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Hepatitis B Treatment

I m 26 year old. Dec 2014 i have donate blood from where i got call of having HBsAG reactive.
I have done following tests with consultation of Gastroenterologist:
        
   DATE          TEST                         RESULT                     RANGE                                     Method

   8 jan 2015   HBsAG                       >250 ( reactive )          non reactive =0.05IU/ml

   9jan2015     HBcAb-IgM Ab HBc     0.02(non reactive)        non reactive =1.0

         "           SGPT                         35.2                           4-36U/L        
         "           SGOT                         30.5                           8-33U/L
         "           Alkaline phospate        83.4                           20-130U/L
         "           GGTP                         24.0                           11-50IU/L
         "           Bilirubin total               0.25                            0-1.2mg/dl
         "           Bilirubin Direct             0.14                            0-0.3mg/dl
         "           Bilirubin Indirect           0.11                            0.1-1 mg/dl
         "           Total Proteins              7.40                            6.30-8.40gm/dl
         "           Albumin                      4.30                            4.02-4.76gm/dl
         "           Globulin                      3.10                            2.3-3.5gm%
         "           A/G ratio                     1.4                             1.10 - 2.20

   12jan2015   HBeAG                        3.703 (reactive)           non reactive =1.0S/CO

         "          AntiHBe                       0.07(positive)               Negative >=0.5 ratio                    ELFA
                                                                                         equivocal 0.40-0.49ratio
                                                                                         positive 250 ( reactive )          non reactive =0.05IU/ml

         "           HBsAB                       1.36                           0 - 10 IU/ml                               CMIA

         "           SGPT                         25.0                           4-36U/L          
         "           SGOT                         23.0                           8-33U/L
         "           Alkaline phospate        88.0                           20-130U/L
         "           Bilirubin total               0.40                            0-1.2mg/dl
         "           Bilirubin Direct             0.10                            0-0.3mg/dl
         "           Bilirubin Indirect           0.30                            0.1-1 mg/dl
         "           Total Proteins              8.10                            6.30-8.40gm/dl
         "           Albumin                      4.40                            4.02-4.76gm/dl
         "           Globulin                      3.70                            2.3-3.5gm%
         "           A/G ratio                     1.2                             1.10 - 2.20

   27apr2015   HBeAG                        1.286 (reactive)           non reactive =1.0 index

         "          AntiHBe                       1.43(Nonreactive)         non reactive>1.0 index                  CMIA
                                                                                         reactive<=1.0 index

   29apr2015  HBV DNA PCR Quant.  <6 IU/ml                      6-110000000IU/ml                         Real time PCR
                                                                                                                                            COBAS TaqMan

   24apr2015  USG(ABD+PELVIS)        Normal                              
                                          
   23apr2015  FibroScan                      3.8kPa (normal)    

I am taking Enticavir 0.5mg daily. my doctor has told me to continue with entecavir 0.5mg.
Do I have to continue entecavir after HBeAG becomes non reactive?
Please suggest me how to continue my treatment to make HBsAG non reactive.
What tests to be done to track my treatment ?

Thanking You
  
17 Responses
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Avatar universal
thank you stephen
Helpful - 0
Avatar universal
HBVDNA is still in the low range, less than 2,000 iu/ml. The variation may be due to different labs.  
Helpful - 0
Avatar universal
got my HBV DNA quant. report :
9 sep 2015  - 179 IU/ml (different lab)
29 apr 2015  -   <6 IU/ml   (same lab)
12 Jan 2015   - 126770IU/ml (same lab)
I am worrying about increase in HBV DNA.  I missed entecavir one day otherwise i take it regularly. please comment on my report.
Helpful - 0
Avatar universal
HBeAg is 2.806 (5 aug 15). yet to do HBV DNA.
I am skinny one, my BMI is 16.8 and my fat percentage is 15%.
How can I have fatty liver ?
Helpful - 0
Avatar universal
A drop in HbsAg is always good. If your ALT remains normal, damage to your liver, in my opinion, will be minimal or zero. However you should take measures to tackle your fatty liver - better diet and more exercise?
Wait for your hbvdna result.
Helpful - 0
Avatar universal
U have responded well to etv. Once u develop anti hbeag ur hbsag will go further down. U can start peg IFN if ur hbsag falls further down after a few weeks.
Helpful - 0
Avatar universal
I am taking entecavir 0.5mg daily.
My HBsAg value
06 May 2015 -  23119.64 IU/ml
30 jul 2015 -    10495.13 IU/ml
My USG was normal but this time (05 Aug 2015) it shows Grade - I fatty infiltration of the liver .
05 Aug 2015 - ALT/AST  - 23/24.
waiting for other reports..
kindly requested to interpret. is it improvement or more damage to liver?
thanking you,
Helpful - 0
Avatar universal
Yes.
Helpful - 0
Avatar universal
Does hbeag seroconversion indicate change of phase ?
I have checked my report of dec 2013 at blood bank, it was hbsag reactive.

