HBV DNA test count

4/12/2010

HVBsag +, HBsab-, HVBeag- HVBab +
HVB DNA count,  118,000 IU or 565,000 cop
ALT 51, AST 28

5/05/2010
Doctor put me on Viread I took it for 1 month

6/11/ 2010

HBV DNA count,  77 IU or 448 cop
ALT 29, AST 18
my question is, should I expect the viral load to go down to zero? if it does, what is my chances getting HVBsag-?

[stef2011]

my question is, should I expect the viral load to go down to zero?
yes if you keep taking viread(tenofovir)

if it does, what is my chances getting HVBsag-?
zero, no hbe negative seroconverted under antivirals, there is 3% on etv but in general antivirals do not clear hbsag

since you are hbeab positive and hbeag negative you have high chances if you add nitazoxanide to tenofovir (viread) but before hbvdna gets to zero because when hbvdna is zero immune system gets suppressed by antivirals and response to immune modulators like nitazoxanide and interferon are less

follow our alinia thread, hbsag has got big drops on hbe negative in the first weeks.to test response to ntz you must find a lab for hbsag quantification in iu/ml

[kenya3510]

I Thank you very much, now what should I do? is it better to hold off on viread now? also I am utilizing quest diag- for a lab, and are they ok?, can I buy ntz over the counter? if not how can I obtain it.

[stef2011]

http://www.lupinpharmaceuticals.com/adrsub.htm#product_t
any of these, check for your country in the list

quest diag- for a lab, don't know about it, you just need to check hbvdna and hbsag both in iu/ml

look for ntz as soon as possible so maybe you get it before und, but even if you get hbvdna und ntz will work although less

keep taking viread once started viread cannot be stopped and add ntz to it

[kenya3510]

Thank you very much, also you say don't stop viread, but my doctor only gave me 30 days worth of viread and he told me to do a blood test. I did, week later I called to find out for the test results and the Doc/assistance told me the results, and she gave me an appointment date to see the doctor which is next week thursday, mind you all this time since my blood test date 6/12/2010 I was not given more viread nor refil. since i stop viread till my doc sees me will be almost more than two weeks. my question is, can you stop viread for a few weeks to a month and get back to it?  what is the sideffects.

[kenya3510]

FYI, I just found this article, and I live in tampa florida.

