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Finally Got HBsAg quantitative results

Hi Stef
Finally got HBsAg quantitative test results today. Test date 4th March 2016,  Dr.  LAAL'S PATHOLAB

RESULT : 1666.10 IU/ml

Hope this is correct test this time

My earlier blood test results as on 1 February 2016
Male,  Age 46 years
HBsAg positive
HbeAg negative
HBcAB positive
Viral load 6250 IU/ml log 3.8
DNA quantitative 7622 s/co
SGPT 140 (came down to 69 on 12 February)
SGOT 80 (came down to 65 on 12 February)
Vitamin D deficient
Ultrasound normal
Upper GI normal
Urine test normal
Rest of the blood tests normal (CBC)

Doctor had prescribed Entecavir 0. 5mg for 6 months.

Started taking entecavir 12 days ago (today was 13th dose)

Please guide now what should I do with respect to this latest HBsAg quantitative of 1666.10 IU/ml

1. Should I continue entecavir?
2. Is it dangerous to stop now (13 tablets taken)?  
I am taking Vitamin D3 10000IU perday since 15 days and also blackseed with honey
23 Responses
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Avatar universal
So,  what to expect now?  Just carry on with entecavir and do regular blood tests to check if HBsAg quantitative decreases?
Helpful - 1
1 Comments
Yes, few people are lucky to clear just on nucs. If that won't work think about adding peginf.
But I'd like someone here to confirm is it true that when starting nucs HBsAg may go up ?
Avatar universal
This whole thing is confusing. First of all never knew that I have this virus,  by chance it showed up in blood test done on 1 February 2016 for insurance purpose. It camr as a shock as I never had any symptoms that may suggest I have hbv.  I am 46 years of age now, don't know how long this virus has been in my body. My doctor is sure that it is not by birth.

Now I learn that taking antivirals will increase HBsAg initially and then decrease it. If I don't take antivirals then what happens?  Sure liver damage in near future?

Doctors do not educate the patient. It's on this forum that I learnt about vitamin deficiency (when I Informed my doctor about my vitamin D  deficiency, he said it is very common thing in India),  I did not know anything about HBsAg quantitative test. Thanks to people like Stef,  Aduiski, Stefen, and all others.
Helpful - 0
Avatar universal
Thanks antistr
My doc says very small risk & the first thing to change is dna/alt & they will then consider treatment to decrease levels & bring back to what my immune system is currently doing. So risk of hcc/liver disease is very small.
Thank you
Good luck
Helpful - 0
Avatar universal
I understand it is dna/alt that causes hcc, although studies say hbsag1500, dna und is about the same risk as most people without hbv. Is my 5000hbsag likely to stay at that level, decline or increase. Why am I told very small risk, more chance of being hit by lorry/struck by lightning. I get very conflicting info. Told don't need treatment so what will/could happen next? How does my hbsag level compare to other hbvers.
Helpful - 0
Avatar universal
Also I thought around 1500hbsag is a good sign, he is 1666?
Although as I said his alt/dna are high.
Are you saying I am not in a safer place?
Helpful - 0
1 Comments
you are perfectly safe if you are inactive, don't think about hbsag quantitive if your dna is undetected. just make your rutine checks to be sure everything is going well.
Avatar universal
I am told I am inactive after accounting for my overall results over 23yrs.
It is just there, benign, not doing anything & he says it just means I still have the virus, nothing more.
Helpful - 0
Avatar universal
Also is it because his alt & dna are high that he has risk.
I am told I will die with NOT from hbv.
After 23+yrs since diagnosis I have a perfect healthy liver, no inflammation or fibrosis/cirrhosis. Just monitored annually.
I have been told I am very lucky.
Helpful - 0
Avatar universal
My hep. doc says I will not develop hcc or liver damage & I have 5000hbsag.
Alt 33, dna und. Never been more than 500. Everybody seems to be obsessed with hcc. Most people with hbv live normal long lives & die of other things.
Aduiski on this site read all my results & told me to live my life I have less than 1% risk of hep b probs my doc says 0.3% risk. How if I have 5000 & sphereaj has1666 he is at risk & my doc says I am not.
Helpful - 0
1 Comments
There are lots of different risk factors about hcc. Hbsag quantity is most determinant factor only when hbv is truely inactive with undetected viral load and normal liver function.
Avatar universal
Thanks Stef
Helpful - 0
Avatar universal
you need 5 to 10 years to see an effect on hbsag, a reduction of cancer risk and repair liver if damaged

if you are one of the lucky 1-5% you ll see hbsag going down, if you are like most you may see an increase first 2 years and then decline after 3 years

some dont get any decline but peginterferon add on after 5 years of etv makes a lot of responders with hbsag decline
Helpful - 0
Avatar universal
Dear Stef

My HBsAg quantitative is 1666.10 IU/ml, what do suggest I do?  Continue with entecavir for 1 or 2 months and do tests again?  And if needed switch to tenofovir?

What are the chances of clearing this?
Helpful - 0
Avatar universal
Hi Stef
Please guide.
My HBsAg quantitative result is 1666.10 IU /ml

Rest of the results are posted above.

Should I continue entecavir 0.5mg and monitor the outcome?

What are the chances of clearing  
Helpful - 0
Avatar universal
Indeed there is. Most people in 40ties have their hbsag value 3 logs something, just like him.
Helpful - 0
Avatar universal
In fact all results except HBsAg quantitative are before I started taking entecavir
Helpful - 0
Avatar universal
Thanks again Sorte

The both ALT results are before entecavir treatment
140 on 1 February came down to 69  on 12 February without medication. I started medication just 12 days ago
Helpful - 0
Avatar universal
So compared to 15000 a reading of 1666 is certainly low,  that gives me some relief. Thanks
Helpful - 0
1 Comments
It's not very low, cuz some people have even 100 IU but it's much better than in most carriers :)

Unfortunately you are not inactive carrier because your viral load and ALT are not low. But ALT jump may be due to starting ETV.
Observe HBsAg and think about adding interferon some day.

I don't have enough knowledge to say if after 8 days of ETV that HBsAg and ALT results can be treated as a baseline.
Avatar universal
Thanks Sorte for clarifying about about expected HBsAg quantitative reading at certain age

This HBsAg quantitative is after 8 days of entecavir. So as good as a reading prior to starting treatment (I can use this as a baseline reference)  right?
Helpful - 0
Avatar universal
Thanks joc2011
Any chances of clearing this?
Is the HBsAg quantitative of 1666.10 IU/ml
Low enough to clear?
Helpful - 0
1 Comments
It's low, most HBe negative people has around 15000 before starting any treatment. Check this after 6 month on etv, few people is able to clear on nucs. I'm not sure, maybe someone confirms but in some people it grows and than goes down when starting nucs, is that right ?
Avatar universal
Also experiencing some mild pain under right side ribs after starting entecavir
Helpful - 0
1 Comments
Pain is normal. Will go away gradually as your liver heals
Avatar universal
Thanks Aduiski
Any chances of clearing it??
Helpful - 0
Avatar universal
Hbsag value is about as expected for your age.
Now that u decided to start, maybe it would be better to continue with it.
Helpful - 0
1 Comments
Theres nothing like HBsAg expected for certain age :)
Avatar universal
Sorry for above comment (looks like cannot use certain symbols)

For this HBsAg quantitative the reference level is LESS THAN 0.05 IU/ML

Less than 0.05 non reactive
More 0.05 reactive
Helpful - 0
Avatar universal
For HBsAg quantitative the bio reference is < 0.05

= 0.05 reactive
Helpful - 0
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