HBV DNA Lowest ever....now what?

[twinboys1girl4me]

I am 41 and have had HBV since birth.  I am hbeag -, hbeab+, A genotype, no mutation, alt high 20's-low 30s, and have been monitored every 4-6 months with scans and bloodwork for 13+ years.

I know it's normal for DNA to fluctuate and mine do but never had been higher than 1270 iu.  January DNA was 888 iu and last week had drawn again and was lowest ever, 160 iu.  Why lowest ever??

They do not do qhbsag in US.  Biopsy completely normal last year.  How do I know if I am a good candidate for treatment to try and rid hbsag?  I know qhbsag is key, but if dont have in US what to do?  I also know based on guidelines most docs here will not treat but do know of a doc where I can get Viread.  Given my numbers should I try Viread or Interferon, or continue nothing?  Like everyone, I would like to lower hcc risk as age increases.  Thank you!

[stef2011]

hbsab is totally useless until hbsag becomes undetectable, don t bother to check it

[twinboys1girl4me]

I checked again.  It says <3.10 but nonreactive.  Is the <3.10 a reference point or does that mean I have some but not over the 10 iu to be reactive/positive?

[twinboys1girl4me]

My hbsab has always been nonreactive.  Does that factor in along with hbsag?  Thanks!

[twinboys1girl4me]

It's crazy that they are that far behind.  All I can think is because B isn't nearly as common as C in the US?  They put so much focus on C and sure would be nice now that they have a cure for it that they start focusing on B.  I really hope they can get it soon.  Thank you!

[twinboys1girl4me]

Thanks so much Stephen.  I do drink coffee and recently started extra vitamin d.  Maybe that is what helped the DNA go lower?  Nothing else changed.  I'm seeing a new hepatologist in a few weeks.  I will ask him about Interferon.  He will probably think I'm nuts and just want to monitor like all other specialistd I've seen.  I too have read Interferon has better success with genotype A (even though i know most are hbeag+ which i am not).  Thanks so much!

[sorte]

have you ever checked did you have any antibodies, HBsAb ? It happends that some inactive carriers have it in very small amout

[stef2011]

i do agree with stephen especially because without hbsag quant we dont know if pegintf is working, US will be forced to use hbsag quant sooner or later it is already 10years late on the rest of the world...i dont think it will take long to have it available

[StephenCastlecrag]

I don't see the purpose of going on Viread. Sure, it should get you to undetectable hbvdna within a year or so, but it will still be a long term treatment. Because you are genotype A, Interferon is definitely the choice for you, but in the US, it will be hard to find a specialist who will prescribe Interferon for you in your inactive state. Of course, INFN does have potential serious side effects. So, in my opinion, I will wait and check-up every 6 months. After all, for HBeAg patients with undetectable hbvdna and qHBsAg < 100 iu/m (this test is not "available" in the US, but I have read that in fact all qualitative HBsAg test in the US is carried out using the quantitative test, but reported just as Positive or Negative), there is a very high chance of natural  s-seroconversion.
In the meantime, you can take some measures to increase your immunity, such as Vitamin D, exercise, and a healthy diet. These should also reduce your risk for HCC. In additional you may like to take up the habit of drinking coffee.
There are many on-going clinical studies to discover  ways to achieve loss of s-antigen, so do nothing may not be a bad option.

Just my opinion.