Result of treatment using TDF after 1 year

[afif120]

Dear all and Stef,

I want to share with you result of treatment using TDF after a year (my son).

Baseline (before taking Tdf):
SGOT 47 (range for normal: 5 - 34)
SGPT 102 (range for normal: 4-36)
HBV DNA 2.43 X 10^8
HBSag Quantitative: 43,205.18 IU/ML

Result after 3 months:
SGOT 89
SGPT 244
HBV DNA 3.19 X 10^5
HBSag Quantitative: 11,570.50 IU/ML
HBeAG  reactive
Anti HBe  non reactive

Result after 4 months
SGOT 60
SGPT 127
HBsAG Quantitative: 6,029.41 IU/ML

Result after 6 months
SGOT 52
SGPT 90
HBsAG Quantitative: 3,482 IU/ML
HBV DNA 5.7 X 10^3
HBeAG reactive
Vit D 25oh : 21

Result after 9 months
SGOT 36
SGPT 69
HBsAG Quantitative:1,461 IU/ML
HBV DNA  2.14 X 10^2
HBeAG - reactive

Fibroscan
Dec 2012 : 6.8 kpa
Dec 2013: 5.5 kpa

Result after 12 months
SGOT 24
SGPT 36
HBsAG Quantitative: 936 IU/ML
HBV DNA  3.30 X 10^1
HBeAG - reactive
Vit D 25oh : 25 (it increases slightly from the result 6 months ago although my son did not take any vit D supplement)

HBsAG continues declining but much slower than before.  HBV DNA is still detected and declining very slowly. ALT and AST are now in the normal range.

At this stage, as HBsAG is already less than 1,000 IU/ML, I would like to have your views whether  my son should immediately start to add on pegasys or it will be better to wait till HBsAG become much lower?


Thank you very much for your view.
Afif

[stef2011]

remember tenofovir first and then monitor hbsag for 3 years and then pegintf+tdf until hbsag clears

in case hbsag doesn t lower by 24weeks pegintf doesn t work and it is best to stop and retry at 5 years

[abdo2008]

tanx stef i do appreciate ur support i will go for pig + tfv for 3 to 5 yrs
best regards

[stef2011]

start tenofovir and add on peginterferon after 3-5years or when hbsag<1000iu/ml

in this second case chances are 60% or close to 100% if hbsag<1000iu/ml

[stef2011]

keep in mind that acute hbv clears in 6-12 months, so clearance by treatments is a long process of 5-10 years treatment, no other ways exsist on the market today

chances to clear hbsag<1000iu/ml with peginterferon are very high and close to 100% with pegintf+tdf add on

in your status you may:
try pegintf but chances to clear are 7-10%

start tenofovir and add on peginterferon after 3-5years or when hbsag<1000iu/ml

whatever therapy or no therapy vitamin d serum levels must be supplemented because hbvers never have optimal d levels 50-100ng/ml for healthy liver and immune function

[abdo2008]

hi stef
today i got my lab result the test was done by fully automatic roches elecsys machine .
HBSAG - 6168 IU/ML
other test remains same as i mention before , so now what is my condition and how to make hbsag negative as i told its affecting my career .

thanks
Regards

[fishooo]

does comoensated cirhosis progresses to decompensated cirhosis with treatment as i am on tenefovir.
also i never did biopsy just ultrasound which showed cirhosis
reading everywhere i got to know that ultasound cannot show cirhosis ?

[stef2011]

tdf has no effect on hbsag for most carriers, you have to try it and see what happens
tdf plus vit d3 to make serum levels 90-100ng/ml

[stef2011]

you did not test hbsag quantity, find a lab that can do hbsag quantitative in iu/ml, only roches elecsys or abbott architect can do this so ask for these machines

without hbsag quant nothing can be said of possible clearance

[fishooo]

hi steff wanted to ask that hdv depends on hbv right so why dont i just keep myself on tdf mono for few years to get rid of the virus so it will automatically eradicate hdv too since hdv needs hbv
also if i am on tdf therapy will i stay compensated all my life or at some point i ll need a transplant?

[abdo2008]

Hi stef

plz plz help me to get rid of this last week i did a test :
HBSAG - positive - 8.68 cut of index ( the test done by ELFA )
HBEAG -  negative
HBV DNA RT PCR - negative- 210 IU/ML
ALT - 30
AST - 22
LIVER ULTRASOUND IS SHOWING FATTY LIVER
my concern is to make hbsag negative coz is compulsory for my job
expect quick response from u stef ,,,, thankfully

[afif120]

Thanks very much  all for giving your views. Best regards to every one in this great forum.

[joc2011]

Wow. the results with TNF mono is so impressive. I have been on INF for 3 years now. Wish we could all have the same response as you soms having.

[stef2011]

Get vit d25oh to at least 40-60ng/ml and add on peg you ll clear very fast, on tdf mono you may clear as well but it may be a slow process you still have hbeag detectable and hbvdna which suppresses immune responce a lot, peg add on will fasten it all

[Rome70]

I think that you can stay with tdf solo until hbsag  keeps going down. The pace is always slows down with lower values. You may be within lucky ones who cleared on tdf. Tdf does not create resistance so keeping it further should not change the virus.
The fact that vit D increased without supplements is also good. It means that the immune system reactivates and probably produces its own interferon. Vit d insufficiency is a consequence NOT a reason of immune system failure in hbv. Another member also reported vit d increase on successful interferon treatment without any vit D supplements.
On the other hand interferon could be more effective when hbeag is positive. So low hbsag and hbeag pos could have a great chance of interferon response.
I am not a doctor though...

[SafiSifa]

WOW. Your results are impressive. I think he will totally clear the virus in the ned year.

[flyinsky]

hi
and happy that your son is getting better especally he respond well to tdf(and the fibros is  regressed)
as i have read before from members you should give him tdv for 2years more,but fellow what your doc says because he knows more than us his situation
also try to monitor his hbsab