HBSAG - Status

[kanchi213]

My HBV DNA quantitative PCR method is 3286 iu/ml or 19326 copeis/ml  and Elastrography of liver ARFI value is ranging from 0.67 - 1.23 mtr/sec.
Doctor has advised me to take baraclade .5mg for next months and i am feeling acute pain in abdomin.

I am confused and not sure what to do..rather blindly take doctor advise on medication.

Please advise me status ..is my viral load is dangrous and should i have take the medicine..

[StephenCastlecrag]

Most of us are not familiar with ARFI to determine stages of fibrosis, so what does 0.67-1.23 mtr/sec correlate to in terms of stages of fibrosis?

Whether you need treatment depends on your liver functions test (especially ALT), hbvdna, HBeAg status, fibrosis stage, history of infection, family history of HCC etc. Acute pain in the stomach is generally not associated with Hepatitis B .

[kanchi213]

My ALT is 48 normal range upto 40. HBV DNA is 3286 Iu/ML and HBEAG is negative. ARFI/Fibrosis is F1.. history of infection I was not born with HBSAG probably got it in my 20'ts (age) and non of family had any liver HCC...

[StephenCastlecrag]

Thanks for the information. The question is: do you need treatment? Here, there are two different advices:
AASLD (American Association for the study of liver disease) recommends treatment for HBeAg negative patietns if:
hbvdna > 20,000 iu/ml and ALT > 2 ULN.
So according to this guideline, you do not need treatment. They recommend, in your case: Follow ALT and hbvdna. If persistent, consider biopsy and treat if moderate or severe inflammation or significant fibrosis. You don't have significant fibrosis and I don't think ARFI will tell you your grade of inflammation.
On the other hand, EASL (European Assosiation for the study of liver) recommends treatment if hbvdna > 2,000 iu/ml and ALT > 1 x ULN.

Personally, I would wait and retest in a few months time. Talk to your doctor.

[kanchi213]

I have sevear discomfort in Liver area and also acute pain in upper abdoime. Raw salt taste in mouth...i am confused with the way things are going in my life...

[kanchi213]

and also vomting sensation...althrough the day..

[StephenCastlecrag]

Sorry, I am not a doctor. The only thing I can think of is gall bladder problem? Best to see a doctor. The symptoms that you reported do not seem to be related to Hepatitis B.

[kanchi213]

Did any one wrote a mail to Relicor which is making cinical trials on HBV (HBSAG Clearance) and have they responded on when they can make their anti-viral REP 9AC ready to treat-ment.

I am praying god every minute of life to help us and provide a better life.

Please let me know if any has ever received any communication from Relicor and do they have any trials in india ?

[Rome70]

Replicor replies that should be available in 3-4 years.

[joc2011]

Pain in the abdomen, cld also be some immune activity, trying to react to clear infected cells

[kanchi213]

Pain in the abdomen, cld also be some immune activity, trying to react to clear infected cells .

Do you mean its good..it will help and clear HDV from infected Cells ??/

Doc prescribed to Baraclude Entv.5mg and i am takeing it from past 10 days...pain reduced however slight burning sensation and discomfort still presist..

Thanks

[kanchi213]

its 2 weeks now i have started Baraclude .5mg and the pain in my liver part is not reduced and moreover i am totally depressed and unable to eat food..always out of mood and feeling like left alone in the world.

I am totally worried and i am getting actue flare from my liver part...unable to change mood..

Please advise what should i do to live normally along with this symptoms..

[kanchi213]

I started with Hbeag negative and undectable VL in 2006 but suddendly VL become 3286iu/ml in 2012. Does this mean i have mutant HEBAG? do to which VL is replicating ? Please advise

[kanchi213]

.I started with Hbeag negative and undectable VL in 2006 but suddendly VL become 3286iu/ml in 2012. Does this mean i have mutant HEBAG? do to which VL is replicating ? Please advise
.
Moreover I have completed 3 weeks of Baraclude .5mg daily once and now some I can see relieft in my abdominal pain and no flares. Is it possible with 3 months of regularly having Tab Baraclude we can see a good improvement and chance of clearing HBSAG to negative..

[kanchi213]

I searched the web to find the latest on REP 9AC' which is a hope of good life for all of HEP carriers and here the info..

"Company  REPLICor  
Tags  Trial Results, Phase II, Systemic Anti-Infectives  
Date  September 25, 2012  
Montreal, Quebec – Tuesday , September 25, 2012 – REPLICor is currently undertaking a proof of concept trial in patients with chronic hepatitis B (HBV) undergoing treatment with its nucleic acid polymer (NAP)  REP 9AC’ in combination with Zadaxin™ or Pegasys™. The hepatitis B surface antigen protein (HBsAg) is produced in large excess by the HBV infection as subviral particles (SVPs) which act to block the immune response to HBV infection. NAPs act to block the release of SVPs from infected hepatocytes, providing an effective method for clearing HBsAg from the blood. The elimination of HBsAg in the blood of HBV-infected patients is well known to be the best indicator of a curative response to treatment.

