Hepatitis B Community
Best Treatment for HBv
About This Community:

This forum is an un-mediated, patient-to-patient forum for questions and support regarding Hepatitis B. Topics in this forum include but are not limited to, Causes, Diagnosis, Family and Relationships, Living With Hepatitis B, Research Updates, Treatment, Success Stories, Support, Symptoms.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

Best Treatment for HBv

I am 53 years old last month I have went for preventive health check up and based on the report findings the followings noted; SGOT 83 IU/L ,SGPT 200 IU/L , Doctor recmended me to see the Gastro.consultant , the gastro.consultant advised me to go for others test the result are as follows: Anti-dsDNA 16.6 IU/ml. , HBsAg test value 9520(Reactive) ,HCV,IgG test value 0.12 ( non Reactive) ,Anti Nuclear Antibody ( ANA) 0.12 , Immunoglobulin IgA 279 mg/dl , Tissue Transglutaminase antibody IgA 0.40 U/mL , Anti Mitochondrial Antibody , Serum 0.26 UL/ml , ASMA 2.70 U/mL , LKM Antibody 0.02 U/ml , Hepatitis B envelope Antibody test value (Ab) 43.0 ( Reactive) , Hapatitis Be Antigen ( HBeAg) 0.15 ( Non reactive),AFP 4.38ng/ml  , HBV DNA Quantitative,Real Time PCR 5156250 IU/ml. Based on this the Doctor advised me for the treatment  Tab.Entavir 0.5 mg one daily. Here i went for second opinion with Lever specialist consultant and he advised me to go for Fibroscan which the result is 5.91 Kpa ( Negative for fibrosis).Now the lever specialist advised for Viraferon Peg 80 mg once in a week and monitor CBC & S creatin every 15 days.I have not started the treatment yet as I am going out of India for 1.5 months as Doctor told me that this treatment will be given under there supervision , please suggest which treatment is suitable under these report.Also with vaccine this problem will be solved and how long i have to take this treatment.
Blank
Avatar_m_tn
only if hbsag goes less than 1500iu/ml peginterferon add on before 3 years of antiviral makes sense
74 Comments Post a Comment
Blank
Avatar_m_tn
You have e-negative hbv

The best trestment so far is Antivirsls like entecavir or tenofovir for a few years and when hbv is very low or undetected add on of interferon. To start right a way with intf for e negative gives very low chsnce to clear the virus. Before starting any treatment test hbsag quantitive test in IU/ml this is needed for monitoring your responce to treatment esp to intf.
Blank
Avatar_m_tn
Thank you so much , i shall do this test as well and update accordingly.
Blank
Avatar_m_tn
Hi
The test you recommend before starting treatment is done , please find the result:
HBsAg test value = 9520 ( Reactive)
Is there any other test to be done , please suggest.
Blank
Avatar_m_tn
Hi,

Is the measurement for HBsAg in iu?

Looks like you are definitely a candidate for treatment (high ALT and viral load). The fact your Dr reco Viraferon, I assume it's the PEG version.

Either anti-virals like ETV or TDF or Interferon, you will have to decide.

Blank
Avatar_m_tn
The result is not mentioned any unit but they mentioned  :
Interpretation of test result ( Vitros ECi)

One Doctor advised Tab.Entavir 0.5 mg one a day ,

I went for second opinion with Gasto. & liver consultant , he had asked me to go for Fibroscan which the result is 5.91 Kpa.
He advised me - Viraferon Peg 80 mg once in a week.

Since I was travelling he suggested me to start after I come back.
Can be posible if I start with Tab.Entavir now and switch over to Viraferon Peg 80 mg once i return to India.Thank you.
Blank
Avatar_m_tn
first of all the hbsag test you did is useless and absolete, in india you can find hbsag quantificationin iu/ml in best labs, the machines which are old as well, available from 2000, but not absolete from the sixties like the one you used, are abbott architect or roches elecsys.if the labs dont have these machines and the kit for hbsag quantification don t go there

second point, it is useless to start entecavir and peginterferon together, and it is useless to start peginterferon without hbsag quantity.another point entecavir is not the most potent, tenofovir is

