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After stopping treatment for 8M, HBVDNA now 113K... What's next
Hi all,
To sum up my case.
- I am F, 29, Asian, chronic HBV carrier.
- I first started treatment with Baraclude in Jan 08, due to very high load of DNA (almost 600m copies) and high AST, ALT (200, 600 respectively).
- About 9M into treatment, I got seroconverted, and HBVDNA undectectable, which was great
- I continued to use Baraclude until March 2011 (3 years, 3M using treatment).
- In March 2011, after consulting with my doctor, I decided to stop the treatment given I had been seroconverted by then 2.5 years.
- Follow up tests were ok, until my latest test last week, which showed: AST 24.5, ALT: 22.9 (in August was 18.1 and 17.6 respectively), and HBVDNA 113,184copies/ml, although HbeAg is still negative (was pos before treatment), and Anti-Hbe Pos. I am in good health otherwise.
I talked to my doctor, who told me to do another check up after three months and should observe more before deciding to start back treatment.
From now till then, obviously I want to know more about my situation.
Can you please let me know:
- Does this mean the virus is active again?
- Is it very likely that I will have to take antiviral for life if after the next text my DNA >100,000 copies?
- Is there anything I can do now to lower this level without taking the antivirals?
Thank you so much.
Qor.
To sum up my case.
- I am F, 29, Asian, chronic HBV carrier.
- I first started treatment with Baraclude in Jan 08, due to very high load of DNA (almost 600m copies) and high AST, ALT (200, 600 respectively).
- About 9M into treatment, I got seroconverted, and HBVDNA undectectable, which was great
- I continued to use Baraclude until March 2011 (3 years, 3M using treatment).
- In March 2011, after consulting with my doctor, I decided to stop the treatment given I had been seroconverted by then 2.5 years.
- Follow up tests were ok, until my latest test last week, which showed: AST 24.5, ALT: 22.9 (in August was 18.1 and 17.6 respectively), and HBVDNA 113,184copies/ml, although HbeAg is still negative (was pos before treatment), and Anti-Hbe Pos. I am in good health otherwise.
I talked to my doctor, who told me to do another check up after three months and should observe more before deciding to start back treatment.
From now till then, obviously I want to know more about my situation.
Can you please let me know:
- Does this mean the virus is active again?
- Is it very likely that I will have to take antiviral for life if after the next text my DNA >100,000 copies?
- Is there anything I can do now to lower this level without taking the antivirals?
Thank you so much.
Qor.
Hi Buddy ! You said that you stopped taking baraclude, and you are on vitamins. May I know what are you taking? Do you feel better or?do you feel any change? thank you
My specialist told me its extremely rare lactic acidosis as I asked this question in terms of Tenofivir.
In reality no one has all the answers all anyone has is their opinion based upon their research there is no "scientific facts" anything we ingest will have a chemical reaction on our body one way or the other.
The only that's a fact is one day we will die the question what of. A grim thought that is.
In terms of medicating its a mine field.
Mike West I do believe Stef tries his best to help people he has done a lot of research and is very well informed. But also I think you have made some valid points to. Starting a squabbling match isn't really going to achieve anything.
I've spoke with some GP's who are so far off the beat with Hep B its laughable in the saddest possible way.
One day I will seroconvert and have done with this in the mean time what else can I do other than ride the wave? I pray we all get out of this rubbish situation we are in! Just my thoughts for what they are worth!
In reality no one has all the answers all anyone has is their opinion based upon their research there is no "scientific facts" anything we ingest will have a chemical reaction on our body one way or the other.
The only that's a fact is one day we will die the question what of. A grim thought that is.
In terms of medicating its a mine field.
Mike West I do believe Stef tries his best to help people he has done a lot of research and is very well informed. But also I think you have made some valid points to. Starting a squabbling match isn't really going to achieve anything.
I've spoke with some GP's who are so far off the beat with Hep B its laughable in the saddest possible way.
One day I will seroconvert and have done with this in the mean time what else can I do other than ride the wave? I pray we all get out of this rubbish situation we are in! Just my thoughts for what they are worth!
Vet B we know the cure Replicor holds is not seeing the light of day the reality is we are met with a wall of silence.
We live in a messed up world and the reality is our health is being held hostage by BIG PHARMA... What can we do? I find when we try to unite against this evil and demand better we get little internet moles like Stephen Castle Crag creating confusion determined to divide us!
We live in a messed up world and the reality is our health is being held hostage by BIG PHARMA... What can we do? I find when we try to unite against this evil and demand better we get little internet moles like Stephen Castle Crag creating confusion determined to divide us!
