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HBsAg Reactive
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HBsAg Reactive

Sir for a job medical in 2005 i found incidently that

HBsAg +  ,   LFTs normal ,  HBeAg  Negative and HBe antibody positive

i had no problems with my health and still i am fit but now again in 2011 for another job medical my labs are as under

HBsAg Positive ,  HBs Ab Negative , HBc Ab Positive , HBeAg Negative ,  HBe Ab Positive , LFTs Normal and
PCR for HBV DNA ( Quantitative ) Negative

Now this HBsAg positive status is becoming a problem for my job abroad ,  how can i get it negative .. i am ready to take any medicines .. how about getting vaccine... interferon ... just want to get rid of this HBsAg please help me please
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Avatar_m_tn
At the moment, there is no definite treatment that will make HBsAg negative, i.e., a cure. However, you are in very good shape with LTFs normal and undetectable hbvdna. It means you have very low infectivity and should not be excluded any job. Unfortunately, there are still plenty of discrimination against and ignorance about hepatitis B.
66 Comments Post a Comment
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Avatar_m_tn
At the moment, there is no definite treatment that will make HBsAg negative, i.e., a cure. However, you are in very good shape with LTFs normal and undetectable hbvdna. It means you have very low infectivity and should not be excluded any job. Unfortunately, there are still plenty of discrimination against and ignorance about hepatitis B.
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Avatar_m_tn
It is illegal to discrimante against you and other HBVers because of your HBV but society does it anyway.

Then, some HBVers ask their friends for help at lab tests to get HBsAg- result.

Illegal?

Illegal against illegal?
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Avatar_m_tn
how about using adefovir 10 mg daily for an year , will it increase my chances to clear hbsag and how much are the chances  of me getting rid of it spontaneously
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Avatar_m_tn
and what about alinia...

and thanks a lot for such an informative reply
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Avatar_m_tn
There are no medications that will definitely clear the HbsAg at the moment. All of the antivirals (such as adefovir) are intended to control the replication of the virus, so as to reduce inflammation and normalize level of ALT. Since you already have undetectable viral load and normal level of ALT, these antiviral will not do anything for you.

Interferon is known to be able to clear HbsAg in a subset of patients. But whether Interferon has a chance to clear your HbsAg in your present state is largely unknown. Stef2011 will be able to tell you more about Alinina, but remember it is not yet an approved drug for Hepatitis B and how it can be used to treat HepB is still unknown.

You do have a small chance, 1-2% per year, to spontaneously clear the HbsAg, but it is a very small chance.

I know the disease is not a problem for you at the moment, it is the discrimination. This is a problem not imposed on us by a virus but by other humans. I don't know what country you are living in, in the West, discrimination against HepB patients are illegal. So it is ignorance, not health concern, that is driving discrimination.  
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Avatar_m_tn

your hbsag quantity will tell if you can clear it, check it and then we may have an idea if it worths to try interferon or alinia now, since effective drugs are close only having a very very low hbsag can make sense for treatment now

levels around 100-500iu/ml are those able to clear on intf
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Avatar_m_tn
thanks a lot for such valueable comments. your such nice comments and after sharing my issue with you , i feel so easy and releived. thanks a lot . i live in Pakistan and there is a lab which is doing HBsAg quantitative . i shall get it done and then i shall again consult you. God bless you
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Avatar_m_tn
hai stephen......we just  the same......i am also eager to go abroad.for a work ....but i am hepa b reactive......i dont know what to do..........hope f u will discover something knew....you will share it with us....i mean a medicine or an herbal plant....
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Avatar_m_tn
as for looking for jobs overseas - don't give up.There are jobs overseas that don't discriminate. It is not easy, but keep trying. There are still some countries that discriminate (like a few in the Middle East), complain to these governments directly and get your government to complain too.

As for cure, it will come one day but get on with your life, don't wait for it.
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Avatar_m_tn

today i gave blood sample for HBsAg quantitative . the result is expected on monday...........

lets see what it turns out to be
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Avatar_m_tn
my HBsAg quantitative report says
  cut off value 0.05 IU/ml
patient value 19 IU/ml

what does that mean...
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Avatar_m_tn
my hbsag quantitative results
   test is performed on the fully automated and integrated Abbot Architect Ci8200 system utilizing
Chemiluminescent technology. The assay has a sensitivity of <0.05 IU/ml. The numerical value of the
patient’s result represents viral load and can be used to monitor therapy for hepatitis B.