Helpful - 0
Avatar universal
The high level of serum HBsAg is consistent with someone who is in the Immune Tolerance phase.
Helpful - 0
Avatar universal
I got my HBsAG quant. test @Dr. lal path labs in pune, India.
It is 23119.64 IU/ml (6may15). what is the significance of this value?





Helpful - 0
Avatar universal
A chance, but small.
Helpful - 0
Avatar universal
Thank you.

Is there any chance that my current treatment will make HBsAG non reactive?
Helpful - 0
Avatar universal
You have responded well to ETV, your ALT is normal and your liver is in very good condition. Also your viral load (hbvdna) is very very low. It is possible you are in the transition period from HbeAg positive to HBeAg negative, because your HBeAb is positive, then negative.
All the guidelines suggest you can stop treatment after HbeAg becomes negative and HBeAb becomes positive and a period of consolidation. Discuss with your specialists then. Consider a quantitative HbsAg (use automatic dilution to get a precise number, not just greater 250 iu/ml) to give yourself more information.
Helpful - 0
Avatar universal
When hbsag will negative then u will have to stop entacavir. If u wil stop medicine virus will replicate with huge ammount. U have seroconvert from hbeag positive to hbeag negative. Consult with stef he will guide u in better way
Helpful - 0
Avatar universal
I have consulted three gastroenterologist. One has suggested to start interferon injection. second asked me to start tablet. rest one told me not to start treatment as my sgpt/sgot are normal and wait for other 3 months.
I have started Entecavir 0.5mg on 29jan2015. After 3 months reports are as below:                              
24apr2015 HBsAG >250 ( reactive )  CMIA  
24apr2015 HBsAB   1.36                CMIA
24apr2015 SGPT                     25.0                                  
24apr2015 SGOT                     23.0                          
24apr2015 Alkaline phospate        88.0                        
24apr2015  Bilirubin total               0.40                            
24apr2015  Bilirubin Direct             0.10                          
24apr2015  Bilirubin Indirect           0.30                            
24apr2015  Total Proteins              8.10                            
24apr2015  Albumin                      4.40                            
24apr2015  Globulin                      3.70                          
24apr2015  A/G ratio                     1.2                            
27apr2015  HBeAG  1.286 (reactive)  CMIA  
27apr2015  AntiHBe    1.43(Nonreactive)  CMIA
29apr2015  HBV DNA PCR Quant.  <6 IU/ml    COBAS TaqMan
24apr2015  USG(ABD+PELVIS)        Normal                             23apr2015  FibroScan                      3.8kPa (normal)    

I am taking Enticavir 0.5mg daily. my doctor has told me to continue with entecavir 0.5mg.
Do I have to continue entecavir after HBeAG becomes non reactive?
Please suggest me how to continue my treatment to make HBsAG non reactive.
What tests to be done to track my treatment ?

Thanking You
  
Helpful - 0
Avatar universal
Reports 3 moths before
08jan2015 HBsAG >250( reactive )              CMIA  
09jan2015 HBcAb-IgMAbHBc  0.02(non reactive) CMIA
09jan2015 SGPT                         35.2                          
09jan2015 SGOT                         30.5                          
09jan2015 Alkaline phospate        83.4                          
09jan2015 GGTP                         24.0                          
09jan2015 Bilirubin total               0.25                            
09jan2015 Bilirubin Direct             0.14                            
09jan2015 Bilirubin Indirect           0.11                            
09jan2015 Total Proteins              7.40                            
09jan2015 Albumin                      4.30                            
09jan2015 Globulin                      3.10                          
09jan2015 A/G ratio                     1.4                              
12jan2015 HBeAG  3.703 (reactive)     CMIA  
12jan2015 AntiHBe 0.07(positive)         ELFA
12jan2015 HBV DNA PCR Quant.126770IU/ml     Real time PCR
12jan2015 Anti HCV   0.5 Non reactive CMIA
12jan2015 HIV(ELISA)  0.18 non reactive CMIA
13jan2015 USG(ABD+PELVIS)  Normal                                                
21jan2015 Liver Biopsy  Grade I inflammation, mild Portal Fibrosis (stage I)    
Helpful - 0
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