That is why really viral load falls on nucs because liver cells live longer then they should. All this and toxicity in the body causes fatty liver.
Stop taking antivirals . Go on high antioxidant therapy fatty liver will resolve.
If you will be taking nucs take with interferon no more then a year. Dont get suckered on nucs like some us did by diss honest big pharma sponsored doctors.
Sorry for the rant. I too know how it feels after six years of taking baracude when the virus comes.back. plus fatty liver developed high blood pressure and coronary artery calcification. Yes nucs cause that in men also.
Oh and did I mention that my hair started growing normally only two years after a quit baraclude.
Stop taking antivirals . Go on high antioxidant therapy fatty liver will resolve.
If you will be taking nucs take with interferon no more then a year. Dont get suckered on nucs like some us did by diss honest big pharma sponsored doctors.
Sorry for the rant. I too know how it feels after six years of taking baracude when the virus comes.back. plus fatty liver developed high blood pressure and coronary artery calcification. Yes nucs cause that in men also.
Oh and did I mention that my hair started growing normally only two years after a quit baraclude.
That is why people stop taking antivirals. Stop making big pharma rich. Demand real cures. And do just interferon if that is all that is available.
Nucs were developed first to treat cancer. They slow down cellular death. Thus the virus lives and need not to make copies of itself as the result of cell death/ immune system killing them with the virus.
Ofcourse we get fatty liver on nucs. This is chemotherapy. Just not as strong. So all that follows with it. All the sides. They just cannot put people for years on nucs. This is corruption and madness at its highest form.
Might as well do repeated six month courses of interferon with immune therapies to get the result.
Nucs were developed first to treat cancer. They slow down cellular death. Thus the virus lives and need not to make copies of itself as the result of cell death/ immune system killing them with the virus.
Ofcourse we get fatty liver on nucs. This is chemotherapy. Just not as strong. So all that follows with it. All the sides. They just cannot put people for years on nucs. This is corruption and madness at its highest form.
Might as well do repeated six month courses of interferon with immune therapies to get the result.
Hi, folks,
Since this thread is old and the original participants are no longer taking part, we'll close it now. If you'd like to ask a question or start a new thread, please click the "Post a Question" button near the top of this page. Thanks!
Claire
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******** CLOSED DISCUSSION ********
No more comments, please.
______________________________________________________
Since this thread is old and the original participants are no longer taking part, we'll close it now. If you'd like to ask a question or start a new thread, please click the "Post a Question" button near the top of this page. Thanks!
Claire
______________________________________________________
******** CLOSED DISCUSSION ********
No more comments, please.
______________________________________________________
If you stop medicating hepatitis b your liver will eventually fail. Maybe you'd like to look it up online on what liver failure looks like. In the mean time you can check the links below to see what could happen to your liver if you have hepa b and you stop taking medication.
http://www.olympus-sis.com/standard_images/Image_1_Kopie.gif
http://livermd.org/hepatitis.html
http://www.olympus-sis.com/standard_images/Image_1_Kopie.gif
http://livermd.org/hepatitis.html
Thanks for sharing your case. I think it's best if you ask your doctor about your concerns as he or she has the medical expertise to answer these questions. While it's good to get insights from other users online, their knowledge does not much up to a doctor's years of medical experience. Ask you doctor if you have any concerns about side effects. All hepa b treatments have side effects to varying degrees like, say for example, Baraclude and Tenofovir.
Baraclude can cause lactic acidosis, hepatomegaly, fat in the liver, and softening of bones. [http://www.baraclude.com/index.aspx]
Tenofovir can cause lactic acidosis, severe liver problems and flare up. [http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/viread/viread_medguide.ashx.]
While Revovir has been found to cause myopathy in very rare cases, it is still a widely accepted drug in treating hepatitis b in South Korea and other countries. [http://www.ncbi.nlm.nih.gov/pubmed/20196804]
The bottom line is that you should always consult your doctor if you have any concerns about your condition and if you have any questions about your treatments.
Baraclude can cause lactic acidosis, hepatomegaly, fat in the liver, and softening of bones. [http://www.baraclude.com/index.aspx]
Tenofovir can cause lactic acidosis, severe liver problems and flare up. [http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/viread/viread_medguide.ashx.]
While Revovir has been found to cause myopathy in very rare cases, it is still a widely accepted drug in treating hepatitis b in South Korea and other countries. [http://www.ncbi.nlm.nih.gov/pubmed/20196804]
The bottom line is that you should always consult your doctor if you have any concerns about your condition and if you have any questions about your treatments.