  cut off value less than 0.05 IU/ml

  Patient value 19.0 IU/ml

what does that mean
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Avatar_m_tn
Your number looks very good. I think you have a very good chance of clearing the virus soon. Stef2011 will check this. When your HbsAg level goes below 0.05iu/ml, you are considered to be negative for HBsAg - a cure.
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Avatar_m_tn

if hbsag is 19iu/ml you will clear hbv 99,9%, i d go on pegintf+simvastatin+vit d3 like otan to clear it very very fast

what about:
hbvdna
hbeag
ast/alt?
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Avatar_m_tn
hbsag +
anti hbs -
hbeag -
anti hbe +
alt and ast normal
hbv dna less than 116 copies / ml ( undetectable )

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Avatar_m_tn

pegintf+simvastatin+vit d3 and you ll clear like otan in weeks, it is clear you have an immune response already

or you are almost sure to clear in next 5 years but i would not wait and also there is a very rare chance for occult hbv by hbsag mutation...better clear now
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Avatar_m_tn
what about simvastatin vit d and alinia instead of peg interferon bec its a lot cheaper and oral and very few side effects

kindly also mention the duration of peg interferon
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Avatar_m_tn
and also what is the role of vaccination as i have a very very low anti HBs titre .
can it be useful ???
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Avatar_m_tn
what about simvastatin vit d and alinia instead of peg interferon bec its a lot cheaper and oral and very few side effects

pegintf is the main effector, vit d and alinia are just of little help to intf response.you may consider normal intf not peg which is out of patent and generic

kindly also mention the duration of peg interferon
it can be from 24 weeks to 48weeks

the role of vaccination...
this is of help only when hbsag is negative if hbsab does not develop
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Avatar_m_tn

also gcmaf might be a try if intf is very very expensive, gcmaf is 660€ for 2 months therapy but there is no data at all if it can clear hbv
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Avatar_m_tn
this peg interferon dose is 180 mcg once weekly for 24 to 48 weeks for hep b

can you confirm it
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Avatar_m_tn
peg interferon alpha 2 a 180 mcg once weekly
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Avatar_m_tn

you may do this:
start vit d supplements 10.000iu daily in case of vit d deficnecy 10-20ng/ml (test serum vit d25oh), in case normal take 5000iu daily until serum levels are 60-90ng/ml

when vitd25oh is at least 50ng/ml start alinia taken with meals every 4-5hrs to a total of 2-3g daily (pills are 500mg).take probiotics or bifidus yogurt while on alinia.do this for 4 to 12 weeks

check hbsag if still detactable add on pegintf+alinia+vit d3

since those who took alinia had hbsag drop of 1500-3000iu/ml in the first months it may be possible you clear hbsag by alinia only

update community with results
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Avatar_m_tn
regarding interferon for hep b

is it   peg interferon alfa-2a   180 mcg once weekly

kindly confirm it as i am checking its price in my country
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Avatar_m_tn

several intf can be used alpha-2a the most used i guess
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Avatar_m_tn

anyway at 19iu/ml it can be possible alinia clears hbsag in weeks since all those who tried it had decrease in thousands
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Avatar_m_tn
yea sure i am really desperate to lose this HBsAg .  i ll start medications real soon .  just completing my home work before going to gastroenterologist .
an i ll keep on updating the community
you are doing a lot for the community . again thanks a lot
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Avatar_m_tn
Bro, plz help me. i wan to know which Lab in Pakistan can do HbsA Quant. Thanks a lot.
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Avatar_m_tn
its done at chightai lahore lab
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Avatar_m_tn
did not take any drugs and repeated the test after 3 months and found it to be 13.7 from 19
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Avatar_m_tn
Now its 13.7
any comments and suggestions
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Avatar_m_tn
my HBsAg quantitative report says
  cut off value 0.05 IU/ml
patient value 19 IU/ml 06 months ago
after 3 months 13.7
and now will get report in a few days
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Avatar_m_tn
Now its 16

So depressed
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Avatar_m_tn
Now its 16
feeling depressed
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Avatar_m_tn
Did you start medication? What's the lab report? No need to be depressed, you are still healthy.
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Avatar_m_tn
just took vit D and hoped
as could not get alinia in pakistan
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Avatar_m_tn
HBsAg Quantitative 19.3 then 13.4 and now 16
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Avatar_m_tn
Why don't you do the Pegasys, stef2011 said it can clear. Maybe you should search Otan, a user here and learn his experience.
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Avatar_m_tn
actually i have quite a tough job now a days and  
taking pegasys with a tough job is difficult

Now arranged alinia
I have started  Vit D Alinia and simvastatin combo
will continue with these and may add pegasys after 3-4 months
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Avatar_m_tn
If my HbsAg is as low as you, i will do whatever I can to get rid of this virus. Many people can't even bring down their HbsAg to your level.
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Avatar_m_tn
Same here. Ali2456, people dream of getting numbers like yours, if they are truly correct. When they get those numbers they have a good chance of clearing for life.

