Finally got my first hbsag quant result...

[itac]

I got it in Berlin so the unit is in German (IE/ml which I believe is equilient to IU/ml?? Can someone can confirm that please):

Hepatitis Diagnostik
HBs-Antigen i.S. (quant.) (CMIA) 2217 IE/ml
Normal ref range: < 0.05

My last hbv dna I got a month and a half ago was around 800-900 ui/ml

Genotype is D with precore and bcp mutations

Vitamin d around 40/100 (taking daily doses of 2000u)

Hbeag is negative and hbeag is positive

Do I have good chances to seroconvert in the future without any meds (besides vitamin d)?

Am I a good candidate to start interferon treatment? What are my chances to response to it and to seroconvert?

Please advise.

Thanks!

[mike9111]

Cool since i was doing the eclia test for curiosity i will try the cmia next summer wheb i travel there. Although the rule say if you used one systen you should not use the other for consistency

[itac]

I got it at Nicolaistraße 22, 12247 Berlin
Institut für Medizinische Diagnostik MVZ GbR, Address
(You can google it)

The exact name of the test on the paper you should ask them is:
HBs-Antigen i.S. (quant.) (CMIA) Unit IE/ml

I paid 18.76 Euros for it. They can get it to you the same day if you do it early.

[mike9111]

Just curious where did u do ur test in berlin and what you ended up telling them so they did the test

[stef2011]

So just because my hbsag is not below 1000 it makes me active? Source?

one of the many studies, this from 2010 on genotype D
http://www.ncbi.nlm.nih.gov/pubmed/20451520

[itac]

hbsag below 1000iu/ml
hbvdna below 2000iu/ml - check
alt below 30 - check
fibroscan below 6kpa - check

So just because my hbsag is not below 1000 it makes me active? Source?

[antigen007]

hello.. well of course I do not contradicting anyone, my query was just a reassurance. pardon me if I sounded judgmental.

[Jason_256]

Yes that's correct. Nobody here is doctors or experts.

[StephenCastlecrag]

You are right, according to most guidelines, itac does not need treatment, just regular monitoring.

But the trouble is, itac and most of the readers, want TO BE CURED!

Very few doctors talk about a cure, here everyone has an opinion on how to get cured. So just remember, most of the members here are not doctor, there are no sure ways to be cured, everyone needs to exercise his/her own judgement. And always consult your doctors - at least they have a duty of care and they are professional.

[antigen007]

hello everyone. Itac's liver seems fine with ALT below 30, right? so why he needs medication,? and I remember reading one article that researchers or doctors are arguing about conducting liver biopsy instead of, relying on blood tests alone to treat hvb. funny thing is, we HVbers, (like somebody uses that term in this community), ahhh nevermind.

[stef2011]

What do you mean I'm not inactive?
What state am I then?

normal chronic hbv, to be inactive you need:
hbsag below 1000iu/ml
hbvdna below 2000iu/ml
alt below 30
fibroscan below 6kpa

[itac]

What do you mean I'm not inactive?
What state am I then?

[stef2011]

you are not inactive and by time you probably will have other core mutations so going with no treatment is bad anyway.

so start tdf and then you will add peg when it will be less than 1000iu/ml

or wait the decades for the other threapies

[Aduiski]

http://www.aphc.info/wp-content/uploads/2014/09/Michelle_MARTINOT-PEIGNOUX1.pdf

[Aduiski]

have in mind that "inactive" in reality doesn't mean inactive but a prolonged well suppressed, very low levels of hepatitis state. Your current hbsag level, according to my knowledge, indicates that your hepatitis is likely to awake sometimes down the road.

[itac]

I'm am monitoring dna and alt every 3 months in the first year after the diagnosis to determine if I'm truly inactive carrier. And then I will only do it every half a year (after confirming I'm inactive).

[itac]

I thought it's pointless to start with more than 1000 ui/ml?
Also realistically speaking what are the odds? Are there studies that provide any numbers for my case?

[Aduiski]

You could monitor your DNA and Alt every 4 months or so, as for many hbeag neg it goes up and down, so if you measure it only once per year it might not give you the best picture. Your body is controlling it well at the moment but not perfectly as otherwise it would be "undetectable" on the dna test

[itac]

Yes, I'm taking vitamin d d3 2000iu
Trying to avoid alcohol since the diagnosis

[stef2011]

Correction for step 3.): check hbsag quant again if below 1000iu start peg
Otherwise start nucs (tdf) and test again to see if it goes below 1000iu, then start peg?

yes that s all i did too and u start low hbsag already compared to me, i started 4800-7200iu/ml of hbsag

geno D will make easily precore bcp mutations, almost all geno d carriers are hbeag neg and some core mutations, also hcc risk is higher than geno a and B

[Jason_256]

Vitamin d is the only thing your taking?

[itac]

Correction for step 3.): check hbsag quant again if below 1000iu start peg
Otherwise start nucs (tdf) and test again to see if it goes below 1000iu, then start peg?

Btw, I doubt a doctor will let me get on nucs with my current status as I'm not a treatment candidate based on the international guidelines...

[itac]

Stef this is my full results from last time (August):

Note: I'm genotype D e negative (with precore mutations A1762T/G1764A), 27 years old, have good fibroscan/ultrasound results for my liver.

ast 17 (ref range: 10-40 u/l)
alt 22 (ref range: 9-46 u/l)
Vitamin d total: 37 (ref range: 30-100 ng/ml)
Intact pth 36 (ref range: 14-64 pg/ml)
Hbv dna 865 ui/ml

So you are saying I should start with this algorithm:
1.) maximize vitamin d
2.) minimize intact pth
3.) check hbsag quant again if below 1000iu start peg
Otherwise start nucs (tdf) and test again to see if it goes below 1000iu?

What are my odds realistically based on existing research for my sub group? Is it less than winning the lottery?

[itac]

Correction: Hbeag is negative and hbeab is positive.

[Jeihan]

stef
i confuse about some terms here. when you say tdf, do you mean tenofovir? and peg for peinterferon? what about nucs?
thanks