Decrease in HBsAg

[Mars86]

I'm on combo etv .5 and tdf for 3 years till now ,,, last month results was

HBsAg was 34,000 iu/ml , base not known (but randomly tested after one year from staring treatment it was 87,000 iu/ml)

DNA 66 iu/ml (base was more than 170 million iu/ml)
normal AST , ALT was slightly elevated (60 iu/ml ) max. normal was till 50 iu/ml... base was normal ALT and AST (about 35 iu/ml)

I was forced to stop etv for only 20 days ... then tested again yesterday ... results

HBsAg 27,000 iu/ml
DNA not tested
normal AST , ALT was slightly elevated (63 iu/ml ) max. normal was till 50 iu/ml...

My Q can I stop etv now and continue with tdf only and vit D3 10,000 iu daily ?

Thanks

[Mars86]

thanks a lot , but i reviewed what is the popular genotype in my country (Egypt) , I found it is Genotype D ,, as well due to DNA is undetectable I could not know what is the genotype exactly

[Mars86]

i do not know the geynotype but i am still HBeAg positive..

ALT is above the normal limit , it is about 75 iu/ml

male , 30 years

[Aduiski]

To make a decision on whether to start pegylated interferon...

- what is your hepatitis b genotype?
- what is your ALT at the moment?
- what is your age and sex?

[Mars86]

i do not know the geynotype but i am still HBeAg positive..

ALT is above the normal limit , it is about 75 iu/ml

male , 30 years

[Aduiski]

"last egfr was 116 , lower limit is 125"

I think you are mixing up your test results, as egfr >90 is an excellent score for egfr, and can not have a lower limit of 125.

Your microalbumin is not measured by egfr, but with urine test that measures levels of albumin in urine and is often expressed by either:
- albumin/creatinine ratio
- albumin
- albumin excretion rate

you can measure egfr with blood tests, either with creatinine or cystatin c or both (as steff recommended).

I would follow steff's and studyforhope's advice (i followed them actually just recently when evaluating my own kidneys)...

In any case...I would advise switching to TAF when it becomes available at your location

[Mars86]

fine I'll apply those tests and let you know


:about pegylated interferon ? what is the correct time to start treatment ?

Thanks

[stef2011]

egfr is not good because theoric based on creatinine which is not itslef a good measure of kidneys function, best tests a combo of:
serum creatinine
cystatin c
creatinine clearance by 24hrs urine collection
serum phosphate
Albumin/Creatinine Ratio