the best thing is to start entecavir or tenofovir for about 3 years and then add on peginterferon, only if hbsag goes less than 1500iu/ml peginterferon add on makes sense
Blank
Avatar_m_tn
only if hbsag goes less than 1500iu/ml peginterferon add on before 3 years of antiviral makes sense
Blank
Avatar_m_tn
Hi
Thanks for your opinion , i shall check the lab. where i find the facility to check HBsAg quantitative iu/ml.
Get the test done & revert you.
Thank you,
Blank
Avatar_m_tn
Hi
I have not started the medicine as yet as I am out of country, need to check with you how long i can delay the treatment if the reports are positive.

Thank you,
Blank
Avatar_m_tn
Can you do combo treatment with ETV/TDF and IFN? Suggest that to the Doc.
Blank
Avatar_m_tn
Hi Stef

Hope you are doing good ,

I last conversation wity you wherein you suggest to redo the HBsAg test on quantative , it has been done and the result is as below:
Result: 7767.68 IU/mL ( in the report its mentioned as CMIA , i think this is test method.
So far I have not started any treatment please suggest.
Looking forward your response.

Thank you,
Blank
Avatar_m_tn
please post also previous hbasg, hbvdna, ast/alt, hbeag/hbeab, genotype and firbsocan

value is too high for pegintf, if any therapy it is tdf to start with
Blank
Avatar_m_tn
Hi Stef

Please find the previous report:
AST 83 IU/L dated 7/11/13 , AST 48 U/L dated 27/1/2014.
ALT 200 IU /L dated 7/11/2013 , ALT106 U/L dated 27/1/2014
HBsAg : 9250 ( Interpretation of test result ( Vitros ECi) dated 9/11/2013
HBsAg serum ( CMIA ) : 7767.68 IU/mL dated 28/1/2014
HBV DNA : Quantitative ,Real Time PCR : 5156250 IU/mL dated 10/12/2013.
Fibroscan: 5.91 Kpa
Genotype : not tested.

Doctor advised me for Viraferon Peg 80 mg once a week.
Ttreatment not started yet.
Please suggest the best option.

Thank you,
Blank
Avatar_m_tn
Hi Stef

Few more test report , please note:
HBe Ab : 43.0 dated 6/12/2013 .
HBeAg : 0.15 dated 6/12/2013.
AFP: 4.38 ng/mL dated 5/12/2013.
Anti-dsDNA result : 16.6 IU/mL dated 13/11/2013.HCV,IgG 0.12 dated 9/11/2013.
Anti Nuclear Antibody ( ANA) 0.12.IgA : 279 mg/dL dated 9/11/2013.
AMA : 0.26 UI/mL dated 11/11/2013.
ASMA : 2.70 U/ml dated 13/11/2013.LKM 0.02 U/ml dated 11/11/2013.

Thank you,
Blank
Avatar_m_tn
both hbsag and hbvdna too high for pegintf to respond, you may try 24 weeks and then go for tenofovir

i myself would go for:
tenofovir plus telbivudine 1 year and then discontinue telbivudine and add on peg to tdf

or tdf 3 years
tdf+pegintf 2 years
Blank
Avatar_m_tn
Thank you so much Stef2011 , tomorrow i will discuss with Doctor and go for the best option . Shall up date you .

Thanks for your kind suggestion.
Blank
Avatar_m_tn
Hi Stef

Hope you are doing good ,
Today I consulted my Doctor and discussed the report , he suggest me to go for TERAVIR 300 Mg one daily.
Also ask me to repeat the blood test after one month for CBC , LFT & S.creatinine.
Please guide me the treatment is okay.

Thank you,
Blank
Avatar_m_tn
very good choice
Blank
Avatar_m_tn
Hi Stef

Thank you so much , shall share the outcome.
Blank
Avatar_m_tn
Hi Stef
Hope you are doing ,
I have one question in mind please let me know " Is there any relation with HB Virus vs.HIV1 & HIV2.

Looking forward your best opinion.

