Huge HBSAG DROP

[joc2011]

Was on TNF for 7 years. Doctor stopped med 3 months ago to see how my body will respond. My initial HBSAG fluctuated 5726 iu/ml for years and years. Doctor ordered new hbsag test and just saw result today: 4126 iu/ml. SO its definitely dropping.  DOctor says he hopes reduction will continue and will continue to monitor to see how far things drop. Otherwise, says will go on PEG INF from December. Great happening. Im happy to see some downward hbsag decline

[sorte]

how about viral load ? Is it still und or low ?

[joc2011]

No. Its not actually. But very low. About 10 iu/ml

[joc2011]

Doctor says viral load very Low. and the HBSAG keeps going down. I feel immune activity every now and then.

[joc2011]

I hope the decline continues. Have my next HBSAG check in abt 2 weeks. Hope the downward trend continues

[joc2011]

Hello everyone. Just got my last hbsag quantity test in. It continues to decline. Now at abt 2070 iu/ml. I started off at at 5800 iu/ml. My DNA also remains undetectable. Im praying this decline continues to well below 100 iu/ml.

[adhbv]

@joc2011 very good news indeed. Your hbsag dropping is as fast as 0.3 log per year, that is very super. What is your hbvdna BEFORE the treatment? What did you do to boost your immune system?

[adhbv]

@joc2011 also, how are alt, ast, ggt? How about the Lymphocyte in blood? I guess your alt and Lymphocyte will be increasing after stopping the treatment so that the hbsag can get lower.

[adhbv]

Is there any explanation for that why your hbasg didn't go down during the treatment? If the treatment helps to make your immune system get stronger, the hbsag level should go down DURING the treatment.

[joc2011]

My HBDNA has always been undetectable even before treatment. I suspect the treatment allowed my immune system to wake up and get stronger, and once the treatment stopped it was able to identify the virus and now fighting naturally.
Honestly i read a lot from this forum and have tried several things in the past over the years but which hasnt given me the kind of decline im currently seeing. I have also tried black seed, 10000 iu vit d, Omega 3 (HIgh EPA and DHA), bee propolis and royal jelly, black seed, turmeric etc. But i also found a way to boost my body alkalinity via daily alkaline supplement i take and alkaline water. Recently started a daily vegetable smoothie whick i take a cup every day- Containing Beetroot, celery, cucumber, carrot, cauliflower, lettuce, parsley, brocolli, Ginger, Garlic, Leek. I believe all of these have helped.
lets pray the huge decline continues. Took another sample for testing last week, will knw the new numbers on my next doctors visit

[Jatashankar]

Ok that's good

[joc2011]

Hello Everyone. Happy to tell you mu HBSAG is still dropping. Now dropped to about 3400 from 5700. I check hbsag about every 3 months and it keeps dropping since last year.

[varsa]

Nice so you have completely stop tenofofir.how is your hbv dna now

[tun2017]

Happy to hear about your drop, joc2011. Did you have normal lft and HBV und before you started TNF 7 years ago? I have normal lft, <20 iu/ml hbv dna and hbsag of 52,000 iu/ml quantitative and they tell me the usual "not due for drug yet". I am confused, I feel very mild headache and often tired. I work from home so it really doesn't weigh me down but my energy is low

[joc2011]

So before start of treatment, 7 years ago. i had normal lft and my HBDNA was Undetectable, even all through the 7 years i was on treatment with TNF.       I actually think the 7 years treatment helped my immune system to build up, evidenced from this gradual decline in HBSAG im seeing after stopping. Plan with my hepatologist is to monitor HBSAG levels every month, and if decline continues we just wait and see how far a decline we can achieve. However, if it stalls, we start up PEGY. Will be more than happy if i can get to levels below 1000 iu/ml.

[Liverpatient]

If you had normal lft's and und hbv dna prior to treatment, then on what basis were you put on treatment to begin with?

[joc2011]

Actually was done by a doctor with relatively not great experience in treating HepB. Was an overkill at the time. I should never have been put on the treatment. But having said that i think i still benefited at the end of the day

[tun2017]

I see... thinking of starting the treatment, hbv dna not undetectable yet anyway (less than 20 iu/ml since I was first diagnosed 6 years ago) but scared I might take TNF forever (which I wouldn't mind if I am able to get my energy back). Most hepatologist here in Nigeria are inexperienced and it seems the monkey of "you're not due for treatment yet" has clung to their back.

I will go for the Hbsag quant one more time to ascertain my possible starting point as I feel 52,000 iu/ml is just out of this world. I am 30 yrs old

[Bravesoul]

@tun2017 your HbsAg levels are indeed super high. I don't wanna scare you bro but a high HbsAg titre whilst a low viral load indicates a high frequency of HBV DNA integration into hepatocyte genome. ( A large number of your hepatocytes are producing HbsAg independent of cccdna). As such your risk for liver cancer is elevated because the liver DNA is extensively damaged, inducing genetic instability. However, there's a few critical steps you can take to reduce this risk. Going on therapy would be wise as it would ensure further integration and damage to the liver DNA is minimised. Also, taking a statin will benefit you as statins have recently been shown to trigger apoptosis (cell death) in hepatocytes that carry cancerous mutations, and they effectively lower liver cancer risk by as much as 68% as demonstrated in studies.
Like you, I too had a super low viral load, normal ALT but very high HbsAg at 22300iu/ml. Starting therapy has ridden me of many symptoms especially peripheral neuropathy and fatigue. Hope this helps

[tun2017]

Thank you so much @Bravesoul. I am aware of the increased cancer risk which is why I am going to be making the urgent steps but I'd just be checking one more time to ascertain the high value is not a one-off dash (which I doubt anyway). I know of a friend who was doing a close monitor and at one point had a 52k+ iu/ml before rapid reduction and eventually cured. Thanks for the simvastatin advice too. Talking therapy, would you advice entecavir or TNF?

