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HBV DNA detected again after stopping Baraclude
I took Baraclude for 3 yrs 3mths and seroconverted to HBe neg/anti-HBe pos. and dna was undetected for about 2yrs. I recently stopped in March. But my recent lab results showed the dna is detected again.

March '12 - Stop baraclude
June '12 - hbv dna 1260 IU/ml
July '12 - hbv dna 966 IU/ml, ALT - 10

My dr said my levels are stable but may also cause liver damage over time. He mentioned the virus in my body belongs to the pre-core or core-promoter mutation group. And he also recommended me to take lab tests every month to monitor.

I wish to know what does "pre-core" or "core-promoter" group mean? What are the repercussions?

Does low hbv dna mean a lower risk of liver cancer?

What should i next do to improve my condition? continue to be on medication? or am I ok to stop and just monitor first. I am thinking of a natural treatment like taking phyllanthus niruri and thymus gland supplement. Anyone knows if it will help?

Appreciate your knowledge here...tks.
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Thanks for your advice. My 1st pregnancy 4yrs ago, I stopped medication (then was lamivudine) after just abt 1.5yrs of taking it when I was planning (anyway lamivudine didnt seroconvert me to hbeag- then; probably cos I was on it for such a short period). So I had my high viral load and hbeag+, but fortunately, my son was not infected. (That was my happiest day, and I have always been thankful to God.) Thats why this time, I thought I should also stop antivirals. I'm not sure if tenofovir, a cat B drug is really safe for pregnancy as it's a strong drug afterall. But I am more worried it may affect my liver health as I really felt weak after my miscarriage, so will continue antivirals with a positive attitude.
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"the bad thing is your alt normal, this means your immune system can t see the virus now and kill it"

What should I do/take to boost immune system so that it can see the virus and kill it? Will vit D3, fish oils, coenzyme q10, milk thistle help?

And if that happens, do you mean ALT will flare up? Isnt that dangerous for the liver health too? as it means liver enzymes are affected and starting to cause damage?
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"hbv is not cytopathic, it is our immune response that causes injury."

I am always very confused abt the immune system. Have always thought a good immune system will help to kill viruses and improve overall health. When you say its the immune response that causes injury, do you mean just short term injury, while in the long run it will help kill the virus, and hopefully eradicate the surface antigens?
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This is a simple explanation, the realty is more complicated and beyond my limited knowledge.
Our immune system will try to eradicate the infection by killing infected liver cells.This causes injury and the liver will replace the lost cells. In chronic hbvers, the immune responses are inadequate to win completely. So many battles are fought and lost. The frequent and repeated liver repair processes cause scarring and fibrosis. Over time, these scarring accumulate leading to severe fibrosis/cirrhosis. So, we either help the immune system to a decisive victory by medications that boost the immune system, or we use medications to reduce viral replication and hence reduce immune responses, leading to "peaceful" co-existence.

Research indicates that it is not that our immune system is inadequate to fight the hbv, it is just that the hbv virus has evolved many mechanisms to help defeat or reduce the effectiveness of the immune response.

In recent years, scientists are learning and discovering more about the pathobiology of hbv infection and our immune responses to it. It is just that we wish they would hurry a bit.

BTW, Tenofovir is regarded as safe to be given to pregnant women in the third trimester to reduce viral load and hence further reduce the risk of vertical transmission.

Also, our immune system and immune-based therapies can control the virus through non-cytolytic and cytolitic mechanisms. And fibrosis can be reversed.
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Thanks for the explaination. I think I somewhat get the picture. So all the vitamins we take will not boost the "immune system" to actually fight the hbv. But it will only control the virus through non-cytolytic and cytolitic mechanisms. Is this right now?

Regarding Tenofovir, I thought category B drug means safe to take all the way throughout pregnancy from 1st all the way to 3rd trimester? You mean theres only human trials done for 3rd trimester tenofovir safety?
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Taking antiviral during pregnancy is a complex issue as two persons are involved. As I am not a doctor, I try to only report what I have read. Lam is a Category C, yet it is used extensively because doctors have a lot of experiences with the drug from women with HIV. Likewise for TDF.