Thank you,
Blank
Avatar_m_tn
no whatsoever, also keep inmind that hiv has never been isolated and purified so all hiv tests say in the booklet of producers "you can t use this test to diagnose hiv infection".....if you don t purify you can t have a goldstandard for testing, see "house of numbers" on youtube and what scientists that won nobel prize think of this and then you can have an idea of yours
Blank
Avatar_m_tn
my idea is "hiv retroviruses" probably exsit but if you dont purify and isolate the virus all the tests are of very little help
Blank
Avatar_m_tn
Hi Stef
Thank you for your quick reply , actually i joined new company where they asked to do the medical test and in that requirement they asked to go for HIV1 & 2 test , since I suffered with HBV little worried if HIV1 &2 comes may be they will consider me in there company..
Blank
Avatar_m_tn
just google online for hiv test false negative there are so many interference.

Blank
Avatar_m_tn
Hi Stef
As advised by the Doctor to go for blood test after one month of teravir 300mg. So today i have done the test , please find the report as below:

LEVER PANEL1:LFT,SERUM:
1. AST - 48 U/L.
2. ALT - 111 U/L.
3. GGTP 35 U/L.
4. ALKALINE PHOSPHATASE ( ALP) - 184 U/L.
5.BILIRUBIN TOTAL 0.52 MG/DL.
6. BILIRUBIN DIRECT 0.10 MG/DL.
7. BILIRUBIN INDIRECT 0.42 MG/DL.
8. TOTAL PROTIEN 7.20 G/DL.
9. ALBUMIN 4.20 G/DL
10.A: G RATIO 1.40.

COMPLETE BLOOD COUNT ( CBC) :
11. HEMOGLOBIN 17.40 G/DL.
12.PACKED CELL VOLUME (PCV) 51.80%
13. BC COUNT 5.67 MILL/MM3.
14. MCV 91.20 FL.
15.MCH 30.60 PG.
16. MCHC 33.60G/DL
17.RED CELL DISTRIBUTION WIDTH (RDW) 13.80%
18. TOTAL LEUKOCYTE COUNT ( TLC) 7.80 THOU/MM3.

DIFFERENTIAL LEUCOCYTE COUNT (DLC)
19.SEGMENTED NEUTROPHILS 59.10%.
20 LYMPHOCYTES 31.80%.
21. MONOCYTES 6.30%
22. EOSINOPHILS 2.30 %
23. BASOPHILS 0.50%.

ABSOLUTE LEUCOCYTE COUNT
24.NEUTROPHILS 4.61 THOU/MM3
25. LYMPHOCYTES 2.48 THOU/MM3
26. MONOCYTES 0.49 THOU/MM3
27. EOSINOPHILS 0.18 THOU/MM3
28. BASOPHILS 0.04 THOU/MM3

CREATININE,SERUM 0.94 MG/DL.
Please review and suggest , I am taking one tablet daily TERAVIR 300 MG.

Thank you
Blank
Avatar_m_tn
all those tests are useless to define response to tdf or response to an hbv infection, is the doctor a liver specialist?

you can save creatinine test as baseline, this is needed every 6 months at least
hbsag quant in iu/ml
hbvdna in iu/ml
hbeag/hbeab
hbv genotype

have those tests as soon as possible because you need it as baseline
Blank
Avatar_m_tn
Hey Steff if  if hbsag goes less than 1500iu/ml how long of a course of Peg Interferon is needed to clear the virus?
Blank
Avatar_m_tn
There is no answer to your question. Hbsag movements is solely dependend on your immune system - virus relationship. Your Hbsag can drop by thousands within one month as well as it may take year to clear hundreds of hbsag. Nobody will tell how you will react to interferon unless you try yourself and see.  
Blank
Avatar_m_tn
Hi Stef
I have done HBSag & Hbvdna in the month of Jan.2014 and the results are as follows: HbSag - 7767.68 iu/ml ( CMIA) dated 28/1/2014.
HBV DNA - 5156250 iu/ml.
Hbeag -0.15.
HbeAB - 43.

