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I have more confused whether the HBV viral load is become undetectable
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I have more confused whether the HBV viral load is become undetectable

I am 23 years old male. Before two years it was happen to found that I was infected with Hepatitis B virus and Genotype is D. I am taking treatment from two years. The HBV viral load was 170,000,000 IU/ML and no symptoms when I was started the treatment. First six months I had treatment with peginterferon but HBV viral load was not decreased. After that the doctor was switched to entecavir and it is gave good result. The HBV viral load was decreased to 9500 IU/ML after 20 months of treatment with entecavir. But recently one month before did blood test. The HBV viral load was increased to 76800 IU/ML. The doctor was told me that this is may be the resistance of HBV against the entecavir. So I gave blood to check the resistance of HBV against the entecavir. But the resistance test also gave good result that mutation of HBV was not detected against Lamivudine, Teluvdine, Adefovir, and Entecavir.
I am not even smoked and drank alcohol from my childhood and would like to keep this attitude for my life long. Still I am very healthy and my Liver function test result was normal. Now the doctor switched to Tenofovir treatment for one more year.
I have more confused whether the viral load is become undetectable and whether can I live as long as without any illness related to the disease. Please give me more information in this regard.
Thank you very much for your time and consideration.
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Avatar_m_tn
When your viral load is high, HBeAg is positive, but ALT is persistently normal you are in the immune tolerant phase in which time the immune system is not active against the virus. Treatment is not recommended in this phase as the virus is usually not doing any damage and existing treatments are all suboptimal. Since your doctor who obviously is not experienced, started treatment, it may take you longer to reach undetectable.
11 Comments Post a Comment
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Avatar_f_tn
Are you hbeAg negative or positive?
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Avatar_m_tn
HbsAg and HbeAg is positive
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Avatar_f_tn
Immune tolerant phase
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Avatar_m_tn
Do you mean HbeAb
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Avatar_m_tn
I don't have a ready answer for you. You did experience what they call a vrological flare. For potent antiviral , first thing doctors check whether you have been taking your medication. Then they like to confirm the flare by repeating the viral load test. In most cases, patients have not been adherent or the flare is not confirmed, and doctors continue with the same treatment. In your case, your doctor opted to adapt your treatment. Another comment is that you started treatment when your viral load was very high, was your ALT also very high at that time?
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Avatar_m_tn
Please can you explain me about Immune tolerant phase condition
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Avatar_m_tn
Thank you very much for your response. my ALT level is normal when I was started treatment. still now it is normal only.
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Avatar_m_tn
My doctor was checking Viral load every 6 months since I have started the treatment. my ALT level is normal when I was started treatment. still now it is normal only.
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Avatar_m_tn
When your viral load is high, HBeAg is positive, but ALT is persistently normal you are in the immune tolerant phase in which time the immune system is not active against the virus. Treatment is not recommended in this phase as the virus is usually not doing any damage and existing treatments are all suboptimal. Since your doctor who obviously is not experienced, started treatment, it may take you longer to reach undetectable.
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Avatar_m_tn
Thank you very much
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Avatar_m_tn
sir, my mother(59 years old)has been detected with HbsAg +ve(250IU/mL) in 2012
at that time her HBVDNA (Quantitative was 37 IU/mL) and her LFT is normal since then.also she is HBeAg -ve ,
HB core antibody, Igm -ve , usg normal, endoscopy normal
but now on 27th april 2013 her HBVDNA came out to be 2500IU/mL,LFT NORMAL,ALT 22U/L..
PLEASE TELL ME WHAT TO DO..AM VERY TENSE. WE r from india .she is not taking any medcine
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