Just read HBSAB and HBSAG double positive is possible and it's usually caused by an immune-escape(?) strain? What are the factors that will create one? Im HBSAB- and HBSAG+ myself, so im assuming what i have is one of the "common" ones.
immune pressure and some weak nucs like lamivudine, adefovir and telbivudine can make this mutations
in italy the hbsag mutants test is available in some hospitals: policlinico tor vergata rome, cisanello pisa (brunetto research laboratory) and san raffaele milan.maybe others have this test but for now i have found it at these hospitals
if hbsab is negative is very unlikly to have mutants, some dna polimerase mutations are linked to hbsag mutations too that's why resistance due to antivirals is very dangerous and combo is always a good thing
interferon is also responsible for hbsag mutants when monotherapy so i'd avoid making interferon mono too
Journal of Viral Hepatitis
Volume 18, Issue 6, pages 424–433, June 2011
Summary. Seroconversion from hepatitis B surface antigen (HBsAg) to
antibodies against HBsAg (anti-HBs) usually indicates resolution of
hepatitis B virus (HBV) infection. Here, two HBV-infected patients with
seroconversion to anti-HBs were found to be persistently positive for HBeAg
and HBV DNA. Immunohistology of liver biopsies confirmed the expression of
HBV proteins in the liver of one patient. The neutralizing ability of
anti-HBs in patient sera was demonstrated by blocking HBV infection of
primary tupaia hepatocytes. Analysis of the HBsAg-encoding region of HBV
isolates from patients indicated the coexistence of heterogeneous HBV
genomes in patients. The majority of recombinant variant HBsAg was reactive
in HBsAg assays and was able to bind to anti-HBs. Circulating immune
complexes (CIC) of HBsAg in patient sera could be detected by polyethylene
glycol precipitation and trypsin digestion. Thus, neutralizing anti-HBs may
appear in chronic HBV carriers for long periods but does not necessarily
lead to complete viral clearance.
studyforhope explained this muatnts perfectly in entry inhibitors post
immune pressure means that when immune system targets hbsag the virus just mutates that and so escape immune system.hbv vaccine doesn t cover this mutations.
it was said interferon makes no mutations but that was a wrong early ipotesis because they only checked the dna genome of hbv, now we have tests on hbsag and hbcag and research is made a more competent way.lso remember that drus makers say only what they want from trials so their trials have very poor value, they only tell you the good part for them....so as researcher double check results many new things come out like interferon making hbsag mutants, it doesn t happen often but it does happen and also monotherapy has no meaning for us as patients, it is just a way for government or insurance co to save money
in the end we will have india with cheap drugs and combos for patients (all tests are available already there) and US as the worst place to cure poeple...so it worths look there for affordable drugs combos
WHat if a person in baraclude therapy wants to have kids?
no effect on having babies or transmitting to babies, also the virus likes us to have babies......
Should he stop taking them for the mean time or is it totally safe?
no it shoudln t be stopped, hbvdna in the sperm does not infect the baby.it is important that the mother is vaccinated to avoid infection at birth
if you are hbvdna und there is no hbvdna in the sperm but the mother must be vaccinated anyway because it is safer.you can infect mother but not baby, it is only the mother to infect the baby at birth if she is a carrier
where do HEPB escape mutants come from? Aside from those who took lamivudine and/ or immunosuppresed. Are they much common with HBEAB + or HBEAB - people? Or doesnt matter what the HBEAG status of a person has?
if you are not on therapy and have high hbvdna the immune system is weak and the virus doesnt need to mutate and doesnt mutate.we can say he is quite smart.so off therapy these mutants are so rare we dont even need to menthion them
when you are on immune therapy and you respond withan active immune response on hbsag the virus is pushed to mutation.if hbvdn is very high you have more chances to make this mutation
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