I copy the following FYI:[notice the emphasis on maternal health]

Hepatitis B Virus Treatment During Pregnancy for Maternal Health

If a pregnant woman has advanced disease or the clinician opts to initiate therapy for other reasons, considerations when selecting an anti–hepatitis B virus (HBV) agent include antiviral efficacy, risk of resistance, human safety data, and pregnancy class of the drug. The choice of anti-HBV agents for pregnant women is discussed below.

"If a woman of childbearing age becomes pregnant while already on HBV therapy, the decision on whether to continue treatment or stop should be individualized based on the trimester that the pregnancy was discovered, the severity of her underlying liver disease, the risk adversity of the mother to medications during pregnancy (especially in early pregnancy), and the risk of flares when stopping the medications (Table 2). With regard to balancing the risk of continuing the woman’s HBV medication vs the risk of flares if therapy is discontinued, the rate of birth defects in the general population from 1989-2003 was 2.72 per 100 live births (95% confidence interval: 2.68-2.76), and the prevalence of birth defects per 100 live births diagnosed during the first 7 days of life (“early diagnosis”) was 2.09 (95% confidence interval: 2.07-2.12).[APRSC 2011] Although these data cannot be precisely compared with the Antiretroviral Pregnancy Registry data on birth defects with HBV medications due to the self-reported nature and limitations of the registry, the reported rate of birth defects with any tenofovir-containing regimen is reported to be 2.4% in the first trimester and 2.0% in the second/third trimester (Table 3).[APRSC 2011] This comparison suggests that there is no evidence that exposure to tenofovir during pregnancy increases the risk of birth defects; however, even babies born to women who do not take the medications can have a birth defect; differentiating whether the defect was medication-related vs due to some other factor is impossible.[APRSC 2011] Thus, treatment during pregnancy should only be continued if the risks of discontinuation outweigh the potential benefit."

Cytolitic mechanism involves killing the infected livers - there are just too many infected liver cells. Non-cytolytic mechanism involves some ways to control/reduce virus replication and/or degrade/reduce cccDNA without killing the liver cells. I myself am trying to understand more about the non-cytolytic mechanism as it is the best way to control/cure HBV. And I guess scientists are working hard in trying to stimulate/wake up/restore this mechanism so as to provide a cure.

I have an open mind on Vitamins and supplements. A balanced and healthy diet should provide all the vitamins that the body requires. In the case of Vitamin D, research indicated most people are deficient and so taking the vitamin is recommended.
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vitamins and antioxidants help keep liver free from damage even if there is attack on the liver, latest research thinks fibrosis and liver dmage is due to higher oxidative stress which breaks the balance between immune attack/damage and repair.the higher oxidative stress is due to immune actiity and inflammation

most carriers get no damage despite ast/alt flares and hbv/immune activity, maybe they have less oxidative stress or a good antioxidative body system

the situation can be furthur complicated by the mutants, some types make more damage to the liver.

oxidative stress tests are available in some very good labs like redlabs.com or europeanlaboratory.nl
these are research level labs, not just commercial ones, it is good to check oxidative stress and correct it because most western diseases are thought to come from that (cancer, diabetes and so on)
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Say you do have oxydative stress? How do you correct it and with what supplements? Or the lab  based on results will make recommendations?
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i checked it one year ago while i was on heptech antioxidants and it was still little abnormal, i added liposomal vit c 1000mg daily and it got to normal range in about 3 months

to detect oxidative stress i checked anox and it was a little higher than normal then i checked mda few months later and it got to normal.
oxidative stress is a balance between your system and ox stress so it must be normal range, not higher and not lower
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Thanks i will do this test . I found labs here that do have it. I cant locate the lab that checks nagalase levels
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Health Diagnostics and Reseach Institute (H.D.R.I)
540 Bordentown Avenue, Suite 2300 South Amboy, NJ 08879,
Tel: +1 732-721-1234; Fax: +1 732-525-3288

blood samples for nagalase must be sent frozen, fedex overnight or similar fast courier needed, for longer time shipments dry ice must be sued to keep samples frozen
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Thank you,
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May I ask you guys a question?

I've just restarted entecavir, finishing up my last 1 mth supply, before switching over to tenofovir. Should there be some overlap? Or just take the last pill of entecavir and the next day take tenofovir thereafter?

