miu/ml whether indicated replication becoming active again?  Will the patient infect other persons?
this is antibody to block hbv entrance in to cells, this should make hbsag negative by 6-12 months while taking etv

Does "HBV DNA" level indicate replication active?  If YES, please advise its value which the patient may infect other persons, additionally exposing to danger of cirrhosis.

hbvdna is only to see if drug is working, it is not a sensitive test and when hbvdna is und means only low replication

you will be always infectious by blood even if you clear hbv, when hbvdna is und you are not infectious by saliva and much less by seamen
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Avatar_m_tn
What will be the result on blood test a patient can stop Entecavir treatment

no result drugs can t eradicate hbv they just stop the damage, only if hbsag becomes negative and hbsab>10miu/ml you can stop after 6 months but this happens on 3% hbe neg and 5% hbe pos

the drug is to avoid cirrhosis and liver cancer due to virus replication so it is a life treatment, maybe hbsag will get very low in 10-15 years but nobody has used it more than 6years because drug is new
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Avatar_m_tn
Hi stefano,

Thanks for your advice.

It is understood that at present there is no cure on chronic Hep B.

1)
Is Entecavir used to slow down replication?

2)
Is HBsAg same as HBV DNA?

So  HBsAb > 10 miu/ml = HBV DNA > 10 miu/ml ?

3)
What does it mean;
3% hbe neg and 5% hbe pos ?

4)
"maybe hbsag will get very low in 10-15 years"
What will be its level?

TIA

B.R.
satimis
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Avatar_m_tn

Is Entecavir used to slow down replication?
yes


Is HBsAg same as HBV DNA?
two things complitely different with no correlation, hbsag are the surface particles of the virus for attachment to liver cells but also particles without the virus produced in excess by cccdna to neutralize hbsab antibody, this antibody blocks the entrance to liver cells for the virus.
hbvdna is not the number of virions in the blood and in the liver but reflects the number of replicating virus in a certain time, its sensitivity is very low in terms of virological response, immune control of virus etc but that's what we got for now, the real tests needed to see what happens in the liver are cccdna quantity and hbvdna quantity in the liver, tests available now in very specialized labs with biopsy but soon available by blood

quantification of hbsag can reflect immune response potency and cccdna quantity and also predict if hbsag clearance is possible, this test is in iu/ml only and not available in US/canada while available in europe, asia, china

What does it mean;
3% hbe neg and 5% hbe pos ?
the percentage of patients making hbsag neg and hbsab pos on hbeag neg and hbeag pos.etv is the only with hbsag seroconversion on hbe neg, tdf has 0% and interferon also very low
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Avatar_m_tn
Hi,

[quote]
no result drugs ........ only if hbsag becomes negative and hbsab>10miu/ml you can stop after 6 months but this happens on 3% hbe neg and 5% hbe pos
[/quote]

Whether you meant:-
if HBsAg - negative
HBsAb > 10 mui/ml

Patient can stop treatment on Entecavir.  But past records report 6 months after stopping treatment;
3% patient became HBe negative
5% patient became HBe positive


hbe = HBeAg ???


Thanks


B.R.
satimis
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Avatar_m_tn

you are hbe negative and in your situation entecavir has only 3% patients that seroconvert hbsag negative and hbsab>10miu/ml so you might be in that 3%
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Avatar_m_tn
Hi stefano,

Sorry I'm NOT very clear of your advice.

My understanding on your advice is:
Previous report indicates that for patients having;
"hbe" (hbeag) - negative

after stopping entecavir treatment for 6 months
3% of the patents has seroconvert
hbsag - negative
hbsab>10miu/ml

I might be in that 3%.  If my understanding is wrong please correct me.  TIA

Furthermore;
1)
If hbsab > 10 miu/ml whether indicated replication becoming active again?  Will the patient infect other persons?

2)
Does "HBV DNA" level indicate replication active?  If YES, please advise its value which the patient may infect other persons, additionally exposing to danger of cirrhosis.

TIA

B.R.
satimis

Blank
Avatar_m_tn
after stopping entecavir treatment for 6 months
3% of the patents has seroconvert
hbsag - negative
hbsab>10miu/ml

absolutely not, antivirals cannot be stopped, only if hbsag becomes negative and hbsab>10 you can stop but not immediately you have to keep taking drug at least 6 months even after hbsag is neg


I might be in that 3%.  If my understanding is wrong please correct me.  TIA
yes but you musy keep taking drug anyway and not seroconverted yet because your hbsag is still positive

If hbsab > 10 miu/ml whether indicated replication becoming active again?  Will the patient infect other persons?
this is antibody to block hbv entrance in to cells, this should make hbsag negative by 6-12 months while taking etv

Does "HBV DNA" level indicate replication active?  If YES, please advise its value which the patient may infect other persons, additionally exposing to danger of cirrhosis.

hbvdna is only to see if drug is working, it is not a sensitive test and when hbvdna is und means only low replication

you will be always infectious by blood even if you clear hbv, when hbvdna is und you are not infectious by saliva and much less by seamen
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Avatar_m_tn
Thanks stefano

B.R.
satimis
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