Is there a chance that I will get more ill after 74 days of revovir? I worry a lot about my healt I can barely afford that drug. Yet it only brings harm rather than cure.
almost no dcotors and tests in the philippines, just corrupted doctors and medical system, just for you to know:
revovir is banned worldwide, trials were stopped for severe sides effects which unmonitored can even lead to death
there are no drugs that can cure hbv you can only block and reverse liver damage by antivirals but they are ineffective to clear hbv
hbvdna is a useless tests in terms of hbv cure, you can use it only to see if antivirl is working but hbv viurs is inside liver cells integrated with yor own dna, it is not in the blood so hbvdna to see if you clear virus is totally useless
hbsag quantity reflects integrated virus inside your liver cells, if hbsag goes und you are almost cleared of infected cells
check all the forum posts, there is only a way to clear hbv tenofovir for many years and then interferon add on to clear hbv in most cases
you also need fibroscan, not available in the philippines, or biopsy, to know if you need treatment.with hbvdna 900iu/ml and alt 15 or alt 60 usually no treatment needed but only fibroscan can confirm
Just wana add a detail. I only took revovir clevudine for 74 days. I actually still have 16 pills right here I'm still w8ting for my dna result to come out before getting another doctor opinion. Tnx again.
Hi
3 months ago I was diagnose with hbv.my hbsag was 14.88 and my alt was only 15.68. Viral load is 923 iu/ml. I was ask my the doctor if I want to monitor it, if any of the value would go up then I will have to take medicine. Or I can already take medicine to lower the load. I decided to take the medicine to lower the viral load but to my dismay after nearly 3 months of taking what that doctor recommended me to use ( revovir clevudine) I was ask by a company nurse to get a gastro clerance so I my blood underwent to another alt test and it came out 300% more. From 15 to 60. I was really confused. Then when the doctor saw it he adviced me to change the medicine from revovir to baraclude and then ask to do another 5na to determine the viral load in my body. From that moment I lost trust to that doctor and want to be refered to a doctor who knows what his doing. I'm from the phillipines. I still have 5 fays before I get the result of dna test. I just only stop using revovir today. Damn that drug so expensive yet so ineffective. And I just read here how equally inffectivetive baraclude may be. Do anyone hee knows a medical clinic with a good gastro?
Tnx in advance.
3 months ago I was diagnose with hbv.my hbsag was 14.88 and my alt was only 15.68. Viral load is 923 iu/ml. I was ask my the doctor if I want to monitor it, if any of the value would go up then I will have to take medicine. Or I can already take medicine to lower the load. I decided to take the medicine to lower the viral load but to my dismay after nearly 3 months of taking what that doctor recommended me to use ( revovir clevudine) I was ask by a company nurse to get a gastro clerance so I my blood underwent to another alt test and it came out 300% more. From 15 to 60. I was really confused. Then when the doctor saw it he adviced me to change the medicine from revovir to baraclude and then ask to do another 5na to determine the viral load in my body. From that moment I lost trust to that doctor and want to be refered to a doctor who knows what his doing. I'm from the phillipines. I still have 5 fays before I get the result of dna test. I just only stop using revovir today. Damn that drug so expensive yet so ineffective. And I just read here how equally inffectivetive baraclude may be. Do anyone hee knows a medical clinic with a good gastro?
Tnx in advance.
http://www.ncbi.nlm.nih.gov/pubmed/20203382
A son and his mother both had HBV infection (ages: 27 and 47 years, respectively), and they had received antivirus treatment with clevudine (30 mg daily). They developed progressive weakness of the lower extremities and difficulty arising from the ground. Both the patients had symptoms for the previous 3 approximately 4 months in process of 14 approximately 17 months of clevudine therapy. The physical examinations showed positive Gower's sign, a decreased gait velocity and symmetrical proximal weakness (MRC grade 4/5). Their blood tests at admission revealed elevated or positive HBs Ag, HBV DNA, AST, ALT, creatine kinase, LDH, myoglobin and CK-MB. For both patients, the electrodiagnostic studies indicated myopathy and the pathologic findings of biopsied muscles revealed myositis. Drug-induced polymyositis was suspected and the clevudine was finally withdrawn. The muscle weakness and laboratory findings were improved for both patients after conservative care. We report here on the first cases of polymyositis that may have been caused by administering the new nucleoside analog clevudine for treating HBV infection.
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so to make it short
clevudine induced myopathy usually sets in around 10+ months, and after discontinuing and proper care the subjects returned to normal.