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Should there be some overlap?

minimum 1 month if you are und, 3 to 6 months is not und.it takes time for tenofovir to reach the cells and suppress hbvdna

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Today I went to see another Gastroenterologist Dr. just to get a second opinion.

Ok, here's what he said.
1) I do not need to be on medication at all since my DNA is not high at all (he considers 7000IU as not necessary for treatment, Only viral load above 20,000IU should treat)
2) I told him my DNA went up from 966IU to 7000IU, when it was stable before. But he said its natural for DNA to fluctuate.
3) I told him I have already restarted entecavir for 12 days. He said to stop today and retake blood test in 1 mth. (This part I was in doubt as I thought its not good to take-stop-take-stop, but he assured me its ok)
4) His reason for me not needing medication was because my liver enzymes have never been elevated, my e-antigen is negative, and my viral load is low (7000IU/ml)
5) His recommendation to me, since I told him I was plannning for a baby, was to take tenofovir only on 3rd trimester (to reduce risk of fetal transmission), and thereafter, I can decide again whether to continue with tenofovir, or stop after delivery.

I am now torn as to what decision to take. I am inclined to his recommendations for not taking medication during pregnancy, but also doubt if he really knows about hepB treatment. Why I say this-when I told him abt tenofovir, he went to flip a drug book to find out more abt tenofovir. I thought all drs who specialise in hepB should be very familiar with ALL the drugs, esp frontline drugs? hmm...so for this, I need advice from you guys. Hopefully you can help me make my decision whether or not to stop medication. Thanks!!
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[quote]
I am now torn as to what decision to take. I am inclined to his recommendations for not taking medication during pregnancy, but also doubt if he really knows about hepB treatment. Why I say this-when I told him abt tenofovir, he went to flip a drug book to find out more abt tenofovir. I thought all drs who specialise in hepB should be very familiar with ALL the drugs, esp frontline drugs? hmm...so for this, I need advice from you guys. Hopefully you can help me make my decision whether or not to stop medication. Thanks!![/quote]

I know what you feel. But understand most doctors have very little knowledge about HBV. Something they heard on a seminar somewhere sponsored usually by the drug company..

Researchers don't have clear answers for us.

From what you have posted yeah you are slowly relapsing. But if you want to have a baby then for sure you are better off antivirals.

So in a way your doctor is right.. with his recommendation to go on Tenofovir. Since it is the most potent drug..

But for us the best available in terms of what is approved is interferon.
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I had stopped entecavir for 6months (from mar-Sept), then now restarted it again for 12 days. If I stop again, will it make the virus go mad and make resistant strains? Thats what I am afraid most. *sigh*..I wished there's a clearer way to handle my case.

So you think I should not stop medication, and continue with etv, then do the switch to tnf?

Thanks for reading my case and giving ur advice.
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well if you can postpone heaving another baby and start doing interferon for a year you may clear the virus or have a very sustained response off therapy..

Unfortunately with chronic hepatitis B with today's drugs there is no clear cut strategies. Even with the combo treatment like Interferon + Antiviral there is really small data available. Clinical trials or lack their off  only test these theories on a small number or people. These treatments are not being standardized yet. And that is a big problem. That there is lack of dual therapy strategy that has shown good results.

But interferon injections is the best way for anybody to clear hbv  if you have no liver damage today given the drugs we have. With antivirals it is very low 1-5% per year.
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my god where are you taking these doctors?are they butchers?maybe they just treat farm animals not humans?this is terrifying they should not be allowed to have contacts with humans

you dont choose if treat or not to treat according to hbvdna, today hbvdna is just to see if the antiviral works

fibrsoscan liver damage, hbv genotype, bcp/precore mutants and hcc risk are the points to see if treat or not.

second if you treat to clear hbv definitively you just go for tenofovir for sevreal years at least 2-3years and then add on intf
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hbvdna and alt were used a decade ago when fibroscan, hbsag quant, bcp/precore tests and so many more info were not available.

today you can choose not to treat when fibroscan is less than 7kpa and no HCC risk or young, but it makes sense to try sequantial tdf+intf to clear hbv once and for all being 40% or more the chances to clear
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hbvdna and alt were used a decade ago when fibroscan, hbsag quant, bcp/precore tests and so many more info were not available.

