up to now, i have Hbsab+, but i am confused again.need help

[liangzaizaia]

i havent been here for a really long time. i got my antibodies last October, but my antibodies were not stable. After the tenth injection of PEG, and the first injection of vac at the same time,my Hbsab is about 10iu. so i got injected at the second month, and my HBSAB is about 30iu. then third month of my injection of vac is about 0iu. the fourth month is about 60iu. the sixth month is about 200iu, the nighth month is 180iu, and the eleventh monthof my injection of vac is 160iu. and i have the tdf at the same time.

so i am confused why my antibodies are not stable. and how am i gonna do in the future???
here is my treatment conditions:
http://www.medhelp.org/posts/Hepatitis-B/my-hbsag-is-35639IU-mi-need-advise-please/show/2216087#post_10625469

http://www.medhelp.org/posts/Hepatitis-B/im-gonna-have-the-peg-in-one-or-two-weeks-have-some-questions-/show/2418441#post_11744516

[liangzaizaia]

i just wanna know why my antibody numbers decreased rapidly. this is what i am really cared about.

[StephenCastlecrag]

Thank you for the response. I don't know whether the "decrease" in your HBsAb is normal or unusual. From the literature, stopping NUCs treatment after loss of HBsAg is durable. Not all loss of HbsAg is accompanied by appearance of HBsAb(whether HBsAb appears later on is not clear). It is also not clear to me why one would need a high level of HBsAb for protection, after all, protection is mainly achieved through immune memory - as soon as the body is exposed to HBV (or HBsAg in the vaccine), the body will immediately produce HBsAb to neutralize the infection.

[liangzaizaia]

do western countries have some similar treatment case? i am confused how i continue my treatment in the next few months?

[liangzaizaia]

1. You had stopped your PegIFN?      yeah,im concerned about its side effect.so i used a course of peg.
2. You are still on TDF.        still yes. i plan to have tdf for at least three years after antibodies appeared.
3. What is the status of your HBsAg? I presume it had been negative, for how long?             until now, it's still negtive for i use tdf. i dont think it can become positive.
4. Are you still under the care of your old doctor?     my old doc had a baby a few months ago. i followed the advise of a famous doc in China. his name is LuoKangXian form NanFang Hospital, South medical university. he answered me online that i should keep the number of my antibodies above 100iu for at least one year.
5. Of course, you are still hbvdna undetectable.            and yes.

[Pitts_05]

@stephencastlecrag My HBV DNA is presently at 698 IU/Ml and my AST 28 U/l ALT 23 U/L can I start to treat with Tenofovir(I'm not financially boyant to treat with more expensive a drugs).
I have also been on Immunace+Liv52+Methionine.
Please I also feel dull pain just below my right shoulder blade I'm suspecting its some kind of inflammation, is it normal for people with HBV?

Thank you!

[StephenCastlecrag]

Your hbvdna is < 2,000 iu/ml and your ALT is normal, and HBeAg negative. Most likely you are in the Immune Control (Also known as inactive) phase, so guidelines would say treatment is not necessary at this stage, just regular checkup of your liver function(ALT etc) and hbvdna, Tenofovir is a firstline drug for HBV, so it will be a very good choice. You are on Liv52 which is a herbal supplement, I don't think they are really necessary - just eat a good diet, exercise regularly, and drink coffee if you like it. Some Hepatitis B patients complain of a dull pain the right upper quadrant. Your shoulder blade pain is not a symptom we have heard of. It could be due to muscle or if severe, maybe due to stones in your gallbladder.
I am not a doctor, just my opinions.

[Pitts_05]

Hello Stephencastlecrag

I recently started feeling a dull pain on my liver which get severe from time to time near the middle of my rib cage, plus I also have symptoms(pimples on forehead,yellow eyes, fatigue) of an acute HBV patient. I'm really disturbed because I thought I was in the immune control phase and I'm not prone to Cirosis and inflamed liver.

I would also love if you can help me with the cost price of PegIFN and Tenofovir

Would really appreciate your response! Thanks in advance!

[StephenCastlecrag]

If you believe the white parts of your eyes are yellow, you should see a doctor immediately to check your liver functions. Jaundice can also be caused by blocked bile duct due to gallstones. A examination by your doctor will determine the underlying cause, it may or may not be related to HBV.
I am not familiar with the costs of PegIFN and Tenofovir as they vary from country to country. In Australia, these drugs are subsidized by the government and available at a very low cost(especially PegIFN). Maybe others can help.

[StephenCastlecrag]

Good to hear from you. Can you please clarify your present situation for us:
1. You had stopped your PegIFN?
2. You are still on TDF.
3. What is the status of your HBsAg? I presume it had been negative, for how long?
4. Are you still under the care of your old doctor?
5. Of course, you are still hbvdna undetectable.