if you are on peg the best combo is:
peg+simvastatin+alinia+vit d3 and possibly tenofovir too, this will improve hbsag clearance veyr very much because peg monotherapy has only hbv clearance of 8% in 48 weeks, too low
heptech products are all ok except fibroguard, you shpuld not take fibroguard as lon as you are on peg
vitamin d take 5000iu daily if your blood levels are around 25ng/ml, if lower 10.000iu a day.after 5-8weeks check vitd25oh and calcium and lower to 5000iu a day if vit d levels are higher than 60ng/ml.optimum vit d levels are 60-80ng/ml
start with tenofovir, one pill a day, at least one year of hbvdna undetactable before trying peginterferon add-on
add alinia 12 weeks before peginterferon add on, pills of 500mg with meals every 4-5hrs, a total of 5 pills a day
simvastatin, add 4 weeks before peginterferon add-on, try 20mg a day for 2 weeks and if no sides 40mg a day
And someone told me that vit d3 is toxic for liver,
this is absolutely a lie from a very ignorant person, vit d3 is completely the opposite and toxicity is false too, there is no cases registered about vit d toxicity at any dose, the only thing confirmed is vit d3>150ng/ml can increase calcium but the blood levels we need are 80-90ng/ml and it is so difficut to get these levels that getting to 150 is just impossible, you need millions iu per months
vitd3 has been shown to prent cirrhosis, fibrosis, cancer, hbvdna lowering and ast/alt lowering.tell the person who told you such stupidity as vit d toxic to go back to school and stop being a doctor before making damage to patients, such ignorance doctors just need to be sued or left with no job, i am so tired of stupid ignorant doctor and all claims i hear on this board, i d start to question "why most doctors are ignorant"?
the combined use of tdf, alinia (ntz), simvastatin, is all aimed to have peginterferon response, both alinia and sim have little if no values used alone but all combined this way they can make previous interferon non responders to interferon responders
interferon response monotherapy is about 8% in 48 weeks but if interferon is added to ongoing tdf long term therapy the percentage goes from 8% to 40% at 48 weeks.alinia and sim may have other synergictic actions
the response at 96weeks of tdf+pegintf is 90% and clearance is also expected very high, the trial is still ongoing so we just know hbsag was very low on those contniuing and responding (the 40% who cleared stoped at 48weeks obviously)
ok thank you thou i need to clarify couple of things:
1.Will this make things worse if you take both INT+TDF from the start or just that the interferon effect on hbsag will incerase to that hopefull 40% (clearance chance per year ?) after 1-2 years of undetectable hbvdna ? Reason I ask this is that if I start INT now I will have it for free.
2.Correct me if I'm wrong on this - for my situation having chronic hep b since childbirth with --no treatments undergone yet-- somehow body got rid of hbe (-) now at age of 27 (hbsag around 3000 coi, hbv-dna around 3000 iU/ml) some doctors say I have more difficult situation than hbe+ patients in terms of treatment . And they sometimes say that may mean treatment to the rest of my life. What does it mean ?
3.You said that Entecavir has no effect on hbsag correct me if im wrong. How about TDF ?
hbvdna must be und for long time before you add intf.having hbvdna und increases intf response.if you start both tdf and itf at the same time the increase of response is little
after 1-2 years of undetectable hbvdna ?
much better, this is what i am going to do
Reason I ask this is that if I start INT now I will have it for free.
i f hbsag is less than 1500iu/ml and hbvdna undet already without tdf you may have very high chances on intf mono too
hbsag around 3000 coi: Meaningless measure
hbv-dna around 3000 iU/ml, Meaningless as regards hbv clearance
somehow body got rid of hbe (-), bad you got rid of nothing, hbv just mutated to get rid of your immune response, hbeag pos is much better to treat
same thing, no effect on hbsag.it may lower it little in 7-8 years on a small percentage of patients but response on hbeag neg is so little i d say antivirals have no effect at all on hbeag neg
1. So does it mean the int will start working after 1-2 years of undetectable hbv-dna REGARDLES of wheter you took it all the time from the start with tdf, or ONLY if you add int after 2 years of undetectable dna. I hope I'm not complicating this too much
2.Ok, but thats sort of confusing. Then a- what is not meaningless measure in my condition and b- in my condition what does that mean to my treatment ?
As for the research papers. You mentioned "add-on of peg-interferon to a stable nucleos(t)ide regimen leads to loss of hbs-ag in patients with chronic hepatitis b" article. I read it they seem to use the treatment protocol that you mention of AN (ent or tdf, adf etc) and the addon of int after some time of undetectable hbvdna. The thing thats sort of confusing is the conclusion. They mention that the add-on of int worked on only 3 in 12 of the patients. Yes one reached hbsag seroconversion (that means clearance and cure ?) but in the remaining 10 of the patients hbsag declined only by -0.01 to -0.25 log10 after 8-24 weeks of combo therapy. The thing that I wanted to ask- arent those standard int treatment results ? It seems like around 10% of patients get improvement, but not 40% ? I might be looking at wrong thing if you could shed some light on this
response to intf with no antivirals and hbvdna und was around 30% may be 35% if i remember correct the study
response tdf and peg add on is 40%
test you done are al meanless to predict hbv clearance or interferon response, only hbsag in iu/ml is usefull for this.this is probably the market reason US labs are not using this.
the other reason is hbsag quant in iu/ml is a very cheap test while hbvdna is very expensive even if usless to predict hbv clearance
there are many studies with add on, check them all
My understanding it that Heptech's "HeptoSheild" increases drug potency via enhanced cellular delivery?
Isn't it also true that many large drug companies use PPC's as a drug delivery system.
So wouldn't it make sense that HeptoSheild would increase the potency of all anti-virals i.e. like Tenooivir, and help increase the chance of clearing the HBV surface Antigen???
it is correct that ppc increases substances delivery drugs included but antivirals have no effect on hbsag and are too weak to block hbv replication totally, even if you take 3-4 times more tdf or etv the result is the same
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