Highly reactive HBsAg

[Mars86]

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 ..

[stef2011]

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