Cronic HBV, HBeAg - positive, treatment suggesstions

[82prasad]

Hi Stef, Vijik and others,
Please provide treatment suggestions for me.

I am having HBV for the last 9 years atleast and my age is 30 years now
My latest results are as follows:
CBC - Normal
Liver funtion test - Normal
ALT - 47 (range is 30 to 65 U /Lt)
AST - 24 (range upto 35 IU/Lt)

HBeAg - Positive (29.901)
Anti ABeAb - Negative (1.53)

HBV Viral Load - 207 (Reference: Sensitivity limit: 3.8 IU/ml)
HbsAg, serum - Positive (>250)   (reference: Negative: < 0.05 IU/ml)

Thanks,
Prasad

[Hafiz2003]

Please interpret this result for me
Hbsag= positive
Hbsab= positive
Hbeag= negative
Hbeab= negative
Hbcab= positive
Am already taking Tenofovir for 3 months.Before initiating therapy my markers were:
Hbsag= positive
Hbsab= negative
Hbeag= negative
Hbeab= negative
Hbcab= positive
Please help me interpret the result for me so as to know whether the medication is working or not. And for how long I should be taking the medication.  Thanks

[82prasad]

Hi Stef and others
My HbeAg status is now negative (anti Hbe is positive). Fibroscan is normal but doctor asked to do a biopsee. Viral load has shooted to 56000 IU/Ml. My lab not doing HbSAG quant, also none of the doctors are well read enough in my area to prescribe this.

I might start Entecavir. can I take this life long without a worry of major side effects

[stef2011]

hbvdna and ast/alt flactuate overtime even to und but this has no specific meaning as to predict responce to treatment or hbv clearance on treatment, only hbsag can predict what to do and what result can be achieved

retest everything quantitative and have a fibroscan if no fibroscan in last 6 months so we can have a clear idea of your status but anyway only pegintf plus tenofovir (sequential tdf and pgintf after best) has shown good results as to clearance of hbv

[stef2011]

change doctor right away hbsag quant is the most important test to define status after fibroscan

[82prasad]

Hi Stef,
Also I had tested HBV Viral load 2 years back, that time it was as high as 13000 ( I donot remember if it was IU/ml or copies or any other unit)

What must have made viral load to reduce so much to just 207?
Is it because of

1. Incorrect testing by lab
2. Units not clear
3. Ayurvedic medicines which I am taking for the last 8 years

[82prasad]

Thank you Stef,
That is right. HBsAg is said to be abobe 250, the reason being I had not asked the lab to test HBsAg quant (my doc had not recommended it)

Now my doc is saying no treatment. I find it incorrect. Should I change my doctor and ask him to prescribe me the treatment suggested?

[stef2011]

attention hbsag was tested with the correct assay but they did not diluite your blood sample for the testing of high hbsag, so the test says hbsag is superior to (>) 250iu/ml and all chronic carriers have more than 250iu/ml....

the best treatment is peginterferon for you in combo with tenofovir, it is best to treat as long as hbeag is positive because you have more chances to clear hbsag by treatment

[82prasad]

Thanks Imran,
Thats a lot motivating.

However my doctor says he will not put me on any treatment. Should i consider a second opinion or is he right?

[imran4535]

User Otan a couple threads below is a good example of this.

[imran4535]

Your ALT is above normal, your HBV DNA is low, your Surface Antigen is low.

Your immune system is most likely trying to clear the virus. You can try boosting your chance of clearing it by using Interferon + Simvastatin + Alimoa for about 48 weeks. Your in a much better situation than most people who don't get the chance to clear.

Imran