A son and his mother both had HBV infection (ages: 27 and 47 years, respectively), and they had received antivirus treatment with clevudine (30 mg daily). They developed progressive weakness of the lower extremities and difficulty arising from the ground. Both the patients had symptoms for the previous 3 approximately 4 months in process of 14 approximately 17 months of clevudine therapy. The physical examinations showed positive Gower's sign, a decreased gait velocity and symmetrical proximal weakness (MRC grade 4/5). Their blood tests at admission revealed elevated or positive HBs Ag, HBV DNA, AST, ALT, creatine kinase, LDH, myoglobin and CK-MB. For both patients, the electrodiagnostic studies indicated myopathy and the pathologic findings of biopsied muscles revealed myositis. Drug-induced polymyositis was suspected and the clevudine was finally withdrawn. The muscle weakness and laboratory findings were improved for both patients after conservative care. We report here on the first cases of polymyositis that may have been caused by administering the new nucleoside analog clevudine for treating HBV infection.
__________________________
so to make it short
clevudine induced myopathy usually sets in around 10+ months, and after discontinuing and proper care the subjects returned to normal.
here is cast-iron proof
http://file.yynet.cn:8080/ff086237f469489353aa4562fd56e048/J+Hepat+2009%2851%29829-834+Clevudine__+myopathy+in+CHB.pdf
PROS
* Clevudine is a unique antiviral
nucleotide analogue because its antiviral activity persists
after discontinuation of therapy, as demonstrated by
in vitro and in vivo trials [3,9–11].
CONS
* two cases of myopathy during clevudine
therapy for chronic hepatitis B. The clinical symptoms
of myopathy developed after 12 and 10 months of
clevudine treatment, respectively.
* The muscle-
related symptoms in the cases resolved after cessation
of clevudine treatment. Taken together, the muscle damage
was diagnosed as clevudine-induced myopathy.
* This study also showed that an adverse event,
a grade 3 or 4 elevation in serum creatine kinase level,
occurred in 9% of patients receiving telbivudine [17]. A
Chinese study showed that five of 105 chronic hepatitis
B patients who received telbivudine treatment developed
clinical myopathy [18]... Although
proper management was delayed in our cases, cessation
of clevudine treatment resulted in amelioration of myopathic
symptoms and normalization of creatine kinase
levels.
http://file.yynet.cn:8080/ff086237f469489353aa4562fd56e048/J+Hepat+2009%2851%29829-834+Clevudine__+myopathy+in+CHB.pdf
PROS
* Clevudine is a unique antiviral
nucleotide analogue because its antiviral activity persists
after discontinuation of therapy, as demonstrated by
in vitro and in vivo trials [3,9–11].
CONS
* two cases of myopathy during clevudine
therapy for chronic hepatitis B. The clinical symptoms
of myopathy developed after 12 and 10 months of
clevudine treatment, respectively.
* The muscle-
related symptoms in the cases resolved after cessation
of clevudine treatment. Taken together, the muscle damage
was diagnosed as clevudine-induced myopathy.
* This study also showed that an adverse event,
a grade 3 or 4 elevation in serum creatine kinase level,
occurred in 9% of patients receiving telbivudine [17]. A
Chinese study showed that five of 105 chronic hepatitis
B patients who received telbivudine treatment developed
clinical myopathy [18]... Although
proper management was delayed in our cases, cessation
of clevudine treatment resulted in amelioration of myopathic
symptoms and normalization of creatine kinase
levels.
people, pls dont argue, i know that we all want to help each other most esp those who are just getting to know they have this disease.
@stefano
i know that here in the Phils the tests are NOT that advanced, but we already have HBVDNA, HBSAG QUANT, and Fibroscan, we just dont have genotype testing :)
@mike
here's a 1st hand experience from a clevudine tester, the trial was forced to stop because of the serious side effects of the drug
http://www.medhelp.org/posts/Hepatitis-B/Results-from-Clevudine-clinical-trial/show/931769
some more papers
http://www.mendeley.com/research/longterm-therapy-with-clevudine-for-chronic-hepatitis-b-can-be-associated-with-myopathy-characterized-by-depletion-of-mitochondrial-dna/
what is myopathy?
http://en.wikipedia.org/wiki/Myopathy
i read the clevudine details and yes clevudeine is only allowed here in the Philippines, and is currently being sold for Php 80 (around 1.5 USD) from an initial cost of Php 300 (6 USD). A doctor also prescribed me this but i decided not to buy this drug. Interferon treatment, to me, is still the way to go but it is too expensive...