Doctor is liver specialist in well known hospital in India.
He started treatment based on these test but he asked me to repeat some test after one month of treatment , the tests are - CBC , LFT & S.creatine. which i did & sent the result to you. I have not shown these result to Doctor as yet.
Blank
Avatar_m_tn
Hi jcm

Are you visiting ILBS in Delhi
Blank
Avatar_m_tn
No I am not visiting ILBS..
Blank
Avatar_m_tn
I Sundeep Kaushik (32M) got to know about this disease when i was going to donate blood at Rotary Blood Bank.

Reports as on 22/12/13
HBV DNA Repots - 1,04,78,275

LFT -
SGPT 90
SGOT 50
ALP 73
(REST IS NORMAL IN LFT)

HBsAg - 279.3
HBeAg - 34.82

Going through with homeopathic treatment

LFT Report as on 1/3/14
SGPT - 108
SGOT - 39

NOW MY QUESTION IS THAT
MY TREATMENT IS GOING IN RIGHT DIRECTION OR NOT?
HOW LONG WILL IT TAKE TO GET RID OF THIS DISEASE?
Blank
Avatar_m_tn
HBsAg - 279.3

this test is useless and done by an obsolete machine, numbers without units are useless and meanless whatsoever
retest hbsag quantitative in iu/ml by abbott architect or roches elecsys
Blank
Avatar_m_tn
hello sir,
my age is 42yrs old last 7months back my lft isnormal readings when i repaeated the lft rpeorts sgot 46 and sgpt 90 dr advised for test i.e ultrasoound scan and hbv dna viral load  ( kindly note :my hbasg detected in the year 2009 and but in the year 2002 earlier in the hbasg was negative and vaccine taken 3doses)
the results are
scanning report :- liver is 15.5cm and enlarged with fatty changes portal vein measures 9mm.
hbv dna viral load  by srl lab Bangalore (head office Mumbai) 18600  IU/ML
MOLECULAR BIOLOGY
HEPATITIS B VIRUS DNA QUANTITATIVE
HBV VIRALLOAD BY TAQ MAN IU/ML 18600
METHOD : COBAS AMPLIPREP/COBAS TAQMAN
Comments
*****
KINDLY NOTE :THE HBV VIRAL LOAD CAN BE EXPRESSED AS LOG 4.27 AND THE CALCULATED VALUE IS 107880CPS/ML (CONVERSION FACTOR:1IU/ML=5.8 CPS/ML

kindly help what to do, iam  going to visit the doctor this week Thursday or Friday. st johns hospital Bangalore gastroenterologist .  iam bachelor plan to marry bu doctor  advised go ahead  with vaccine with wife   and confirm vaccine worked or not , then go for a  child  supposed if infected to your wife  you  can have 100% protection to the child  there is a treatment
Blank
Avatar_m_tn
i visted today viral load 18600 world wide doctors will not prescibe any antiviral medicine  if it is more than 20,000 then only required.
he advised to take heptral 400mg for 3tabs one vitmain e one daily for one months
any how i purchased heptral purchased but is too costly in bangalore and started medicine
and dr adivsied to repaet lft test fter one month revist me exaclty one onths iwht lft reports
Blank
Avatar_m_tn
ok those tests were baseline before therapy, now you need to retest hbsag quant in iu/ml and hbvdna at the 3rd month of therapy, at the 6th and then at 1 year
Blank
Avatar_m_tn
thnkyou
HBSAG QUANT IN IU/ML in bangalore test facilities are not there only LFT and hbv dna
heptral 400mg and vitmain e started medicine to take.

