How to know if Entecavir stopped working

[Aydin1358]

Dear all,
First I have to really thank for all of you who are giving us lots of good information.
I am 33 years old man and I think I have Hep B from birth, because of our family history.
I started taking Entecavir 2 years ago and the reason to start treatment was having 640 milion copy/ml of DNA and ALT more than normal range (almost two times of normal ). So Doctor decided to treat. Almost after a year of taking Entecavir my DNA dropped to 20 copy/ml, but still ALT more than the normal range. Then 6 months later DNA increased to 70 with abnormal ALT and  6 month after that DNA went up to 137 with ALT 70. When I started treatment my Hbeag was positive but after a year it turned to be negative and Hbab get positive.
Now I am a little worried about Entecavir suspecting that maybe virus gets resistance to it because of my DNA increase but doctor telling me that these variations in DNA are ok since it is not too much variations and the most important is that your e-antigen is negative. Yesterday I again tested for DNA test but really I am worried.
Any comments and suggestions will be much appreciated.
Aydin

[studyforhope]

You will likely see a small rise in hbv dna when switching to tdf only. These two antivirals have a mildly additive effect when taken together. It is possible that you have some partially adaptive mutation in your hbv genome that explains the less than perfect response. If you have to pay for tdf yourself it would be advisable to buy it from india via internet ordering, you can save more than 70%. i dont have the website handy, but you will find it if you look long enough. I think one of the indian names for tenofovir is tenvir. The indian pharmaceuticals are of the highest quality, you do not need to worry.

[Aydin1358]

Thanks Stef;

I am wondering why my hbvdna goes down so slow.
Now almost 3 years on ETV with the last 6 month of  added TDF.  
I have already taken ETV one and half more month than the date of blood test that showed 13 IU/ml.
What may possibility happen if I stop taking ETV? Can I start taking it later if I see any rise again in my hbvdna?

[stef2011]

it would be best to wait for hbvdna und, you are close to it maybe one more month

hbsag doesn t matter now

[Aydin1358]

Hi everybody:

After being on ETV+TDF combo for 2 months, my HBV DNA reduced to 30 from 70.
Now after 6 months, the number has reduced to 13 iu/ml. My ALT is also 1.5 times of the normal still.
I did Hbsag test and turned out to be 14000 IU

What do you think now. Can I stop taking Entecavir now safely and go only with TDF. I can not afford to have both at the same time.

Regards,

[Aydin1358]

Finally after lots of discussions with my doctor, he agreed to prescribe TDF. From today I am going to TDF+ETV combo. I have to pay for TDF out of my pocket which is expensive almost 610 $. But ETV is covered. Lets see how much difference this combo will make.  
I just need Hbsag measurements and need to discuss with my Dr. where we can do it in Canada. not knowing this, I will have no idea when should I start Interferon. I just hope that since my ALT was always high, my hbsag has lowered considerably. we will see.

[stef2011]

12.30 nmol/L

extremely low but convert to ng/ml which is the correct unit for vit d.for optimum health and immune system you need 60-90ng/ml (normal range 50-100ng/ml)

2000iu is nothing it wont work if vit d is low due to chronic infections, you need at least 10.000iu daily and then recheck in 4 weeks to see if it has increased or not.you need both vit25oh and calcium test to see if everything is working correctly

which form and brand of vitamin d you suggest?
only vit d3 which is the natural form, puritans is ok because they make 5000iu pills and 10.000iu pills and very cheap