I am confused now about the hbvquant

[miracle852]

Earlier this year on a routine medical check check up. Doctors said I have HepB.
The way the hbvquant has been flunctuating however is somehow confusing to me
April  was 30,000cps/ml,
May was 268,296 cps/ml, 46,099 IU/ml  (I took Tenofovoir however for about 8 weeks and stopped) and in
August is undetectable.
I did fibroscan scan and LFT and they all said it was ok.
My question, can the count go up so drastically and then got undetected within few months.
A doctor today suggest I do HBVantibody test however but apart from that what else would anybody suggest?

[stef2011]

Does that mean the arv are of no use?

yes on those with no liver damage, young,  low hcc risk they are useless.immune therapies like interferons are better to try on these ones.while those with liver damage/cirrhosis can save their lives thaks to antivirals

So what lowers hbsag then?
drugs not on the market does, rep9ac targets hbsag and many others not on the market

Do interferons do that?
on few

what can make hbsag undetectable?
antivirals for years and later on add-on of interferon clears in 40%.

[miracle852]

Thank you Stef for those explanations.
Does that mean the arv are of no use? why then do doctors recoomend them?
So what lowers hbsag then? what targets it? Do interferons do that? what can make hbsag undetectable?

[stef2011]

.....to say it very clear, hbvdna is just a marketing way to sell more antivirals making believe to those less informed that hbvdna und mean no virus...the virus keeps replicating despite hbvdna is und in the blood and keeps mutating as well

[stef2011]

Does UND has anything to do with whether one is infectious or not?

absolutely nothing, only hbsag undetactable has to do with hbv clearance and antivirals dont lower hbsag

[stef2011]

because antivirals target hbvdna, not the virus, infact they dont clear hbv they just lower replication

antivirals on market now, as you can find in the boxes or instructions, are not a cure for hbv, they just lower hbvdna replication and stop liver damage but do nothing to virus

[miracle852]

ok. if it does not matter, why then do they use it to measure effectiveness of therapy? Does UND has anything to do with whether one is infectious or not?

[stef2011]

But my concern again is can it fluntuate that much within 3 months?

yes it does, my sister went from 300.000iu/ml to over detactable range 100millions iu/ml to 88.000iu/ml again in 3-4 months, she got a stomach viral infection or who knows what that decreased all her little immune reponse to none (immune tollerant) so she experinced again normal alt and hbvdna in the billions and back in a few months

absolutely normal, this is also why hbvdna quant has little meaning out of therapy

[miracle852]

Thank you Stef. But my concern again is can it fluntuate that much within 3 months? Does that follow scientific logic? Could it be that the results are wrong?
I will try to do those other tests to get the results.

[stef2011]

hbvdna is useful only to measure if antivirals are working, if you have acute hbv you must monitor:

hbsag quantity in iu/ml
hbsab quantity in miu/ml
hbcab igm  quant or qualitative, both are ok

hbvdna is useless to see clearance of hbv virus be it detactable or undetactable

[okun]

get through it and you will never catch hep b again.