http://www.mahalo.com/nitazoxanide
~~~~~~~~......

TREATMENT OF CHRONIC HEPATITIS B


Nitazoxanide alone has shown preliminary evidence of efficacy in the treatment of chronic hepatitis B over a one year course of therapy[10]. Nitazoxanide 500 mg twice daily resulted in a decrease in serum HBV DNA in all of 4 HBeAg-positive patients, with undetectable HBV DNA in 2 of 4 patients, loss of HBeAg in 3 patients, and loss of HBsAg in one patient. Seven of 8 HBeAg-negative patients treated with nitazoxanide 500 mg twice daily had undetectable HBV DNA and 2 had loss of HBsAg.Additionally, nitazoxanide monotherapy in one case and nitazoxanide plus adefovir in another case resulted in undetectable HBV DNA, loss of HBeAg and loss of HBsAg[11]. These preliminary studies showed a higher rate of HBsAg loss than any currently licensed therapy for chronic hepatitis B.The similar mechanism of action of interferon and nitazoxanide suggest that stand-alone nitazoxanide therapy or nitazoxanide in concert with nucleos(t)ide analogs have the potential to increase loss of HBsAg, which is the ultimate end-point of therapy. A formal phase Ⅱ study is being planned for 2009.(World Journal of Gastroenterology 2009 April 21, Emmet B Keeffe MD, Professor,Jean-François Rossignol The Romark Institute for Medical Research, Tampa)

[stef2011]

they are crazy people these antivirals cannot be stopped because the virus can lead to mutation
do not go there anymore look for a reputable specialist, if you go on and off these antivirals you can develop resistance mutations that make virus untreatable by any drug, they are not doctors they are killers

plus i dont see the point of a blood check at one month, these drugs require months to years to make hbvdna und according to its quantity and you must get a level of hbvdna much less than what assays can detect to be sure you will not develop resistance

believe me they don t know what they are doing, what country is it?i am curious of such stupidity in medicine

[kenya3510]

I am in florida,
I think the drug worked in my opinion, because in less than 2 month I got it down to 77 iu/m from 118,000 iu/m. I have an appointment next thursday and planning to talk to him about Alinia also. Tomorrow, I will see if the pharmacy can refill viread with out the doctor's permission.
Stefano, is Alinia over the counter medicin? any how thanks for your help

[stef2011]

no you need prescription but since on trial for hcv and not hbv you might only find few doctors for prescription, on hcv community some in us could do it to have insurance coverage

check the lupin distributors in your area and how to do without a prescription for nitazoxanide.doctors cannot prescribe since there are no guidelines on hbv it would be off label.actually alinia is produced by romark in tampa and they've even supplied alinia free for hcv members with no money to buy but they are not interested on hvb and will not offer any assistance

if you are in florida do change doctors, you will find better ones for sure, you might ask any expert or liver specialist in the community and start and stop antivirals in a month is a crazy thing

[enolia]

Hello

In case you get another blood test, please let us know if stopping viread caused any flare up in your viral load.
I am also on viread and was wondering at some point if I could stop it or not but I have been told by Dr and everyone here that this is dangerous.

Good luck,

[stef2011]

it is very difficult to have flare up in one month only, the risk is virus mutation if you start and stop

the flares up are due to the fact the complete suppression of hbvdna suppresses immune function too (hbcab titer of antibodies lower and other substances related to hbcab) so when you stop tenofovir (or any other Nuc) there is no immune system to block the virus.
if the cccdna has got very low by a long treatment (low hbsag) there will be no flares up on the contrary the virus might infect a lot of cells in the liver making a mess.

so this is why combining interferon can make possible to stop Nucs safely, interferon reactivates immune system and when you stop Nucs there will be no flare

[enolia]

Or if you use Alinia in combo with Nucs? It should (hopefully) trigger the same process and help protecting from flares...But we don't have any enough data on HBV...

[stef2011]

yes in theory this works, but you have to check if hbsag gets lower during ntz so that you have proof ntz is active

i say in theroy because we have seen from patients on alinia group that who started alinia while hbvdna und and hbe positive because of prior entecavir or tenofovir therapy has very little response, the same happens with interferon.so it would be best to have little hbvdna positive when you start ntz

there is a test that can predict flares which is more sensitive than hbvdna pcr, i posted about earlier, it is hbcab Igm quantitative.if higher than 0.2s/co virus is becoming active, if lower than 0.2s/co virus is inactive (best values under 0.0s/co).for example mine is decreasing slowly 1.7s/co in march and 1.5s/co in may

so as they have made on alinia hcv trials the sequence for best results is:
ntz lead-in for at least 4-12weeks
after add interferon or entecavir or tenofovir

in my case it worked the same but because i added long before hbvdna und:
etv first for about 12 weeks
ntz added when hbvdna still at about 126iu/ml

[stef2011]

we have enough data, if you check closely with hbcab Igm you can safely understand if flare is coming on go back to tenofovir before any damage happens

plus if you get some hbvdna at 100iu/ml ntz will become more active, so close monitoring of hbsag, hbcab, hbvdna pcr quantity can safely allow to stop tenofovir

[stef2011]

hbcab sorry forgot hbcab Igm (not to be confused with hbcab Igg)

[kenya3510]

I been taking viread for the last 5 weeks, but I did stop for less than a week and got back on it, my question to you is, how long since you been taking viread and if any sides, and do you combo with Alinia now?

[kenya3510]

I run in to this article about chinees medicin, what do you think?

http://www.itmonline.org/arts/hepb.htm

[stef2011]

not safe, sources are not controlled and there are no real trials.it is known that phillantus have some antiviral effect but since we have alinia, antivirals and interferon with knwon safety and results (and limits too) i d say all other herabls are a waste of time.
there would be no hbv in china if they worked

[kenya3510]

Thanks

[enolia]

I have been taking viread since last December (6 months now) and there is no sides really. In the begining I felt some abdominal pain and some gas but it went away now. I am more afraid of the long term side effects and I hope I can find a solution before that time. I am not on combo with alinia yet as I am pregnant and don't want to take 2 drugs at the same time (with baby)...I will wait until after delivery and try to have the combo even though I would have to figure out how (hard to have it prescribed by Dr).

Thanks Stefano for all the explanations.

[kenya3510]

I just met with my doctor today and I ask him if there is known sides on viread and he told me nothing so far he also confirm that i might have to take it for a long time or till the hbv clears itself out, which less than 5% of the people do clear it out. (long shot).
I asked him about Alinia, and he reply that, it is used for antibiotic, however they are testing it for HCV as this time, but he don't know nothing about utilizing it for HBV and he just said to wait until all the hype is settled not to do anything until then.