I have a best friend who was diagnosed with Hep B and auto-immune hepatitis from the liver biopsy. His viral DNA count is in 400K+ range and he has level 3-4 cirrhosis according to the biopsy. His ALT/AST are in 100+ range.
Doctor put him on Viread (300 mg) for past two weeks. He has been having very bad bloating and his old bronchitis seems to have returned (most likely the overly active immune response).
My question is: what should be the typical treatment in this case? I know steroids would help reduce the inflammation overall, but in this case it could offset the anti-viral therapy. Would the auto-immune response automatically reduce once the viral DNA gets suppressed? We are going to the hepatologist this week. It has been 2 weeks since start of Viread.
what is fibroscan?biopsy is not reliable to measure severity of cirrhosis
he needs heptech products immidately if on cirrhosis and vit d3 normal levels to around 50-60ng/ml.vit d is beneficial in autoimmune diseases and hbv/cirrhosis too
viread is ok but hbvdn needs to be ud as fast as possible and if this is not achieved fast, say 7-8months better add etv too
autoimmune hepatitis can be managed by immune suppression but vit d and gcmaf have some reports about resolving autoimune diseases.i d use some vit d or probiotic gcmaf and see if autoimmune hepatitis improves or not
heptech products alone can help liver repair liver very fast, a fibroscan is a must in this situation, biopsy cannot monitor liver damage
Thanks for the quick reply. Sorry for my ignorance to some of the terms you used. What is etv? I am not sure if fibroscan was suggested by his hepatologist and if its standard procedure in USA? He has been taking milk thistle for past two months; not sure if that is ok to take along with anti-viral Viread? He also has bit low level of calcium.
sorry you are in US that s the worst healthcare in the world for liver and hbv (maybe also other diseaes)
to protect drug makers they are decades ago without fibroscan and hbsag quantity tests...without these tests yo buy drugs but can t see if hbv is getting cleared definitively or if liver is regressing damage
good thing is heptech is produced in US so you ll have easy access to it,
An update after 7-8 months since my original question. He has been on viread (300 mg) and the HBV viral load has been undetectable in 6-7 months since starting the treatment. His ALT/AST has returned back to normal and the AFP (tumor marker) levels are back in normal range (< 8 ng/ml) than original levels (before starting viread) of 70s. His platelets have been hovering around 120-130 range though. His ultrasound shows insignificant kidney/pancreas changes with slight splenomegaly but liver contours not being overtly cirrhotic. Overall, he feels much better and has been recovering from weight loss. His GI is very good in monitoring blood tests every 3-6 months and is hopeful of sero-conversion of HBV e-entigen in next few months.
this is useless, not an endpoint anymore, you must monitor:
fibroscan every 6 months and use heptech or change diet as suggested in the community, please search dont ask to repost the diet
ultrasound every 6 months to be sure no fatty liver or liver cancer present
hbsag quantity in iu/ml by abbott architect or roches elycsys
all the rest is just complementary tests to these main and most important tests, i d say the others are totally useless without knowing if infected cells are declining (hbsag quant) and if liver fibrosis is declining (fibroscan)
heptech plus diet with hbvdna is capable of regressing even advanced compensated cirrhosis in less than 2 years as it happened to me, quality food all organic, diet, heptech are the most important antivirals alone do not repair the liver and regress cirrhosis in just 50-60% of cases so the point is diet after taking the antivirals
Good diet (high in anti-oxidants) goes without saying. But it is hard to trust taking any herbal or supplements without long term and controlled studies in larger group. May be the good diet and antivirals make you believe more in these supplements than they are really worth. Anyways, thanks for suggestion.
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