i request go to latest artice for hepatitis b cure
here is the article
Hepatitis B virus infection: Degradation of viral DNA in the cell nucleus is opening up new treatment possibilities
21 February 2014 Helmholtz Zentrum Muenchen - German Research Centre for Environmental Health
Scientists from the Helmholtz Zentrum München and the Technische Universität München have discovered how the viral DNA of the hepatitis B virus (HBV) can be degraded in the cell nucleus of liver cells, consequently allowing the virus to be eliminated. Viruses such as HBV can persist by depositing their genetic information (DNA) in the cell nucleus, where the DNA is normally not degraded. This prevents antiviral drugs from eliminating these viruses. But the newly discovered mechanism could make this possible without damaging the infected cell in the liver. In the current issue of the prestigious journal 'Science', the scientists report that now new therapeutic possibilities are consequently opening up.
Although preventive vaccination is possible, the World Health Organization (WHO) reports that more than 240 million people around the world are currently suffering from a chronic hepatitis B infection. They face a high risk of developing liver cirrhosis or even liver cancer. In Germany alone, more than half a million people are affected. Although available antiviral medicines can control the hepatitis B virus, they cannot completely eliminate it. As a result, the HBV in the patient's liver is reactivated as soon as the treatment is discontinued.
This is due to virus DNA (cccDNA: covalently closed circular DNA) "hidden" in the cell nucleus. This virus DNA stores multiple copies of the virus in the nucleus of infected liver cells (hepatocytes) and in this way protects itself from destructive influences. The cccDNA serves as a template for the virus' own proteins and new viral genomes. An international team of scientists headed by Prof. Ulrike Protzer and Prof. Mathias Heikenwälder, Institute of Virology at the Helmholtz Zentrum München and the Technische Universität München, has now found a way to selectively attack and eliminate the viral genetic information in the cell nucleus of the liver cells without damaging the host cell in the process.
"The degradation of viral DNA in the cell nucleus that we describe represents an important mechanism in the defence against the virus", Protzer reports. "Moreover, for the first time, the results offer the possibility to develop a treatment that can heal hepatitis B."
The scientists have discovered that in addition to interferons (the immune system's defence agents), activation of the lymphotoxin β receptor in the host cell promotes certain proteins and supports their function in such a way that they chemically modulate and degrade viral cccDNA. This keeps the virus from reactivating, and also prevents the disease from breaking out again, even after the treatment has ended. On the other hand, the proteins do not influence the genetic information of the host cell itself, which here is the liver cell. "With the activation of the lymphotoxin β receptor, also combined with substances that are already available, we have a very promising new therapy concept available", Heikenwälder explains.
In addition to the Helmholtz Zentrum München and the Technische Universität München (TUM), TUM's Klinikum rechts der Isar and the Düsseldorf, Hamburg, Mainz and Munich university hospitals also participated in the publication. International partners from Belgium, France, Switzerland and the USA also contributed.
The research was supported by the German Center for Infection Research (DZIF).
http://www.helmholtz-muenchen.de/en/news/press-releases/2014/press-release/article/23568/index.html
Blank
Avatar_m_tn
Hi Stef2011

I am in 3rd month therapy & recently done the test please find the report:
27/4/2014 = HBsag ( Quantitative) CMIA - 8612.42 IU/ml. { Base line was 7767.68IU/ml dated 28/1/2014 }

27/4/2014 = HBV DNA ( Quantitative, Real Time PCR)  - 33181 IU/ml. { Base line was 5156250 IU/ml dated 10/12/2013 }

Liver function test dated 27/4/2014 - AST 40 U/L , ALT ( SGPT) - 65 U/L , GGTP 29 U/L , ALP - 143 U/L , Total protein - 7.10 g/dl ,

Complete blood count dated 27/4/2014 - Hemoglobin 17.20 g/dl , PCV - 52% , RCB count 5.68 mill/mm3 , MCV 91.60 fl , MCH 30.30 pg ,MCHC 33.10 g/dl , RDW - 14.30% , TLC 5.80 thou/mm3 .

I am taking one tablet Teravir 300mg ( tenofovir)  daily.
Please look into the report & suggest.

Thank you,



Blank
Avatar_m_tn
Hi Stef

Sorry one correction on HBsAG ( Quantitative )  report the result now is 6821.40 IU/ml instead mentioned in the earlier as 8612.42 IU/ml

Thanks
Blank
Avatar_m_tn
too early to say anything, antivirals take years to have a real effect on clearance of infected cells.it is good hbsag is going down if it ever reaches 1000-1500iu/ml you can consider pegintf add on before 3 years of tdf
Blank
Avatar_m_tn
Hi Stef

