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Best strategy for monitoring HBV status
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Best strategy for monitoring HBV status

I am on entecavir, HBV dna und at 4 weeks after starting the treatment. Now my doctor is suggesting HBV dna and Liver panel at every 3 months and AFP and ultra sound at 6 months interval. Considering that qHbsag and fibroscan are not available in USA, this plan seems reasonable to me. Any suggestions?
5 Comments Post a Comment
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Avatar_m_tn
plz tell me what was your hbv dna before treatment  and which medicine you used?
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Avatar_m_tn

without fibroscan and hbsag quant is like a blind driving a car if there was liver damage......in any case unless you are hbeag pos entecavir will make no difference to hbsag

as regards fibroscan: did you have biopsy before taking etv?what was liver damage?as you may easily understand fibroscan is not available to just get all on therapy since you can t really see when the liver gets damaged and start therapy only then.
if you have cheap flights like in europe (as expensive as a bus/taxi) i d move to have fibroscan and hbsag somewhere else

if you are hbvdna und at 4 weeks no need to check before 6 months unless cirrhosis is present
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Avatar_m_tn
I did had a biopsy, fibroscan and qHbsag before. Here is my history

Feb-
HBVdna 1350 IU
ALT 60
Hbeag - negative
Biopsy - Fibrosis F2-F3

March (in India)
HBV dna 9900 IU
qHbsAg 2300IU
Fibroscan 6.4
ALT 42

Started etv in May

June -
HBV dna - TND
ALT 40
MRI - no HCC lesion.

so do you think above mentioned strategy is optimum?





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Avatar_m_tn

well liver has no damage and biopsy was probably wrong with f3, anyway fibroscan less than 7kpa is not relevant damage and less than 8kpa reduced hcc risk so it was possible for you to just monitor

anyway now better stay with etv 1-3 years and then add on intf if no new drugs available

monitor hbsag quant because it can rise instead of go down on antivirals, when it reaches a low value intf add on can be tried.on the trials there was a patient  with hbsag 8000iu/ml at 3 years of etv therapy, then intf was added and hbsag got to about 100iu/ml in 48weeks

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Avatar_m_tn
Hi Stef,

Some more results-
Feb-
HBVdna 1350 IU
ALT 60
Hbeag - negative
Biopsy - Fibrosis F2-F3

March (in India)
HBV dna 9900 IU
qHbsAg 2300IU
Fibroscan 6.4
ALT 42

Started etv in May

June -
HBV dna - TND
ALT 40
MRI - no HCC lesion.

Oct -
HBV dna < 20 IU/ml
ALT 55

Jan -
HBV dna < 20 IU/ml
ALT 52

Do you have any ideas about what ALT is not going down despite having HBV dna untected for more than 7 months now? Is it something to worry about?
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