@stefano
i know that here in the Phils the tests are NOT that advanced, but we already have HBVDNA, HBSAG QUANT, and Fibroscan, we just dont have genotype testing :)
@mike
here's a 1st hand experience from a clevudine tester, the trial was forced to stop because of the serious side effects of the drug
http://www.medhelp.org/posts/Hepatitis-B/Results-from-Clevudine-clinical-trial/show/931769
some more papers
http://www.mendeley.com/research/longterm-therapy-with-clevudine-for-chronic-hepatitis-b-can-be-associated-with-myopathy-characterized-by-depletion-of-mitochondrial-dna/
what is myopathy?
http://en.wikipedia.org/wiki/Myopathy
i read the clevudine details and yes clevudeine is only allowed here in the Philippines, and is currently being sold for Php 80 (around 1.5 USD) from an initial cost of Php 300 (6 USD). A doctor also prescribed me this but i decided not to buy this drug. Interferon treatment, to me, is still the way to go but it is too expensive...
just look a jagado from philippines who just posted using revovir as a cure of hbv....that is not a different way of cure, that is corruption
if a doctor prescribes clevudine in all western countries he would get to jail immediately.can you call that a doctor curing a hbv patient?
why philippines allowed clevudine (called revovir there), why are philippines doctors prescribing such a useless and dangerous drug which is not even studied by the drug maker now?do they count paralized or dead patients in the philippines under revovir?how do you avoid things like this or save people in the philippines from crimes like this?
is not a way - it is only a discussion based on our knowledge and trials results.
if you want to share with us your experience, and say what you think that help you, we will discuss that - but mainly most of the people will made an argument that no research was made on this and maybe more people will try ... but give a try (after all we are in the same situation and everybody look for the best )
if you want to share with us your experience, and say what you think that help you, we will discuss that - but mainly most of the people will made an argument that no research was made on this and maybe more people will try ... but give a try (after all we are in the same situation and everybody look for the best )
it is not different way of curing it is making damage to patients, since many here, me included have had damage from these ignorant doctors
so we are trying to avoid them by spreading knowledge.
they should be sued and removed from their position because of the damage they are doing...this is not possible according to the laws of every country but if we spread knowledge we can simply avoid them
as to my experience i just moved to the best known researchers in the world, so their knowledge is obviously superior to any.they are making the gidelines for the future for the rest of the world by their studies but anyway there is little left today the only hbv cure now is interferon+tenofovir or entecavir by hbsag quantity monitoring.poor countries or corrupt countries dont have this now maybe they will in the future
The Ignorant remarks came from stef2011
What Im saying here is dont call other ignorant merely because his way of curing the virus is different from yours
What Im saying here is dont call other ignorant merely because his way of curing the virus is different from yours
>>> sorry you got to an ingnorant doctor
LOL.
Stef2011 - Mr Know EVERYTHING but still Hepa Carrier
LOL.
Stef2011 - Mr Know EVERYTHING but still Hepa Carrier
tenofovir is more potent than entecavir and it also has zero resistance, so it is better to use tenofofvir.it is also cheaper
in the trials we have seen 3 years of monotherapy with hbvdna undetactable and then add-on of interferon with hbv clearance 40% 1 year and probably double to 80% by 2 years
i think if you add interferon after one year only of hbvdna und the hbv clearance is less.human trials of tenofovir few months and then add interferon has hbv clearance at 26% by 1 year
i think it is good to make tdf for about 1-2 years and have baby then add interferon after the baby
In addition, can you please let me know why do u ask advise me to switch to Tenofovir instead of continuing with Baraclude? Do you think I have already developed resistence to it?
Also, do you think it is worth to wait for another month or two to see how my body changes before start taking the therapy again? Given that this is going to be another long one... From some of your other posts, once one started Baraclude or Tenofovir, it might mean decades...
Also, do you think it is worth to wait for another month or two to see how my body changes before start taking the therapy again? Given that this is going to be another long one... From some of your other posts, once one started Baraclude or Tenofovir, it might mean decades...
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sorry you got to an ingnorant doctor, baraclude does nothing to hbv and also hbeag serconversion does nothing.
to know if you can stop treatments of whatever type you need to check hbsag or cccdna by biopsy.hbsag less than 200-300iu/l on geno b and c and 500iu/ml on geno a and d
as to cccdna i am not sure if i remember correct but it should be less than 5copies per cell
without achieving these results the infection is like before therapy...therapy did nothing....
i do suggest to use tenofovir and make hbvdna und for about 12 months and then add-on interferon for 96weeks, 40% clear hbv at 48weeks already and the rest get hbsag very low and go on to clear in the remaing weeks
if hbsag is 20-100iu/ml after 96 weeks of this combo you can even stop all therapies with no infection or hbvdna coming back and go on to clear hbsag slowly all by your self in the following years
at the moment this is the only hbv cure with the higest rates of clearance all the rest is not a cure for hbv
off label add on of alinia to interferon will increase 40% clearance for sure, we dont know how much but it will