Thanks for your revert , yes i can understand its long process . I shall continue with the current therapy and will do the test after every 3 months completion.
Thank you,
Blank
Avatar_m_tn
hi dear,
last three month back hbv dna quantitative is 18,600 iu/ml ,  lft was sgot 40,sgpt 90 scanning shown with enlarged  fatty liver with 15.5cms and my body weight was 94kg and dr advised heptral 400mg for one month  and repeat lft tests with weight reduce

after one month sgot went to 53, sgpt 88  weight  was one kg reduced and adv for 6weeks same treatment with heptral 400mg

after 6wks my health was upset with one side head rotating feeling dr adv vertigo treatment and almost cleared went for diabetic check  in blood and urine  urine was nil and blood test shown i am diabetic patience   and further audio meter check for right ear and found nerve weak and upto 40db can't ear and adv for tablet for ear nerve strength   why was telling this, doubt whether heprtal 400mg create any side effects on body.
further on 5june2014 my lft done sgot was 80 and sgpt was 155, body weight was 88kg  and  due to this value last 3months back hbv dna was 18600 iu/ml gastroenteritis dr  come to conclusion that my body was reduced  94kg to 88kg and heptral 400mg not responded  and  my viral maybe  increased further and not to delay  started.  tenofoivir  300mg daily in morning after 2hrs eating. reapet lft after 6weeks
kindly  suggest whether iam in right right direction treatment.

hemanth
Blank
Avatar_m_tn
You are forgetting most important test that is HBsag quantitative in IU/ml.
Get this test done also go for fibroscan test.
Blank
Avatar_m_tn
thank you for reply

right know iam taking treatment from  st johns hospital Bangalore.   iam already started taking medicine  tenvir 300mg daily.
regarding hbsag quantitative in IU/ml and fibroscan test not available in Bangalore i.e why dr gastro not suggested these tests. in fact i was daigoinsed in the year 2009 and in the year 2000 was hbsag was negative and also vaccine taken  but my luck medicine not worked.
Blank
Avatar_m_tn
Hi Stef
As shared earlier I have started taking treatment effective 31 Jan.2014 , please find my base line test report and after three month report for your review and advice:
Test Report on 28 Jan. 2014:
HBsAg ( Serum CMIA) quantitative : 7767.68 IU/mL.
HBV DNA Quantitative , Real time PCR : Plasma - 5156250 IU/mL.
Fibroscan - 5.91 PKa.
L.F.T.- Complete:
SGOT / AST 48 U/L.
SGPT / ALT - 106 U/L.
ALK . Phosphatase - 139 U/L.

Report after 3 months:
Test Report on - 1 May 2014:
HBsAg Quantitative ( CMIA ) - 6812.40 IU/mL.
HBV DNA Quantitative ,Real time PCR - 33181 IU/mL.
Fibroscan dated 14/6/2014 - 7.45 KPa ( fall under F1/F2 - mild fibrosis )
L.F.T.- complete:Report on 27/4/2014-
SGOT / AST 40 U/L.
SGPT / ALT  65 U/L.
Alkaline Phosphatase ( ALP ) 143 U/L.

Beside these I have done the other test first time dated 28/5/2014 :
Calcium , Serum ( Arsenazo 111) 9.80 mg/dL.
Phosphorus , Serum ( Molybdate UV ) 2.40 mg/dL.
Vitamin D , 25 - Hydroxy ,Serum ( CLIA ) 41.05 nmol/L.

I met with my Doctor today and showed him the report , he suggest to continue with Teravir 300 mg daily ,I am already taking Cap.uprise D3 , 60000 units once in a week , so far I had 4 Cap.of uprise. Last month i felt neck & shoulder pain and Doctor suggested me to take Cap.uprise 60K.

My question to you is am I in the right treatment or need to change please suggest.
Also worried on my Fibroscan increase from last time wherin ALT had reduced from the base line values.
I asked Doctor how to bring down the ALT , he suggested me to take Solubid 300 mg tablet , 1 tab. twice a day after meal for 3 months. Is it correct to take Solubid tab.

Looking forward your opinion .

