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Highly reactive HBsAg

Dears;

I'm 27 years male , Chronic HBV in immune Tolerant Phase and still Immune Tolerant since I got diagnosed last year in Jan...

I was treated with ETV .5 since exactly 12 month and added TDF in the last three months .. DNA is about 240 iu/ml but HBsAg is highly reactive 130 000 iu/ml ... what is the meaning of this high value ? why it keeps increasing while DNA is going to decrease ?

base line DNA was more than 170 * 10^6 iu/ml ... Normal ALT/AST ..
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what do i have to write on google to get to the page?
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Yes Steff from what I'm experiencing I agree.
The next step is everyone is writing an fb message to Timothy Block HBF president  asking for him to support a petition giving them every chance to do the right thing. But numbers of people who support the idea are growing on face book alot.  If anybody feels the same please write it and pledge your support and write him a private message.
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no, these associations are 99,9% corrupt and just drain money
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Thanks stef :)
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Hi everyone does it suprise you that HBF won't help us get REP9AC' on the market?
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of course it is the same, peg add on is made on both 1 nuc or 2 nuc
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In case it doesn't go down (DNA) .. is it safe to take the three medications together ?

Thanks in Advance
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Thanks for precious advice :)
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of course it is if hbvdna stopped decline, while if it is still going down you better wait before peg add on
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I visited the Dr. today he advised with peg add on + etv and tdf ... what do u think ?  is it ok or not ?
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thanks stef for your valuable advice :)
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one good point of your status is that your virus should be wildtype, it has little opportunity to mutate with your low hbvdna so when immune system will be recovered hbsag shoudl be easier, at least theorically

anyway it is not good to have hbvdna detectable so if it does not go down to und by few months it is important to consider possible aid from ntz or ezetimibe
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i think we have to wait for you to reach hbvdna undetectable then follwoing years there should be immune cd8 recovery at some degree and pegintf might be considered to try clear hbsag

did you try way to boost immune response to make hbvdna und faster?like vitd25oh to 90-100ng/ml?nitazoxanide add on?ezetimibe add on?
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Avatar universal
Thanks Stef

months of therapy on etv = 11 months
months of therapy on combo = 14 months

total months of treatment = 25 months
baseline of HBsAg =  not determined but it tested randomly and found 89000 Iu/ml and increased to 131000 iu/ml then added TDF and decreased to 67000 iu/ml now ...

Base line VL was greater than 170 * 10^6 .. now it is 240 Iu/ml

Thanks
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Avatar universal
please sum up the following:

months of therapy on etv
baseline hbsag
baseline hbvdna

if hbvdna stops decline and remanins detactable after 6months i would go for etv+tdf combo

of course etv has no effect on hbsag for you like for most patients, on me it made hbsag increase and didn t work to make hbvdna fully und
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Avatar universal
Dears;

Your inputs will be highly appreciated...

Thanks
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Avatar universal
ok now HBsAg is around 67,000 IU/ml but DNA is still around 240 IU/ml ..

would I stop this treatment at all or what ? what are the consequences ?

Thanks
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Avatar universal

the big mistake was to start treatment but now you are already on it and better continue until this combo of antivirals makes hbvdna undetactable, hopfully we may see an hbsag and hbeag decrease that allows pegintf to work, especially hbeag turning to negative

do you know your genotype?if not test before hbvdna und


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your input ?
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After 2 weeks your vl reduction coming from very high is expected to be 100 to 1000 fold, so you had closer to a billion true vl at start.

It is harder to control a  virus that replicates uninhibited, producing hugh vl numbers.  But the full picture is more complicated.
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Thanks

Next Month I'm going to retest DNA again , I'll inform the forum back .. BTW when I was first treated with ETV, after 2 weeks I retest DNA again and it was 870 000 iu/ml this only in 2 weeks ... the question is, does the baseline VL is an indicator of the treatment ?
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Avatar universal
When your baseline dna was determined to be higher than 170 million, was an effort made to determine your true baseline vl by retesting the sample with an appropriate dilution of 100fold?

You could be one of these patients with a vl of eg 40 billion. Then a primary treatment with entecavir alone is wrong. Hopefully the late add on of tenofovir will bring they vl to und.

A moderate reduction of hbsag quant under intense antiviral treatment is expected. But it will not go much further down and your chances of ifn add on to clear you are very small.
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Avatar universal
I forgot to say that ALT/AST are in normal range
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Avatar universal
Stef ,

I examined HBsAg Quant. last month it decreased about 30000 iu/ml , it is now about 980000 iu/ml .. what do you suggest ?
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