Entecavir + Interferon combo

[cyrus131]

Dear all,

     I have been on Entecavir 0.5mg for over 6 years and my HBV DNA is nearly undetectable.  I will see my doctor tomorrow and what tests should I perform so as to assess whether I will benefit from the Entecavir + Interferon combo treatment (i.e. higher chance to achieve Hbsag seroconversion.)  Many thanks.

Regards,

Cyrus

[cyrus131]

Dear Stefano,

Just had a follow-up yesterday and got my latest blood test result

Dated : 11 March 2014
HBsAg : Negative, HBsAb : 22 mIU/mL

I will continue to take Entecavir 0.5mg for further 6 months.  Is this HBsAb level low and do I need to further boost the immune response by injecting vaccine like Otan did?

Also, I have injected interferon for 49 weeks and I still have 1 spare dose in my refrigerator.   Should I inject it in the coming week?

Your expert advice is highly appreciated.  Many thanks.

Regards,

Cyrus

[stef2011]

is my chance of getting liver caner and fibrosis the same as before?

no in any case, also data we have is too little to say hcc risk is increased, we may say this on cirrhotic patients.i suggest you have regular nagalase screening if nagalase is normal there is no way to develop cancer, it also takes very long time for cancer to develop after nagalase become abnormal

Should I continue to have ultrasound screening of my liver every 6 months as before?
yes and if you add nagalase monitoring too you can be sure to have no surprise

[cyrus131]

Dear Stefano,

Thanks.  Since I have hep B since birth and I am now 40 years old, is my chance of getting liver caner and fibrosis the same as before?  Should I continue to have ultrasound screening of my liver every 6 months as before?

Best Regards,

Cyrus

[stef2011]

you absolutely need to keep peg beyond 48weeks until we have good hbsab, check this in advance and look for another doctor if there is any trouble

i remember otan got n touch with a researcher/doctor in HK or singapore, check her posts, he was very expensive but studying and treating to make hbsab once hbsag is neg
he is using peg, zadaxin and hbv vaccine

or simply look for another doctor willing to go over 48weeks

the maximum peginterferon strength is after 48weeks, in the second year of use, and this is quite normal to use 96weeks on responders

you may also start the hbv vaccine or zadaxin before 48weeks if these are non prescription in your country

[cyrus131]

About 45 weeks.  Should I check the HbsAb level? I am afraid my doctor will not allow me to inject interferon beyond 48 weeks.

[stef2011]

there are 2 members here clearing hbsag in combos where simvastatin is present:
otan peg+sim
another member i dont remember now: tdf+sim+gcmaf

too little patients to say it helps but since we know it prevents hcc, fatty liver and has few sides if any, it can be tried by others to confirm

both otan and other member had low hbsag, i think this is the main factor for peg response but this said sim may have a role or not, we need to find out