Thank you,
Blank
Avatar_m_tn
first thing alt must not brought down but as high as possible while hbvdna undetectable

as to tests we need to check when hbvdna is und still too high, also results at 12 weeks are usually not so important, just hbvdna to see if antiviral works

as to vit d it is too low and weekly dosing is not known if good or bad, the best schedule would be 10.000iu of d3 daily now.also check pth now and if it goes down while vitd25oh goes up, this will tell us if receptors of vit d are blocked or working.if receptors are working you should see pth goes minimum of normal lower range as vitd25oh goes 100ng/ml or higher

also no dairies diet is best when vitd25oh gets higher than 100ng/ml
Blank
Avatar_m_tn
forgot to mention when vitd25oh>100ng/ml no dairis and 2.5liters of water needed
Blank
Avatar_m_tn
Thanks Stef for your suggestion ,agreed i will start 10K d3 daily & will check pth as well.
one more clarification , should I drop the idea to take solubid tablet twice a day to lower the ALT ?
As per you rest of the treament is Okay.

Thanks again for your help & advise always give us hope to fight with HBV.
Blank
Avatar_m_tn
what tablet?

the lower the alt the less hbvdna/hbsag decline, it has no meaning to do that, plus alt levels that can make damage are 1000-2000, not your low numbers
Blank
Avatar_m_tn
Thanks Stef , got your point..
Blank
Avatar_m_tn
Your Vit D level is very low. 41 nmol/L is equivalent to 16.4 ng/ml. Take at least 10,000iu of D3 daily.

Your ALT level is not that high. TDF should bring down your Viral Load and your HBsAg down. Like stef said, the higher the ALT while under medication, the better your HBsAg decline.

I notice your fibroscan result has gone up. How is your diet? Lots of turmeric in your diet will be great for your liver.

Good luck.
Blank
Avatar_m_tn
Thanks mustthinkpositive , u are right gone up , My diet is normal , I don't take alcohol , little non veg and lots of veggie  , take egg as well. Do u recommend any other diet. I take turmeric in all foods .
Blank
Avatar_m_tn
I took the advice of Dietician from the hospital and they advice me to take:

Daily Food Allowance:

Cereal----------------------------------------------- 100g---------------------------- 6 serving
Pulses------------------------------------------------ 60g----------------------------- 2 Bowls
Tone milk and milk product ------------------- 750 ml-------------------------- 3 medium glasses
Egg white------------------------------------------- 160g---------------------------- 4 eggs
Vegetables----------------------------------------- 300g---------------------------- 3 Bowls
Root Vegetables---------------------------------- 100g--------------------------- 1 Bowl
Fruits-------------------------------------------------- 200g------------- ------------- 2 medium sized
oil or white butter----------------------------------- 20g---------------------------- 3-4 teaspoon
Suger-------------------------------------------------- 5g------------------------------ 3teaspoon
Nuts---------------------------------------------------- 10pc Almonds / 3 Walnuts

These are some dietary guideline like Raw turmeric are good for liver also see my post on " Healthy Food for the Liver"

Hope this help
Blank
Avatar_m_tn
sorry i didn t notice the unit was nmol/l (damn labs still using crap units)!

you have to consider that vitamin d deficiency makes fibrosis of the liver itself, independently from having any disease

italian guidelines to correct it are:
from 600.000iu to 1.000.000iu single dose
then maintenance dose from 2000iu to 5000iu

i thin you d best take 600.000iu single dose then test vitd25oh in a week and according to blood levels go for 5000iu or 10.000iu daily
Blank
Avatar_m_tn
JCM
SRL and Dr lalpath has this test but SRL is cheaper!  

