pls help.. doubt regarding hepatitis B

[naveen1993]

I am hepatitis b positive diagnosed before 3 years..  age 22 years from india.. e antigen negative.. ast 19, alt 22.. HBV DNA 986 IU/ml.. my liver is otherwise normal.. I m feeling healthy. now my doctor advised me to take entecavir 0.5 mg/day for six months.. waiting for HBsAg quantitative value.. is it advisable to take entecavir in this situation?  if I take this tablet is there any chances to get HBsAg negative? pls tell me what should I do to make Both HBV DNA and HBsAg negative? ?

[StephenCastlecrag]

You have asked some interesting questions to which I do not have ready answers. Your doctor is proposing to treat you for 6 months with Entecavir in order to reduce your viral load, perhaps to undetectable. I am sure Entecavir will reduce your viral load, but I am not sure it can do it within 6 months to undetectable, but more importantly, I am not sure that your viral load will remain undetectable  after stopping Entecavir. Yours is only the second time I have heard that a doctor is prescribing antiviral treatment for an inactive patient. We are not doctors, so we have no clinical evidence that treatment will be beneficial in this instance, also I have not read any scientific literature reporting the same.
Since your qHbsAg is not low enough to have a go at Interferon, you may like to wait for 6 to 12 months to see how your viral load and qHBsAg behave. In the meantime you may like to check your Vitamin D level and to take supplement if it is low.

[SafiSifa]

I take some natural supplements during my treatment.

One of the supplement is cur cumin (turmeric). It is very popular spice in India. It is very very cheap, you should consider to take it.

See what I take: http://www.medhelp.org/posts/Hepatitis-B/Urgent-Advise-for-Entecavir-Usage/show/2044528

[naveen1993]

I too have same doubt like kapcio.. pls clarify it

[naveen1993]

thank u sir..

I have one doubt.. in my condition if I control DNA and surface antigen level by proper drugs, is there any possibility to progression of the disease to cirrhosis and cancer...?? what should I do regularly? how to monitor my liver?? how long I will live??

[kapcio]

Is there evidence that its beneficial to start interferon or combo treatment in the immune control phase? Is it easier to clear hep B then?
Is there any qHBsAg or HBVDna  threshold from which the clearance rate is higher? Why usually treatment starts when there is already damage to the liver and/or test results are very high?

[stef2011]

safisifa is a lucky one in the 2% who clears with antivirals but it is just like those who clear naturally per year which is about 3-4%, difficult to be so lucky like him

[stef2011]

antivirals are for life or tenofovir about 17 years, they have no effect on the virus just lower its replication stopping liver damage

the cure is use tenofovir until hbsag goes lower for 3-5 years and then add on peginterferon to clear it definitively.

[naveen1993]

Good luck... thaku for sharing..

[SafiSifa]

Read my story : http://www.medhelp.org/posts/Hepatitis-B/My-All-Test-Result-After-12-Months-Treatment-of-Entecavir-I-am-cured/show/2355051

[naveen1993]

Thank u sir.

My HBsAg quantity is 5418 IU/ml. my doctor told me that to reduce HBsAg I have to take interferon, since my dna level is low and LFT is normal I don't need interferon, for me treatment is not indicated but he just wants to reduce my hbv dna level with entecavir to avoid further future complications.. he thought that six months is enough to reduce it.

Is it needed?
If I take entecavir can I stop it after HBV DNA become undetectable? or when to stop?
or In this HBsAg quantity and DNA level what should I do? taking entecavir here will cause any problem?
Along with HBV DNA will entecavir reduce HBsAg atleast some extent?

pls guide me.

[StephenCastlecrag]

Being HBeAg negative, normal ALT and hbvdna < 2,000 iu/ml, you seem to be in the immune control (inactive) phase. Treatment is generally not required. This phase may last a long time, during which time you may become HBsAg negative. For some patients, they may transition to the immune escape phase (re-active) during which hbvdna and ALT will be elevated, treatment is then necessary.
In your case, treatment is not generally recommended. Ask you doctor what he hopes to achieve for you by taking Entecavir and why for only six months?

If your qHBsAg is low, less than 1000 iu/ml, you may like to try a 48 week course of Pegylated Interferon, it may give you a good chance to become HBsAg negative.

I am not a doctor, just my opinion.