today you can choose not to treat when fibroscan is less than 7kpa and no HCC risk or young, but it makes sense to try sequantial tdf+intf to clear hbv once and for all being 40% or more the chances to clear
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sorry i forgot about pregnancy issue, at this point your best choise for you and for the new born is switching to tdf and stopping etv in 3 months

be aware most doctors just dont care to study and get updated so they are totally useless especially on hbv which changes every year with new studies, vaccine fails in more than 28% babies and it fails making invisible to tests hbsag mutations, the only way to avoid this is taking tdf before pregnancy

vaccine failure is due to hbsag mutation, so after vaccine the tests will see hbsag negative and hbsab antibody for protection and hbvdna un but the virus has mutated to the occult form which will come out many years ahead with very low hbvdna, normal ast/alt, hbsag neg and hbsab pos.this form desoite being so invisible to tests can make a lot of damage anyway, hcc and cirrhosis too because some of these mutants are directly cytophatic, they kill cells while infected
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phyllanthus niruri powder is not that much effective..i am buying my medicines produced by SKM (http://www.skmsiddha.org/) which is in this business for a long time and the quality is good... again i would advise not to venture into phyllanthus niruri and wait for some more time for my results..it may not be the only one that is controlling my hbsag and dna but i am taking some other siddha medicines as well..

to the question of why indian and chinese governments are not taking steps/investing in conducting trials for phyllanthus niruri if it really has worked for HBV..(1) Allopathy doctors wield a lot of influence in the goverment (2) there is not much research materials available for siddha medicinal system.  Knowledge has been passed within the families and it has been lost with the family. In some cases, the knowledge has been retained in dry Palm leaves in old literature which a lot of people are not able to interpret in the right way (3) Government is not ready to provide funds for clinical trial for siddha medicines (4) also interest in learning and practising siddha is not much.. a lof of people are studying in the hope of getting a job in a government hospital.. i can list down so many other things (whatever i mentioned is w.r.t. Indian govt).

also siddha medications are known for long term effect on our body rather than short term relief provided by allopathy medicines.. siddha medicines are targetting to improve the immune system of our body and hence act as a preventive medicine..
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I understand your dilemma. I don't want to add to what I said before: it is a fine balance for both mother and unborn baby. Whatever you decide, you must be monitored by both a liver specialist and an obstetrician. I hope you can find doctors who are experienced in your special case. By all means, get second, third, fourth.. opinion until you feel confident with the advice.
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we already have hbv cures, patented, with much to eran from drug makers...they are not interested to cure but to lifelong drugs to sell, so they dont market

natural cures can t be patented so there will never be an interest in this

what you get from this....governments are all corrupted and drug makers just make business so they are intrested to make drugs to sell for life, not cures of any kind.

they already sell drugs for diseases that don t exist with max profit, if making drugs keeps being a business like this the model will never work, maybe making  alot of competition and stopping using patents can make benefit
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let s see if myrcludex trial in russia can break this rotten hbv market and wake up other drug makers........this is the only news since replicor has no money to move rep9ac in to market
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Unfortunately what you read here is what most of us are told.

For instance in the US all is measured really is HBV dna, and that is how progress is evaluated.

testing for mutants, genotype is not routinely done, or health insurance approved with some patients - it is labeled as investigation procedure and not necessary.

No surface antigen quantitative test is available. No Fibro Scan.

In fact most doctors here will tell you that still a biopsy is better then Fibro Scan. So there is really no need for it.

Once the person begins to understand the level of incompetence or flat out lies (for reasons that I will list below) about treatment they were told, they have no desire to see doctors, and argue with them, so they turn to internet and herbal self medication. Which makes health insurance companies happy.

it is a flat out business - a doctor has to get his bonus checks from the drug companies from writing prescriptions and at the same time not to upset the health insurance company he works with by doing too many tests. Even If the patient needs them. So given this system how can one really treat, and experiment and try to make a difference?

really honest and decent doctor cannot simply work in this system. I am saying it as a patient based on my own experience. The costs are high the quality is close to 0. If they miss routinely acute Hepatitis B then draw your own conclusions..

Some doctors don't even care anymore what they do if it is good for the patient or not. They do what is recommended by FDA..and the treatment recommendation provided by the drug company...  a safe bet to avoid a law suite just in case and stay in business for a while. Where everybody is happy and profiting except the patient if this is a serious illness.  some docs yes read it from the manual how to treat hepB.