@hbvsearch thanks for the suggestion. Sending you a message via inbox

[Liverpatient]

@Bravesoul, so have you already started treatment? I had the impression that you are still finding out whether you  need treatment or not? Do you think starting on treatment could help my chronic kidney disease, thin fiber neuropathy and muscle and joint problems? Thanks.

[Bravesoul]

@tun2017, your friend was likely going through the immune active phase and was among those who clear HbsAg shortly after losing HBeAg. This can occur in Upto 10% of patients going through this particular phase!
I'd suggest starting with entecavir cuz it's taken at only 1/600th of the standard dose of TNF at 0.5mg (vs 300mg for TNF) thus the side effects are way too small if any, while being equally as potent as TNF. Also, if in the rare event that you develop resistance to EVT, TNF can be effectively used as a rescue therapy.

[Bravesoul]

@liverpatient yes, it's been 3 weeks since I started therapy with ETV, and I have seen a conspicuous improvement in peripheral neuropathy and energy levels. If your issues are tied to HBV, you might benefit from therapy. Therapy may help alleviate the symptoms, but likely not in the short term. You might need to take treatment for as long as a decade to see major reductions in various hbv viral proteins that are causing ur symptoms, since treatment doesn't directly affect hbv antigens.  

[Bm2016]

@bravsoul, did i also go through immune active phase too?  i was initially under monitoring every 6 months for decades, and when i turn 30, my hbv dna spike very high,  then i took hepera/lamivirdine, and shortly dr. told me my hep b virus mutated, wild type  and i took viread, and hbv dna became very low in 6 months, about 4 years later, hbeag became negative, and hbeab positive, but ALT was highly elevated all time, in 80 to 150 range, dr. told me i have 2% chance to get rid of hep b, another 5 years later, i was hbsag seroconverted,  hbv dna undetectable, and hbsab  (10+ ui/ml)  show up immediately, another 6 months for alt to lower to 30s range.

has been almost 3 years now, my hbsag has been negative, and hbsab 10+ui/ml since then.

quality of life has been improve dramatically, energetic all time, eat well, sleep well,

[tun2017]

@Bravesoul, thanks. So what's the best way to use a entecavir, vit d3 and statin? Can I use them all at once after meal or it's best to stop? And when do you consider to stop taking entecavir?

[tun2017]

@Bravesoul, thanks. So what's the best way to use a entecavir, vit d3 and statin? Can I use them all at once after meal or space them? And when do you consider to stop taking entecavir?

[joc2011]

u can buy it on amazon. On amazon search for Life Extension Vitamin D3. Usually 5000 iu. But u can take 2 of 5000 per day to give u 10k.

[joc2011]

With respect to ur headaches; i believe they are part of the mild sides u will expect to experience while on Pegy. Other sides that can occur include: Flu-like symptoms (headache, muscle aches, tiredness and fever) usually lessen after the first few weeks of treatment. Also Poor appetite ,
Nausea, Insomnia (see sleep problems), Diarrhea.

[Bm2016]

i just read the EASL (European Association for the Study of Liver)  2017 clinical practice guidelines

http://www.journal-of-hepatology.eu/article/S0168-8278(17)30185-X/fulltext

as well as when is it safe to stop antiviral
http://www.hepb.org/blog/can-hepatitis-b-patients-stop-taking-antivirals-experts-finally-answers/

hepb.org blog has this article that suggested if a Hep B patient is
HBeAg negative,
normal ALT, 30 for men, 19 for women, normal AST, no sign of liver damage/cirrhosis
undetectable viral load
has been on anti-viral for more than 3 years

all above met, then can stop viral treatment, but still require frequent monitoring after.

but if the HBsAG level remain high (it did not state the numeric value), risk of reactivation, and should stay on anti-viral treatment.

again, i am not a  doctor, or in medical field, i am just reading information posted on internet.

[joc2011]

I am also monitored every 2 to 3 months by a gastroentologist

[joc2011]

I meet all those criteria. I was on TNF for 7 years. I have had UND hbdna for as long as i can remember, and Hbeag negative too.  the purpose of this post is to share the big HBSAG decline im observing after stopping

[Bm2016]

very good, hope you can clear the HBsAG very soon

[joc2011]

i will definitely feel safer if i can get to levels below 1000 iu/ml

[joc2011]

You are actually doing great. Its good progress. WIth such low levels your body can eradicate it over time, especially with Pegy it should be gone in no time.

[stef2011]

hbvsearch remember to take 10.000iu of vit d3, low vitd25oh levels can make peg no response and with such low hbsag it is easy to clear

[joc2011]

joc2011
im actuallly thinking about the symptoms i will be having when i start PEGY in december. Are u having any sides from the pegy? Pls can u share?

[joc2011]

im actuallly thinking about the symptoms i will be having when  start PEGY in december. Are u having any sides from the pegy? Pls can u share?

[tun2017]

Hi @hbvsearch, What natural medicine did you use to achieve the decline in your hbsag auant?

[joc2011]

hbvsearch. So what was this natural medicine you took. Why dont u share