Interim results from REPLICor’s proof of concept trial were disclosed today at the 2012 held at the University of Oxford Christ Church and Examination Schools, Oxford, England. Patients who had cleared HBsAg from their blood with REP 9AC’ monotherapy were subjected to combination treatment with REP 9AC’ and either Pegasys™ or Zadaxin™.

Profound increases in anti-HBV antibodies or immune function were observed in all patients with as few as 6-10 weeks of combination treatment. Many patients have achieved HBV antibody levels seen in healthy patients after vaccination with a total of 12 weeks of combination treatment. All patients who have achieved this therapeutic vaccine-like response have been removed from treatment and continue to control their viral infections off treatment. The remainder of patients are expected to achieve full immunological control of their infection in the coming weeks.  REPLICor expects that the profound reactivation of a therapeutically effective immune response with short term  Zadaxin™ or Pegasys™ treatment given in combination with its HBsAg release inhibitor REP 9AC’ can achieve durable immunological in most patients, regardless of viral genotype or state of their HBV infection"

Please let me know if any one has any latest information then this one...I am praying god every min of the day to help all of us...to comeout of this truma..

[kanchi213]

source link:

http://www.evaluatepharma.com/Universal/View.aspx?type=Search&query=REP 9AC#
Regards

[stef2011]

yo have nothing with your liver f1 is perfect liver so baraclude is not indicated, i d use fibroscan instead of ARFI, too new and no statistic yet

get hbsag quantification in iu/ml and hbeag and hbeab tests, with these tests results you may try to clear hbsag definitely by 3 years on tenofovir and then interferon add on

taking entecavir (baraclude) only will not clear hbsag and will just empty your pockets of money.these antivirals alone have no effect on hbv virus, they can only lower hbv replication to lower or reverse liver damage but sine your liver is ok i see no reason to use it

also take genotype test and check if you have family history of liver cancer

[kanchi213]

thank you stef...makes me feel happy with you post..i will check with my doc on change to tenofovir

[kanchi213]

I will take the adivsed test in Jan'2013 and update the details..thank you

[kanchi213]

Is any one using Entaliv (DRL) instead of Baraclude since the cost of the medicine is cheap compared to Baraclude ?? both belongs to Entecavir.

"Entecavir INN (/ɛnˈtɛkəvɪər/), abbreviated ETV, is an oral antiviral drug used in the treatment of hepatitis B infection. It is marketed under the trade names Baraclude (BMS) and Entaliv (DRL)."

Please let me know why are Doctors not promoting Entaliv instead of Baraclude??

[kanchi213]

I have tested for HBSAG quantitative and the results are 10025 iu/ml. I am worried now since i feel its at a higher side.

Please advise me medication
HBSAG +
HBEAG : Negative
HBEAB : Postive
ALT : 48 ( Range 15 - 40 )
HBV DNA : 3286 iu/ml
HBSAG Quantitative : 10025 iu/ml cutt off . >0.05 iu/ml
Aslo, I am having sever discomfort/ acute burning sensation or pain (confused to discribe my position) in under upper abdomin right side...excatly where my liveris situated.
Fibroscan / ARFI  : F1 or ARFI range .67 to 1.23 m/s

Doctor advised me to take Baraclude on Nov 25 2012 and i have started from the same date.

Please advise what is the best medication for me and  how can i live better.

[StephenCastlecrag]

It is difficult to say whether you have developed HBeAg negative chronic Hepatitis B. Normally, one would like to see whether the rise in hbvdna was persistent. However, since you have started Entecavir, your hbdna should level drop and so would your ALT. At the moment, it seems you would have to take Entecavir for at least several years. The rule to determine when to stop taking Entecavir is not well defined yet. Some research seems to indicate it can be guided by the level of HBsAg. The chance of seroconverting your HBsAg is very very small.

As for your pain, hope you are getting better. Some patients complain of a dull pain, but very few complain of an acute pain.

[kanchi213]

Thank you stephen. Also, I would like to take stef opinon on the same..whether I can start interferon + ent/tenofovir

I have tested for HBSAG quantitative and the results are 10025 iu/ml. I am worried now since i feel its at a higher side.

Please advise me medication
HBSAG +
HBEAG : Negative
HBEAB : Postive
ALT : 48 ( Range 15 - 40 )
HBV DNA : 3286 iu/ml
HBSAG Quantitative : 10025 iu/ml cutt off . >0.05 iu/ml
Aslo, I am having sever discomfort/ acute burning sensation or pain (confused to discribe my position) in under upper abdomin right side...excatly where my liveris situated.
Fibroscan / ARFI  : F1 or ARFI range .67 to 1.23 m/s

Doctor advised me to take Baraclude on Nov 25 2012 and i have started from the same date.

Please advise what is the best medication for me and  how can i live better

[stef2011]

i think it is ok to take entecavir for at least 3 years and after this period you can consider intf add on or myrcludex if available then

i dont think it is of any use to start intf+entecavir all at once you need hbvdna und and hbsag to decrease for intf to work for sure