You are lucky to be living in Europe where health care is a right not a service. And where doctors are not that dependent on drug and insurance companies how and with what to treat I am told.

The kind of a perfect world health care,  only is available to very rich people or politicians - which get it free also btw.  The rest of us in best case scenario is how much knowledge we can gather and how much our health insurance will allow our doctor to do and also a bit of help from God.

Look at the way at how clinical trials are set up for HBV today. Take for example Gilead GS9620 - imiquimod in pills .. How many patients did they take first in their trial? Why don't they expand the criteria and take people that have taken other drugs not just ETV?

The so called researchers that work with them what do they exactly do and how many people they are helping by doing such small trials of medication that works better then what we have today?

They monitor this forum, so why don't they come and respond and answer some questions? How come the fight against HBV is so slow if they are so commited?

So you see all the research or to be exact product testing is done and set up by the company like Gilead.

They could have just give them the drug and say here.. Try it on as many as you can and reports us the results. Report the results here on this forum where members could have spread the word in their countries to patients and doctors and government officials. And these companies would still make money. maybe not as killer profits as they do these days..

So that is why we as HBV community are stuck with lack of drugs. And lack of really solid treatment strategies of what works not to suppress the virus but to cure the patient.

Because this market  is dominated  by drug companies from one country where everything  has to bring money in order to do it - big money that buys influence and policy making.

These companies need to recover profits from all the time they put developing anti HIV agents. Which is what were are treated with really. In some way Europe is the same way they way they approve drugs.

So yes there is great hope in countries like China and Russia to provide at least the alternative way of doing things. Medicine cannot be for profit, it is emoral, it is not christian. At least they have the funds to pull something like this off now.

Because this is not working - running clinical on HBV drugs to approve them over a period of 5-7 years is ridiculous. Giving the devastating consequences chronic HBV carries for the patient and how much it raises the cost of health care overall. When there must be a simpler solution.

I see so many good reports about herbal treatment, various supplement. Why there is not trials on those? Why no one asks those wise old men in China and India that know herbs for their input?

So given the current situation, all we can do those of that know the truth about hbv treatment all we can do is share knowledge.  So people can at least know what to tell their doctor the next time they go and see him and what tests they need to be ordered. That is one way of beating this system. Which i truly believe will change because people are fed up with this and they understand where the problem is.



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With regard to Replicor if they have no money to bring the drug to market why don't they then put a bulletin on their web site that they are excepting donations. We will all donate. How many sick HBV folks world wide. Money can be generated if they need to. So I think it is not that.

I think we should e-mail and invite Michelle Bazinett here and ask her what the deal is. With the power of internet it is possible to raise all the funds they need and to treatment say in Thailand or other country that permits it. It is not an issue. If Replicor people are ready and have the drug and want to help funds will be there.
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guess what!

this is proibited by law, we have tried this way already but citizen cannot donate
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the system is made exactly to serve big drug makers, small ones are not allowed to disturb and citizens the same
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that is crazy!
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Stef, in my case, would you support the decision for me to STOP entecavir now (after restarting for just 11 days since my previous break in March) and try for a baby. Then 2nd trimester take tenofovir (if DNA rises to above what level?). Definitely, I will be taking tenofovir in 3rd trimester. Its just the 1st trimester that I dont wanna mess with any drugs as its the most impt period for the fetus. Im sorry that you may not have come across this scenerio, since you are not female. But Im sure there are many females like me who want to have a baby, but stick in the middle. I think Im having anxiety issues already..worrying so much!

And also, will it worsen the hbv virus if I stop now? Im more worried about mutations and resistance issues (I have been taking entecavir for 3yrs 3mths, then I stopped in March 2012, then got back again 11days ago.)

Thanks.
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Oh, and for sure, if I start tenofovir from 2nd or 3rd trimester onwards, I will take it for a long time, no more stopes definitely. I do not mind taking for life, as long as I do not develop resistance to it.
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Could I ask if you are a female too?