25-hydroxy vitamin D --------------  in ( ng/ml)
Blank
Avatar_m_tn
Thanks jrai , this test been done through Dr Lalpath lab. only they have old method like nmol/L.
Blank
Avatar_m_tn
Vitamin 25 hydroxy D has been after after taking 1 dose of 60000 IU , I am continues taking Vitamin 60 K dose on weekly basis so far I have taken 4 dose. I will go for one more test and share the report with you.
Blank
Avatar_m_tn
60.000iu weekly is too lightly, it is less than physiological doses, it is only about 8500iu daily.if so it is much better 10.000iu daily
Blank
Avatar_m_tn
Sure i will go for 10000 IU daily and update accordingly.
Thank you,
Blank
Avatar_m_tn
You need to tell the billing person very slowly and repeat the test name again and again to be sure! It's Vit 3d

I do this test from SRL as its cheaper here Rs.1300

Also Bonshine is a good brand it comes in 60 softgel capsules of 2000iu
Blank
Avatar_m_tn
I too use Bonshine , I have not faced any problems till now . Hi Jrai , how are you ?. I hope you have now put on weight .
Blank
Avatar_m_tn
Thanks ,please tell me from where are you getting the treatment . Also where is SRL lab in Delhi.
Blank
Avatar_m_tn
Hi yibok
Please let me know from where u buy the vitamin d3 and what brand as well as how many iu...?
Blank
Avatar_m_tn
SRL is everywhere in Delhi beside the website will guide you. I do the test from SRL Faridabad sector 16,

I guess yibok said he take Bonshine, well they have a website and ask for distributor number you can get a lot cheaper from distributor.


Blank
Avatar_m_tn
I am doing well, my BMI is 24 so I am in a good range.

With Vit D, high health is a lot better now! What about you?
Blank
Avatar_m_tn
Hi Stef

Todays I got blood tested for osteoscreen panel -1 :

PHOSPHORUS - METHODSPECTROPHOTOMETRY - 2.7mg/dL.

25- hydroxyvitamin d , serum - 18.22ng/mL.( Method Electrochemiluminescence).

CALCIUM (METHOD SPECTROPHOTOMETRY) - 10.1 mg/dL.

parathyroid hormone , plasma pth ( INTACT)  - 63pg/mL. ( method - CHEMILUMINESCENCE)

Please suggest the vitamin d 3 dose , presently I am taking vitamin d3 dose weekly 60000 iu/ml. So far i have taken 5 tab. vitamin d3.
Others report I have posted last week .


Thank you,
Blank
Avatar_m_tn
Still extremely deficient, incrase to 70-80.000iu weekly and add vit k7 from natto food if available and o diaries diet

rcheck vit d in 3 months

calcium should go to 9 as it d increases, k7 is use and no diaries diet.also drink 2.5l water per day
Blank
Avatar_m_tn
Thanks Stef , you always a great support . I will follow the instruction. Many thanks .
Blank
Avatar_m_tn
Hi Stef
As per your advice , I have ordered followings:
1. Swanson ultra high potency natural vitamin k-2 ( Menaquinone-7 from Natto)

2. Swanson premium highest potency vitamin D-3 5000 IU.

I have received the medicine today.

Please let me know the dose, should I take daily one or weekly.

Best..
Blank
Avatar_m_tn
please post again your baseline vitd25oh, i dont remember

you can take 10.000iu of d3 daily, this is a normal dose and has no issues

vitamin k is ok at 90mcg daily to 1000mcg daily, it has no toxicity at any dose so you can choose the dose.i d go for 200mcg daily if taking 10.000iu of d3
Blank
Avatar_m_tn
Hi Stef

Vitd25oh was 18.22 ng/ml  tested on 22 June 2014.

Best.
Blank
Avatar_m_tn
go for 10.000iu daily, you have severe deficency

very severe deficiency less than 10ng/ml
severe deficiency 10-20ng/ml
deficiency 20-30ng/ml
Blank
Avatar_m_tn
Hi Stef
Thanks for your suggestion , shall follow as per your recommendation.
Blank
Avatar_m_tn
Yes, you should take Vit D3. If you are of darker skin, Vit D from the sun will be harder to absorb.

I don't have a reco on any diet. I think the avoidance of bad food is more important.
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Hepatitis B Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Hepatitis Answerers
Avatar_m_tn
Blank
stef2011
Italy
Avatar_m_tn
Blank
StephenCastlecrag
Australia
Avatar_m_tn
Blank
Rome70
Moscow, Russia
Avatar_m_tn
Blank
andrey19
Russia
Avatar_m_tn
Blank
mer971
Avatar_m_tn
Blank
makeadifferencenow