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Hepatitis B

My mother is in Vietnam and she need help with this test result:
Hbsag: 1.87x 100000
ALT: 147
AST:98

She has hepatitis B for more than 2 years. She took Baraclucle 0.5 mg for 6 months but stopped for more than a year due to some redness reaction in her body. Can she continue to take this drug? For how long if she continue? Please help my mom about treatment because she did not understand any of these and she does not have much help from the doctors in her own country. Any advice is very appreciated.
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Avatar_m_tn
Hbsag: 1.87x 100000
you got it wrong, check carefully hbsag cannot be reported with this number with no assays, that number of hbsag cannot be reached with any unit or test.recheck and post complete number and unit

ALT: 147
AST:98
don t say much except that virus is active and liver damage too

baraclude cannot be taken for 6 months, just useless and dangerous, this drugs takes from 6 months to years to just start activity and must be managed by a doctor who knows both drug and hbv, the current doctor doesn t.
to some redness reaction in her body, never reported for entecavir, probably not due to entecavir and even if so no doctor will discontinue this but switch to another drug

she must find a good liver specialist from what you posted she didn t see any doctor, it is not possible to manage hbv on a forum without an expert doctor
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Avatar_m_tn
post the other tests taken and a better option than entecavir might be tenofovir, more potent and no resistance detected for this drug but anyway you have to find a liver specialist first
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Avatar_m_tn
you might inquire here for expert liver specialists in vietnam so that they can manage hbv treatment possibly by tenofovir instead of entecavir (avoid antivirals like lamivudine, adefovir, telbivudine,clevudine, not potent enough)

http://www.vnmap.org/


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Avatar_m_tn
contact this member
tambui

he is having more advanced tests and better hbv managment in vietnam than in US, he is seroconverting after 11 years of infection by tnf+lam+thymosin combo
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Avatar_f_tn
Yes I posted wrong the test result. It is the test of HBV-DNA with the result of 1.87x 100000. That is her last test result. The following are her previous results:
Dec, 2007: hbv- dna: 9.46x 10000 copies/ml
June, 2008: hbv-dna:  less than 500 copies/ ml
April, 2009: hbv-dna: 2.74x 1000 copies/ml and AST is 37, ALT is 58
......, 2009: .............: 600 copies/ml
Aug, 2009: 1.34 x 100000 copies/ml and AST is 41, ALT is 76
Dec, 2010: 1.87 x 100000 copies/ml and AST is 147 , ALT is 98

She has just started Baracluce for two days. Should I told her to stop it and change into tenofovir? I do not no they have it available in Vietnam. Do you know how much it may cost? What is your advice on this? I need some guidance. Thanks a lot.
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Avatar_f_tn
Also, is there any other tests you recommended my mom to get? She is taking 0.5 mg Baracluce now, is it strong enough? Thank you so much for your reply
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Avatar_m_tn
baraclude is ok, i am on it too because i have weak kidneys, she must check that hbvdna gets to zero by 6 months possibly

it is very important she was not exposed to any other drug before and the best managment would be resistance test before hbvdna gets to zero because baraclude doesn t work if there are lamivudine mutants.but i don t think this test is available there so she might just check that hbvdna gets to zero by 6 months and then monitor every 3-6months to stay zero and never stop the drug

tenofovir should be cheaper than baraclude, the names of tenofovir drugs are: viread from gilead, tenvir from cipla and tavin from emcure

these drugs will not eradicate hbv but just stop any liver damage and progression to liver cancer or cirrhosis, to have some chances to eradicate hbv baraclude or entecavir must be comboed with nitazoxanide as shown n our posts or interferon, interferon can have heavy sides so nitazoxanide would be the best choice and also the drug tambui took might help

if hbvdna doesn t get to zero by 6 months it is better to combo with tenofovir 2-3 months and then use tenofovir only.tenofovir is the most potent with zero resistance, baraclude 1,2% resistance if there are no lam mutants (with lam mutants resistance is very high)
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Avatar_f_tn
thank you so much for your valuable answers.
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Avatar_f_tn
is that ok if my mother take Baraclucle 2 hours after she eats dinner? or can be any time?
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Avatar_m_tn

no absolutely 2 hours after the last meal and no meals the next following  2 hours.the stomach must be empty because food lowers absorption of drug

i also noticed that taking the drug while sleeping had less potency, probably if you lay in bed absorption is less

this is very annoying but i had no choice because tenofovir made my creatinine jump high borderline so etv is the only choice for now

if you have a chance to add nitazoxanide do it too since it is active on hbsag and all hbv strains so it might both protect from hbv mutations even if the risk is only 1.2% and eradicate hbsag
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Avatar_f_tn
Do you know anything about a drug name: Planovil (300mg)- supposed to use for hepatitis B and HIV?
My mother is taking Braclule and her doctor in Vietnam change her drug using Planovil. I am so confused and can't find it online.

Many thanks
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Avatar_m_tn

just check active ingredients on the drug

i dont see why change entecavir (baraclude) to Planovil unless this drug contains tenofovir
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Avatar_f_tn
Dear Stenfano,
Planovir does contain Tenforvir after I checked it out. Its ingredient is Tenofovir disoproxil fumature, 300mg. It is used for HIV and Hep B patients. I assume that it is Tenofovir. Please correct me if I am wrong.
Do you think it is ok to switch drug like that? Does she has to take calcium with it? When she should has to check her BUN? Can she take multiple vitamin with it? Does she has to take with an empty stomach?

Thanks,
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Avatar_m_tn
Do you think it is ok to switch drug like that?

yes it is the best especially in combo with lamivudine like the other member from vietnam, of course lam must be never taken without tenofovir because it makes resistance while tenofovir makes no mutants or resistance ever.remember to check creatinine because on kidneys already damaged tenofovir increases creatinine and kidneys damage while it is perfectly ok with healthy kidneys

Does she has to take calcium with it?
no better take vitamind or daily sun exposure, in case she takes vit d she needs to check calcium and vit d level every 6 months.

should has to check her BUN?
no not bun but creatinine

Can she take multiple vitamin with it?
i'd take alinia (nizonide500) instead of vitamins.vitamins are useless if she had a good diet, only vitamin e 300/400iu and vitamin d have had results increasing immune response to hbv.also selenium and zinc are ok and it can be obtained eating 2 or 3 walnuts a day
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Avatar_f_tn
You are so thorough and explained very well. Your time and kindness are well- appreciated.
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