Im not so comfortable with taking tenofovir throughout pregnancy (unless benefit outweighs risk by a lot), because, though its a cat B drug, if you take it everyday, you never know how it interferes with the developing fetus, esp the first 8 weeks when the crucial developments are taking place. My 2nd consideration is, I do not trust drug makers in some ways as after 10yrs, they may suddenly change their stand after finding some abnormalities in pregnancy women taking tnf.
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it is best to make a new thread for all other members that had tdf on pregnancy to give feed back and possibly suggest a good doctor

i am not a doctor so i can only suggest:

since etv is not safe for pregnancy it is good to stop it as soon as pregnant like you've done

i d start tdf immediately, if your hbvdna was low/und tdf should start its effect on virus very fast

tdf has no resistance and there are no issues reported about pregnancy and i d not worry about this, i d start it immediately because we dont know if hbvdna can get und in 3months, 6 months or longer.
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good idea stef. I shld start a new thread on this.

but now, the question is whether i really need to be on medication or not.
I know for HBe-antigen neg patients, there's no clear end-point for treatment. And some guidelines suggest not starting on medication and just monitor and treat when necessary.

So now, I do not know if DNA 7000IU/ml is considered high enough to treat. This dr I just went yesterday says its low and only above 20,000IU and elevated ALT then should consider to treat with meds. But my regular dr says its a jump from previous 966IU and stable levels before, so may result in a flare (but so far my ALT has been very low fortunately)
Which is more accurate?
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hbvdna is useless for liver damage, we have fibroscan today

hbvdna useless to see if you can clear hbv or if you have many infected cells, whatever the values there is no corrispondence at all

ast/alt liver damage, not at all, again fibroscan will tell

today hbsag quant is the most important with this you know the chances to clear the virus once and for all, the chances to get cured!and high alt which means active immune system especially if hbvdna is low/und
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Yes, I am a mother of 2 children.  But I didn't have your dilemma when I was pregnant because my viral load was undetectable and liver enzymes were very normal.

I agree with StephenCastlecrag's advice about getting third, fourth,....etc. opinions until you find a good hepatologist you are comfortable with.

Although Tenofovir wasn't approved for Hep B until 2008, it has been used on HIV patients since 2001.  If there were issues regarding pregnancy, they probably would have emerged already.  However, almost everything is possible and I agree it's a hard decision.
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What do you mean when you say hbv dna is not impt to see infected cells, and ALT/AST not impt to see liver damage? I thought there's a corelation between hbv dna and progression to liver damage/cancer? And ALT tells if liver is inflammed or not?
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You are a lucky mom! May I ask if you were on any meds before pregnancy? And were you all along HBeag neg, I presume?

My stand is not to be on meds untill I see a "flare", which I suppose is an elevated ALT. If this happens before I am pregnant, then I will start tenofovir. But hopefully, it won't, or can delay till at least 2nd trimester, where I'll be more comfortable taking meds. I am really praying all goes well..as I am one paranoid person.
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Hi guys, I need your advise here. I took another set of bld work last week and here are the results.

History:
March '12 - Stop baraclude
June '12 - hbv dna 1260 IU/ml
July '12 - hbv dna 966 IU/ml, ALT - 10
August '12 - hbv dna 7500 IU/ml, ALT - 12 (note this was done after my miscarraige operation end July. Not sure if there's any correlation)

October '12 - hbv dna 113 IU/ml (reference range <20IU/ml), ALT - 12, AFP - 0.8, all other results in the comprehensive metabolic panel are within normal range (too many to list here), liver ultrasound normal.

The lab report stated that this test was performed using the COBAS(R) AmpliPrep/COBAS(R) Taqman(R) HBV Test, v2.0 (Roche Molecular Systems, Inc.)
Performing site: Quest Diagnostics

Want to know is this result accurate? If so, why the sudden drop in hbv dna after 2 mths? I am still off medication. The only thing I did was to take vit D 5000IU, vit E 400IU andvit C 1000mg daily. Oh, and I also did chinese accupunture weekly (but that was done because I wanted to strengthen my uterus after my miscarraige. accupunturist said my "qi" was weak)

my gastroenterologist dr didnt want to put me on tenofovir. said will see me in 6mths?? I told him thats too long and he then said ok 4mths. I was actually thinking every mth! He has no knowledge of fibroscan, oxidative stress test and he still can tell me that he has consulted several other drs abt my case and all said not to treat. How? Is it safe for me to continue like that? happy with my results but worried at the same time too.
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Here is the test that checks for mutations http://www.specialtylabs.com/tests/details.asp?id=10529

Your DNA is low which is great. They usually put people on treatment with DNA above 1000 copies..

