HBeAaccuracyG

Hi,
I m on Lamuvidine+ Baraclude 1mg after I developed resistence to Lamuvidine two years afgo.
My DNA was up to 9log1.01, which came down to 4log1.248 last year. HBeAg was 6.95 which came to 0.12 last year.
however, HBeAg has gone to 0.16 in April09 and then to 0.25 in Aug09. So far I have not gone for DNA.
Do the last two results indicate increase in viral load?? what should b done then ??

[Sharp7]

HBeAg: the number does not mean much. In your lab, does 0.25 indicate positive or negative? Please get the HBV DNA test done frequently. I can comment further, but it is pointless until you tell me your HBeAg status. Were you positive earlier (6.95) and negative now (0.25) or do both numbers indicate that you have always been HBeAg positive, and still are?

[smruti324]

thnx for so fast a reply.
both r positive only. Yes, i have been always positive. i do not think negative HBeAg is geven  value ,as above 0.1, it is reactive and hence positive.

[Sharp7]

Alright then. Let us know of your current DNA VL

[chanthou]

Did you doctor say that you are resistant to Baraclude again?  Did your HBV DNA fluctuate? or just come down from 9 to 4 log?  I have HBV DNA fluctuate during the last six months:  from 120,000 copies to 280,000 to 40,000 and now in August upt to 500,000 copies.  I shifted from lamivudine last year to baraclude.  Doctor said I am resistant to both lam and baravlcue.

[bram44]

There is a test to predict drug resistance. Usually this is order before putting patient on a particulat treatment path. What is your starting DNA (before going on medication) and HBeAg status ?

[stevenNYer]

Important info is missing from your post.  You should post your age, estimate time of infection, eAntigen and eAntibody status, DNA, ALTs, all pre and post treatment.

Whatout that, this is a guess from just what you posted.  Being eAntigen positive to begin with, you probably had a gigantic viral load before your started treatment.  If this is true your doctor should not have treated you with just LAM because you can certainly expect viral resistance given that you are eAntigen positive with a huge viral load.

But you can't turn back the clock, so now that you have resistance to LAM, you should not be comboing with Baraclude (Entecavir) because these meds are in a similar class.  You should really combo with with Tenofovir.  Or even better combo with Entecavir and Tenofovir.  

Since you already have resistance to LAM, you need to do your best to minimize risk of future resistance.

[chanthou]

My DNA was 35 million copies at the start of treatment and HBeAg positive

[bram44]

As SteveNYer mentioned, can you post your age/AST/ALT ? Do you have any symptoms ?

Since you are already under doctor supervision, what is your doctor saying. Did he confirm there is drug resistance ?

Quest diagnostics did drug resitance test for me part of finding DNA geno type. May be you need such a test (which predicts mutations and resistance).