Dis-continuing combo treatment

[Peteshine]

Guys,

I recently got my April results back and my ALT is 20 whilst my DNA is now >15.. I was told the labs don't give the actual DNA as they don't test for anything lower than 15... Firstly would this be a good indication of UND or is UND actually 0? Also there are talks of me finishing my combo treatment at the end of July and i'm a bit worried. Obviously my results are stable at the moment as i have daily treatment. If i do come off the combo tx what would be a good and accurate 'monitoring' time after that. As in, should i insist on having blood tests every month starting Aug and the months after?

[britgirl477]

Oh and as for the tests...yes they are for life as bberry states. I don't have a problem with that but then I have been checked every 6 months by my diabetc clinic since the age of 14 so I guess I am used to being monitored. But then when you get to a certain age you expect to be a member of some sort of 'medical club' do you not????
Brit

[britgirl477]

Hey Pete,
Surely tho if you are fine and dandy and getting checked every 3 -6 months by ur doctor then there is less chance that your VL can jump out of control without you knowing about it. I guess you can stay on pills all your life but then maybe build up a resistance. I know that for Teneofovir there is no world-wide resistance at present but that it is likely to come even tho' at a low risk. So it's between a rock and a hard place isn't it? I think in the long run I would want to be off the pills and be monitored. I mean can the damage in 3-6 months be that huge? I am not sure bout that? Maybe each time you come off pills and then go back on does maybe there is  a lot of damage????? Expert advice would be needed I guess. Then again maybe you will come off pills and be totally fine for ages and ages. And then ofcourse Pete... there's the one that we keep forgetting and which I KNOW and have complete and utter faith in and that is that they are just so very very clever and a cure is just around the corner. I mean it really is only a matter of time. Did you not see the press recently sayin that the year 2020 is the year when all diseases known to man today will have cures. Of course new ones will have replaced them Pete, so you gotta make sure you haven't picked them up lol
Brit
Brit

[bberry]

yes sir  - it is for life indeed . unless ofcourse we turn hbsag negative then we wont have to worry about it.

but why are you worried about monitoring every six months.. i mean meds or no meds as long as you got hepB  you still need to be seen by your doc every 3 to 6 months regardless . for life , that is

your doctor knows best. and i think i should trust him

[Peteshine]

I think I'm definately more worried bout the fact that even if my VL doesn't increase for months after i stop combo treatment and after many years of this, it suddenly goes shooting up with no indication. When we talk about regular blood tests (every 6 months) are we talking bout for life?

[britgirl477]

Well maths was my worst ever subject at school so you are not alone. I appreciate what you say bout coming off the tablets. I guess you get used to them and know that they are doing a good job in your body and thus you DO NOT want to come off them. But is it not the best thing to do? I mean you could be UND for a long long time and might be good to get time off them for a bit. I am the same as you once my doc has had me on these tabs and gets final labs back he says I will need to 'discuss' with him what next steps I take concerning coming off or staying on. Part of me wants off these tablets which I view as just awful things (even tho' they are doing me the world of good) but I am also concernes about what might happen if I come off them. It's a hard one, so I totally feel for you. But you are obviously doing really really well if you are UND so as bberry says huge cheers for that!!!!
Brit

[Peteshine]

Hi guys,

Thanks for the replies.... Britgirl it woulda been nice if i was given the exact DNA level.... However i guess it now means i have achieved UND and thats also a good thing.... I am however nervous bout coming off treatment cos those little tabs didn't bother me none every morning and now that i won't have them by my bedside i will be forever anxious about my VL levels.... Lets just hope it stays completely down and with no problems. The other side of it is having to adjust back to those tablets after a couple of months, knowing i will need them for the rest of my life if my VL does shoot up....

In regards to maths i really sucked in that but i'm sure it is common knowledge what  stand for... I just got it wrong... Lol....

[bberry]

Good news. even better with you coming off meds.. if your doctor says he wants you off meds then he sees good enough a reason for you to do so . you will monitor cloesly the first 3-6 months maybe like zelly said once a month at first then every 3 months and maybe space them out even longer after that. hope you stay in good health.

lets all celeberate this good news with some shots of tequila..hahahhaa ok joking but good news by the way :-)

[britgirl477]

Peteshine,
Did you not do maths at school??? lol I was confused by that also. My last HBV DNA read HBV DNA <9 so I was told it meant undetectable and that was as far as they could say. But is this not the whole thing about chronics in that you never know exactly what number of virus are left after getting to undetectable levels? If it was a zero then would that not mean you would clear the HBsAg too?
Brit

[Peteshine]

Sorry yes... Lol.... I meant <15......

[zellyf]

Well, that depends.  You said your DNA is now ">15" which means, "greater than 15".  That's not a typical thing to see so do you actually mean "<15"?

[Peteshine]

Would that then seem i have reached UND if the test do not measure anything below 15?

[zellyf]

Pete,

UND is whatever number is too low to be measured by the test.  There is no 0 for chronic patients as some replication is always occurring and some virions always present in the body.  Zero would be mean no infection.

I'm not sure what the recommended monitoring time is but I'd want at least every month for the first 3 months to watch for a rebound.  Hopefully, someone else has some idea.

Good news!