Stefano may explain better the link between vitamin D and antiviral activity. But we know that higher vitamin D doses have antiviral effect. So keep monitoring your DNA because it does fluctuate..

Other way of doing it is maybe put you on interferon and see if you can clear HBV..it will be a sequential treatment for you since your body seems to have some control of the virus.
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In no way should you be treated with Interferon if are planning to have a baby. because Interferon is contraindicated for pregnancy. Treatment is usually recommended if your viral load is > 2000 iu/ml (over 10,000 copies /ml) and ALT >  1 x ULN, but this is not relevant in you case as you are planning to have another baby.

Vertical transmission increases for women with very high viral load (> 10^7 iu/ml) even if the standard HBIG and 3-dose vaccine are administrated within 12 hr our birth. So some doctors would consider treatment in the third trimester for women with such high viral load.

So, look like you have successfully stopped Entecavir. You should continue monitoring in the event of a relapse, hopefully it will last for a long time. During pregnancy, however, the immune system is suppressed against potential antigens expressed by the fetus (LOL), so it is possible that your Hepatitis may re-activate during your pregnancy. Of course, your immune system will be restored after birth, so there is no need to rush to treatment. You should always consider your liver specialist and the ob/gyn.

Just my opinion.
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i agree too dont take drugs, keep going with vitamins and make serum vit d25oh superior to 50ng/ml and keep going with vit E too and let us know

how about ast/alt?hbsag quant not available?

after pregnancy i  d go with intf if hbsag is not too high

one thing to keep in mind pregnancy will elevate nagalase to suppress your immune system to protect the fetus, this may change immune balance with hbv, we will see this after pregnancy
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Don't you think it is better to treat HBV before thinking of getting pregnant? I think it is better to get once life together in order first regarding health.

Of course you cant use any of these heavy drugs when one is pregnant.. that is a given..
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I will try to do a vit d test elsewhere. This gastro I'm seeing doesnt think much of a vit d test and says it's not impt.

ALT 12
AST 15
Bilirubin total 0.8
Platelet count 307,000
WBC count 5800 (how to increase this? Noticed it's a bit low. Ref range is 3800-10800/uL)

For the moment, I will not get pregnant. I agree with veteranB. Health is more impt. Pregnancy can be postponed. I will try to see if I can get a Hbsag quant test done somewhere. meantime, I will monitor for the next few months and see if everything is stable first. Do you think I should do blood work again in a month's time? Or what is the frequency I should monitor now? I am afraid of a "flare".

Thanks very much for your knowledgeable advices. I have really learnt a lot from u guys and really appreciate it. I will pray that God will facilitate the process of hepB cures and lauch them ASAP! God bless!

SO this Quest Diagnostics can be trusted as accurate lab readings?
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pure melatonin 20mg daily before going to sleep can increase wbc but it is not important if they are in normal range
dont look at immune system numbers too much, it is more important the quality of immune response than the number of immune cells around

vit d is essential for hbvers, another stupid ignorant doctor just bothered to prescribe or not prescribe.....
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what did you do while taking beraclude... your results is amazing... I have a HBV DNA load of 70,000,00 plus and now 4 months taking this meds and im not yet undergo a blood chem since is to expensive i rather buy beraclude to continue my medication... can you give me advice on what you do while taking this meds... thanks I'll wait your reply
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can you teach us on how you prepare the phyllanthus niruri... we have this herb in our place which you can see everywhere... did you boiled it and drink or taking it as a salad?

I also taking USANA Hepasil DTX which have a milk thistle, turmeric extract and sylimarin which help liver function... I have plan to shift medication to alternative medicine which deals with herbs if Beraclude did not work for me... Thanks
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Stef, can I get your opinion on this? Now that I am not taking entecavir anymore, but hbv DNA is still detected. What can I do/take to make DNA undetected again? Will u recommend alinia mono therapy? Since alinia has no sides, I don't mind to take it.  Feels kinda weird not taking anything...it's ironic I know.
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