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 ..
antivirals have no effect on hbsag and on hbv infected cells, they can only lower replication
since you are 27yo on immune tolleran tphase i do hope your doctor knows what he is doing because you can t take antivirals for life so it is best to try to clear hbv definitively and antivirals alone cannot do this
keep the combo etv+tdf which should have been used from the begining since such high hbvdna cannot be lowered by entecavir only, anyway just make sure hbvdna gets to undetactable by 6 months on the combo etv+tdf and keep monitoring hbsag
you have to consider add on of interferon to these antivirals to clear hbsag, this can be done after 1-3 years of antivirals monotherapy, as you can see from other patients on this combo of antivirals plus interferon hbsag gets cleared or lowered so much that antiviral can be stopped without disease activity
be aware that just taking the antivirals is useless and possibly dangerous because they cannot be used life long, so add on of intf in your case is a must.it is also unknown if these antivirals can develop resistance and severe sides on the long term because nobody used them for longer than 5-10years yet
too little data on immune tollerant treated patients because you should have not been treated
anyway the good point is clearance of hbv is easier when you will add intf
when I can add it on ? after UND DNA directly ?
follow your new liver specialist which sounds very updated
what is the conclusion of this high value of HBsAg ?
this is good on immune tollerant phase, that means you have no immune response yet and when it will be activated under these drugs hbv will be cleared fast
please update the community about your results it may be easily possible that treating while still immuen tollerant is good to clear hbv, no data about this but my personal view is that it is easier to clear
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 ?
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
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
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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