You have a good chance of clearing the virus which millions of people are stuck with for life. If you don't make the right choices and continue to explore other methods than the virus can get the upper hand and the advantage.

It can mutate and your numbers can get in the millions, this could lead to Cirrhosis and HCC (liver cancer). You can also be very infectious and put your family and friends at risk.

If I were you I would take a more responsible approach.
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Avatar_m_tn
dear
i am greatful for comments
What can i do in your opinion
Wt do u suggest
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Avatar_m_tn
Whats situation at your end
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Avatar_m_tn
With numbers as low as yours I would do the following.

1. Start with a full set of labs and tests from a very good doctor
2. Get a genotype test and under an expert doctor look to start interferon therapy, possibly with Alinia

You may have a very good chance of clearing the virus if you act quick and smart. The virus is very smart, if you waste time it might get out of control of your immune system.

Also keep in mind in Pakistan most doctors are terrible. Your results could even be wrong.
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Avatar_f_tn
Any update ali? Did you start with peginterferon?
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Avatar_f_tn
Dear,

Please let me know that, in specifically my case where Hbsag value is 4007, which i have tested in June 2012 and DNA was not scanned in test. could i get success in medical examination for Australia immigration, as they have even mentioned on their website that they does not treat HBV as treat to public but in some cases need undertaking.
Please provide your doctrine in this regards, since i have received my EOI(Expression of Interest)  and have a chance of one month for visa application, but i need to pay a visa fees in this regards, which is approx 3060 AUS $ and i don't want to loos it.

Please advice.......
  
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Avatar_m_tn
Going to repeat the HBsAg quantitative
Did not take any medicines
18 months ago was 19
an year ago was 13.4
6 months ago 16

Fingers crossed lets see whats the result now
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Avatar_m_tn
hbsag + since 2005
anti hbs -
hbeag -
anti hbe +
alt and ast normal
hbv dna less than 116 copies / ml ( undetectable )

HBsAg quantitaive from 19 to 13.4 then 16 and now 20.23 over last one year
No treatment taken

Now have started with
-PEG interferon 180 mcg once weekly
-Alinia 2gm daily in divided doses
-Vit D
-Simvastatin 20 mg daily
Today was the first day
will recheck HBsAg after 8 weeks

any suggestion ?
any hopes ?
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Avatar_m_tn
test hbsag after 4 weeks instead of 8 weeks, its not too costly.
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Avatar_m_tn
yea its not that expensive
is it expected to come down so early
can be discouraging
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Avatar_m_tn
but check hbsag and cbc and report, it will be useful to predict future response.
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Avatar_m_tn
hbsag + since 2005
anti hbs -
hbeag -
anti hbe +
alt and ast normal
hbv dna less than 116 copies / ml ( undetectable )

HBsAg quantitaive from 19 to 13.4 then 16 and now 20.23 over last one year
No treatment taken

Now have started with
-PEG interferon 180 mcg once weekly
-Alinia 2gm daily in divided doses
-Vit D
-Simvastatin 20 mg daily

tolerated the first inj well
and continuing with the rest of meds
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Avatar_m_tn
20.23, and the unit is iu/ml?

hbsag should go und by 24 weeks, add hbv vaccine when hbsag goes und
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Avatar_m_tn
yes the unit is iu/ml
is that the right strategy
what do u think
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Avatar_m_tn
thanks a lot
i was waiting for your reply since the time i had inj pegasys 3 days ago
first day was awful and now feeling almost normal
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Avatar_m_tn
anything else i can do
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Avatar_m_tn
stef ???
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Avatar_m_tn
if you have reached good blood levels of vit d like 40-60ng/ml you can go on with pegintf and see hbsag at 24 weeks
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Avatar_m_tn
got two inj
many still to go
its tough but managable
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Avatar_m_tn
hey
got the 5th inj pegasys 180 mic today
platelet 159000
WBC 3000
ALT 103

ALT had always been normal before that  
HBsAg quantitative 20.9 iu/ml before starting therapy
Also taking Vit D

What does that mean
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Avatar_m_tn
hey stephen also comment on my raised ALT
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Avatar_m_tn
Newtr kindly comment on my raised ALT
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Avatar_m_tn
I am hoping it is an indication that your immune system is clearing the virus. Stef2011 will be able to tell you more. Keeping my fingers crossed for you.
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Avatar_m_tn
yea must think positive to cope up side effects of pegasys
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Avatar_f_tn
Hi ali! What sides are you experiencing while on int?
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Avatar_m_tn
a lot of weakness
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