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HBsAg quantitative after 6 months on entecavir

Hi All
Started entecavir 0.5mg 6 months ago
Baseline readings were
1. Viral load 6250 Iu/ml (came down to 333 iu/ml in two months)
2. HBsAg quantitative was 1666.10iu/ml
Now 6 months after entecavir the HBsAg is gone up to 2636iu/ml

Please comment on this rise in HBsAg quantitative

3. VITAMIN D LEVEL was 19ng/ml
Now after 5 months taking 10000iu perday it has risen to 166 nmol/L
Normal range us 75-250 nmol/L
(last time same lab gave reading in ng/ml and now nmol/L,  how do I convert?)
29 Responses
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Avatar universal
once started never stop it untill by chance if u clear the virus off u.
Helpful - 0
Avatar universal
Nmarius- do keep us posted.
Are you HbeAg negative or positive?
Helpful - 0
1 Comments
HbeAg negative. HbeAb positive.(tested last year in july).
Avatar universal
Thanks for the inputs Jatashankar. Hoping it's an immune response :-)

Also my SGPT is 50 and SGOT 47 after 6 months on entecavir. Both had come down within range in two months from 140 and 80 respectively before I started entecavir. Now Viral load is "less than 20iu/ml" (it was 6250iu/ml 6 months ago)
Helpful - 0
1 Comments
I can say i am in your situation. Viral load 5 months ago ~6500 ui. Now after 5 months of etv is undetectable. Let see how our situation works in the future. I will do a hbsag quantitative soon and i will see if my last hbsag will increase or decrease. Before treatment start it was 12000 ui/ml.
Good luck!
Avatar universal
Rising and declining of hbsag is just a part of the chronic phase of hbv. U cannot predict anything significant on it. Its just like u feel very energetic on a day and lithargic on the day next. Hbsag variation is very unpredictable either on nucs or ifn. To my understanding till now, production of hbsag is linked both to immune system and virus's defence system. On ifn people respond differenlty. Some show immune boost up leading to lowering of hbsag titre while some show immune suppressed thereby increase in hbsag titre. When u stop ifn body immunity recovers to its original state and thereby hbsag decreases but will not remove it however it may happen in a low percentage people.
On nucs the drug slowly deters the virus to which the virus respond by defence of more hbsag production but gradually subside to continuous treatment.
Still the mystery of hbsag is unsolved. Reading various posts in this forum i personally feel entecavir is more superior in reducing hbsag than tenofovir though tdf is considered as superior drug.
Helpful - 0
Avatar universal
Rising and declining of hbsag is just a part of the chronic phase of hbv. U cannot predict anything significant on it. Its just like u feel very energetic on a day and lithargic on the day next. Hbsag variation is very unpredictable either on nucs or ifn. To my understanding till now, production of hbsag is linked both to immune system and virus's defence system. On ifn people respond differenlty. Some show immune boost up leading to lowering of hbsag titre while some show immune suppressed thereby increase in hbsag titre. When u stop ifn body immunity recovers to its original state and thereby hbsag decreases but will not remove it however it may happen in a low percentage people.
On nucs the drug slowly deters the virus to which the virus respond by defence of more hbsag production but gradually subside to continuous treatment.
Still the mystery of hbsag is unsolved. Reading various posts in this forum i personally feel entecavir is more superior in reducing hbsag than tenofovir though tdf is considered as superior drug.
Helpful - 0
Avatar universal
Yes,  stress does play a role...
Helpful - 0
Avatar universal
Oxidative stress. Her hbvdna increased when she got stressful and exhausted. During treatment she was not in good mood too.
Helpful - 0
Avatar universal
Thanks Chimpz for the input. Want to know why that happens though
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Avatar universal
SPhereAj: my mom 56 yo had treatment and hbvdna became und. But hbsag increased.
Helpful - 0
Avatar universal
Hi All
The Viral DNA result came in today, it's undetectable.
In two months it was 333iu/ml from 6250iu/ml. Nearing 6 months it's undetectable. However HBsAg quantitative has gone up to 2656 from 1666.10iu/ml
Helpful - 0
Avatar universal
Except Hbsag thats way iam worried
Helpful - 0
Avatar universal
Then what are you worried about coolnaresh?
Helpful - 0
Avatar universal
already i told all test are normal
Helpful - 0
Avatar universal
There is antiviral therapy in allopathy that can keep the check on the virus and protect liver damage. Ayurveda also does not have prove cure for hepatitis b, neither has homeopathy.
Helpful - 0
Avatar universal
There is no treatment in allopaty
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Avatar universal
Coolnaresh
I am guessing you are from India. I am also from India.
Best thing is to see liver doctor/hepatologist.
Do following blood tests for you and your wife
1. LFT -  liver function test
2. HBsAg quantitative test,  Viral load
The liver specialist will be able to guide and suggest a treatment if necessary.
If you hot infected recently then  you may clear it on your own
Helpful - 0
Avatar universal
I am not creating the topics this is true.my wife hand broken with accedent.when doctors told to me your wife have hbsag with high values.they told me to your also effected that virus wiyhout testing.they told to me tell the virus load but after that they dont tell any thing about that. but 2 months later checking my wife getting value.
Helpful - 0
Avatar universal
Wow. Thanks, you know this stuff well Study For Hope!!!!  :-)
Helpful - 0
Avatar universal
Thanks again Studyforhope
I wonder about Safisifa's case. He cleared the virus in one year and his HBsAg steadily decreased on entecavir 0.5mg. Could it be due to supplements like blackseed, honey,  turmeric technology that he took regularly?
Or is it age?  He was 29 when he started antiviral. I am 46.
I am starting blackseed with honey, let's see what happens
Helpful - 0
1 Comments
The most likely reason for safisifas success is a lucky new tcell clone and an effective epitope, not mutated,  that allowed a systematic elimination of infected cells.
The supplements that he took are additionally helping his immune cells to function well.

The younger you are the better your tcell system works.
Furthermore, a shorter time in which the virus could adapt it's epitope structure to the recognition forces of the tcell system will lead to a higher chance of finding an effective tcell clone.
Avatar universal
@studyforhope, thanks for the insight. Now what to do?  Continue with antiviral? Will HBsAg decrease eventually? Is this rise harming the liver?
Looking forward to your inputs.
Thanks again
Helpful - 0
1 Comments
I would continue with the antiviral and not worry about the increase of the surface antigen. Its rise will not harm the liver.
cccDNA tends to lower to a certain degree upon prolonged antiviral use, this might also decrease your hbsag levels in the future. But not to a large degree.
Avatar universal
Coolnaresh, we understood your situation. Stop creating any topics, your wife should test again for HbsAg and HbvDna, do a fibroscan, and other liver tests, like ALT, AST. Than, come back with results.
Helpful - 0
1 Comments
exectly
Avatar universal
My wife with HBsAg that is first test value is 7010 , after 2 months it will be 483.82 iu/ml. (billrubin is nil) those tests are CMIA tests Remaining alla test are normal. But I am not suffer with that virus. My dought is it is cureble or not we dont have any childrens please help me sir. first test date is 18/04/2016 and second test date is 27/06/2016. Please help me......
Helpful - 0
Avatar universal
My wife with HBsAg that is first test value is 7010 , after 2 months it will be 483.82 iu/ml. (billrubin is nil) those tests are CMIA tests Remaining alla test are normal. But I am not suffer with that virus. My dought is it is cureble or not we dont have any childrens please help me sir. first test date is 18/04/2016 and second test date is 27/06/2016. Please help me......
Helpful - 0
Avatar universal
Thanks Stefen
Will check
Helpful - 0
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