Baraclude vs. Viread

[AsianMale]

Hi All,

I am an male in my mid-20's of southeast Asian decent, and I'm quite torn about how to proceed. I acquired HBV through vertical transmission and am currently in the immune clearance phase.

My ALT levels are 5-6 times normal.
I am e-antigen positive, e-antibody negative.
My viral load was 30 million in Oct 2008. Since then, I've been taking a cocktail of herbs intended to treat hepatitis (including milk thistle) and in Jan 2009, it is now 13 million.

I am torn because my family would like me to stay with herbal cocktail, but several doctors want me to begin treatment. The doctors say the fluctuation in viral load is natural and not necessarily tied to my use of herbs.

Firstly, has anyone had success with the herbal remedies?

Secondly, if I begin treatment, the goal would be sero-conversion (i.e. e-antigen negative, e-antibody positive). Would that essentially mean I'm cured and won't need to worry about HBV anymore?

Thirdly, my doctor says it's pretty much a flip of the coin to decide whether to go with Baraclude(entecavir) or Viread(tenofovir). There seems to be very little data about the success rate of either. Can anyone please help me to decide which route to take? For example, comparison of side-effects, success rate(i guess that means sero-conversion) in asians, etc.

And finally, how much of a difference would it make if I start treatment now or in, say, 6 months?

Being 25, I will potentially be taking this pill for many many years, so I'd like to make the right choice.

I'm new to this forum and would very much appreciate your time.

[djxpress]

I would like an opinion as well.  I am in the USA and they don't have fibroscan here.  I am a 36 y.o. asian-american male, HBV positive since birth.  My lab tests come up with normal ALT/AST.  They don't do quant on HBsAg here in the states.  

2/3/2012
AST 23
ALT 28
Viral DNA 2300 IU
HBeAg - negative
HBeAb - positive
AFP - 3.0
all other liver enzymes within range.  No symptoms.

The ultrasound and MRI came back unremarkable, with normal liver size, density, etc.  Again, no fibroscan can be done here in the states.

My doctor is Robert Gish, a world renowned hepatologist.  He wants me to start Entecavir treatment, which I understand is for life.

Any thoughts?

[stef2011]

hbvdna meanless changes
Viral load = 26000 HBV copies/ml
Viral load = 93100 HBV copies/ml

all the rest meanless as regards hbv infection status and possible clearance, if we want to clear hbv we need hbsag quant in iu/ml and then start tenofovir monitoring hbsag quant in iu/ml (hbvdna must be und) after one year und i'd consider interferon add on with possible use of off label use of simvastatin, alinia and vit d3

[action4speed]

Dear Stef2011, thanks for the reply.
I would like to request Stef2011, Cajim and Steven NYer and others to kindly go through following test results and let me know your understanding of what is best to do in my case.
I am entering exact information of my test results in the following context. I am not so good in understanding everything within that.

30 Aug 2011:
Viral load = 26000 HBV copies/ml
HBeAg = Non-reactive (cut-off rate:1.00, Patient Rate: 0.34)
Anti HBeAg = Reactive (cut-off rate:1.00, Patient Rate: 0.02)
Anti HDV(total) = Negative (0.29)
HBsAg = Reactive (cut-off rate:1.00, Patient Rate: 1072.29)
Anti HCV = Non-reactive (cut-off rate:1.00, Patient Rate: 0.12)
Anti HIV = Non-reactive (cut-off rate:1.00, Patient Rate: 0.12)

15 Dec 2011:
Viral load = 93100 HBV copies/ml
Anti HBeAg = Reactive (cut-off rate:1.00, Patient Rate: 0.01)
HBeAg = Non-reactive (cut-off rate:1.00, Patient Rate: 0.60)
Anti HDV (total) = Negative (0.349)

I will check for fibroscan and will let you know about it. Waiting for your response before starting my therapy.

Best Regards,

[stef2011]

first i d check liver damage as soon as possible, US is useless for this, you need a fibroscan, if result is less than 7kpa (mild fibrosis) you have the choice to wait

second id check hbsag quant in iu/ml and if the level is less than 1500iu/ml i d go on therapy immediately because the chances are you will clear hbv with sequential tdf and interferon

why to wait if you can do sequential therapy with tdf+interferon and clear?if you wait hbeag will get negative sooner or later and chances to clear will be  much much lower.hbeagnegative is due to bcp and precore mutants mainly and hbv gets more aggressive in this form

the hbv cure with 40% clearance is:
1-3 years of tdf with hbvdna totally undetactable
2 years of interferon add on

also look for all posts about simvastatin and vitamin d3, alinia, to boost interferon response.a guy just tried interferon+sim and he is clearing hbv at 12 weeks already

[action4speed]

Hi All,

I have been through all the comments which are quite informative for me.
Please help me with your knowledge.
I tested my blood in mid 2007 and found that I had contracted HBV with inactive virus but positive HBeAg. The test took place by Elisa method (qualitative) which is now deemed to be obsolete. I did the test three times in four years up to mid 2011 by the same Elisa method which showed inactive virus. But in late 2011 when I tested my blood by quantitative (new method) my viral load was 12000 copies/ml and positive HBeAg. after 4 months it increased to 90000 copies/ml. my doc has just prescribed Tenofovir but i have not started using it.
my liver was shown as normal in ultrasound. I have no other problem in my body but very rarely I feel minor pain inside my chest on both sides.
Please help me with your detailed advice on how to start medication and which medication can be best and what do you guess about the pain?

I appreciate the informative comments to save each other from the fatal disease.

Best Regards,
GRS

[stef2011]

did the docotor tell you to check creatinine before and after taking viread?

you need to check creatinine, phosporus, calcium, complete urine test every 4weeks to see if your kidneys were damaged and cant stand viread.
if you have no creatinine before taking viread you need creatinne clearance by 24hrs urine collection, this is the most reliable test because creatinine can be normal in some even with kidneys damage

this is a very rare side effect found only in some with cirrhosis but better check anyway