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INF + Tenofovir + Simavastatin
After treating with mono entecavir for 5 years, I decided to switch to tenofovir (Pavtino-B made in India) combo for two months.
And recently I have consulted with my doctor to add on interferon  Pegnano 180mcg/0.5mL made in Vietnam

Now I am on : INF Pegnano + Tenofovir + Vit D3 10.000IU + Simavastatin 40mg

Here is my status HBV

Date : 19/05/2014
HbsAg : 8462 IU/ml
Anti-hbe+ seroconversion year 4th entecavir
GGT : 38
ASAT : 38
ALAT : 29
Creatine : 12 mg/l
HBV DNA : Undectable since 3 months with Entecavir
Fibros scan : 4.3 kpa
Phophatase Alcaline : 156 UI/L
Alpha Foetoproteine : 2.28 ng/ml

After 6 Injections with interferon starting from 03/06/2014, here is the test result 15/07/2014

HbsAg : 7386 IU/ml
Anti-Hbe+
GGT : 75
ASAT : 79
ALAT : 87
Creatine : 12 mg/L
Vitamine D TOtal : 50 ng/ml

I am thinking to increase my dose on Vit D3 to 20.000 IU and Simavastatin to 80mg.

Can you give some advices?





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you can try but since this is all experimental we cannot suggest anything.hbsag decline is a good sign since such high levels are less responsive

please let us know if hbsag decline further with sim 80mg.be careful about muscles pains, vit d should prevent that but it is a common side on high dose sim

Creatine : 12 mg/L, is this creatinine?
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Yes Stef 2011 it is Creatinine and it is reached near upper limit.
Anyway there is no problem with dose vit D3 20.000 IU ?
I will keep updated.
Thanks for quick response stef
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it is best you do creatinine clearance by 24hrs urine collection just to stay on the safe side

in the meantime you can decrease creatinine by baking soda 1 tea spoon daily and then check your ph urine to stay around 6.5-7 this will help kidneys a lot.to check urine ph you can buy small paper test sold at pharmacy

other ways to decrease creatinine are not good during pegintf because they decrease inflammation and this is needed while on peg
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if your results keep this way i think sim combo may be more interesting than nitazoxanide or ezetimibe.i think you and otan are the pioneers on this combo

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Do you know your HBV genotype?
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Stef : what is the backing soda ?  you mean taking it a tea spoon per day ?

The_PS : I dont have a test on HBV genotype because it is expensive i just ignore it.

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http://en.wikipedia.org/wiki/Sodium_bicarbonate

if you dont like the taste you can add lemon or maple syrup, it is good to lower acidity (low PH).acidity promotes cancer and makes a lot of work on kidneys that try to balance ph towards alkaline 7
the optimum balance is around 7-7.5 of ph for human body
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Thank Stef2011
I will find it when I go back to the city.
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Also monitor cpk if you go on high dose 80mg sim because it can make muscles and back pain, if so you can take paracetamol but for short period, in case of pain it is best to lower dose
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I go with tenofovir + vitD3 20 000 ui in the morning and simvastatin 80mg at night before bed.
after taking simvastatin I just feel tired and sleepy immediately and wake up with normal mood with no pain at all.
Should I continue with the high dose or more test need to be done to assure the safety ?
Thank Stef2011 for always sharing a good info

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No no test strickly needed, you should feel a lot of pain before test cpk becoming elevated.tollerability is different person to person i remember i could tollerate 20mg not more
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very interesting articles that might give ideas on antiviral effect of simvastatin if there is any in vivo:

Cyclophilin A: a key player for human disease
in particular the paragraph: CyPA and hepatitis virus
http://www.nature.com/cddis/journal/v4/n10/full/cddis2013410a.html

simvastatin is a cpa inhibitor
http://circres.ahajournals.org/content/98/6/811.full
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I just have a test on creatine this morning cpk seems not elevated.
Creatinine : 12mg/l
Creatine phospho-kinase (CPK) : 90 ui/l
Regarding to baking soda it is likely no one know about it in my town (Phnom Penh capital of cambodia).

I will continue to find it anyway.
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HbsAg quantity test after 12 injection pegnano + simvastatin 80mg + vitd3 20000 IU

HbsAg : 2848 IU/ml
ASAT : 60 UI/L
ALAT : 69 UI/L
GGT : 80 UI/L
Akaline Phosphatase : 215 UI/L  (N: 80 - 306 UI/L)
Creatinine : 11 mg/l

Blood Cell count are in normal range
Leucocyte count are in normal range
- Neutrophils : 2,50 giga/l             ( 2,00 - 7,5 )
- Lymphocytes : 2,41 giga/l             (1,50 - 4,0 )
- Monocytes : 0,48 giga/l
- Platelets : 193 000 / mm3

It is a huge drop HbsAg so I think i countinue with simvastatin 80mg and Vitd3 20.000 UI per day.


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wow thanks for the update, it is indeed a very huge drop and very unusual by 12 weeks, right when you take more sim and with such a high baseline of hbsag

did you feel more sides by sim 80mg?some more low fever?
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I took simvastatin 80mg since the 6th injection so it is already 6 weeks.

For side effect, i feel a bit tired and sleepy a few days at the beginning then i think my body can adapt it and feel normally.

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also which date sim was increased to 80mg?
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I started Simvastatin at the same time with Interferon begin with 20mg for a few days then inscrease to 40mg for 6 weeks and finally started with 80mg till now.
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-66.34% by 12 weeks, very unusual.

if others try this we will be able to confirm if it is sim
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I will ask for it on the 17th when I meet my doctor. Perhaps I have a good chance as well. I did another hbsag test to confirm before I head back to the states
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http://clinicaltrials.gov/show/NCT00994773

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869246/

Principal Investigator: Teddy Bader, M.D. University of Oklahoma

doctor bader is studying simvastatin on hbv but i dont think they ever combo with peginterferon.i did try sim myself with tdf plus etv but it didn t work combo with nucs.

it would be sueful to find some study with pegintf plus simvastatin, even in vitro, but i only found hcv trials with sim
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also remember to increase vitd before starting treatment, it is best to get some immune action before adding antivirals or peginterferon

my guess on this is:
tenofovir reduces virions fast, this lowers immune activation but if we get vit d high before reducing virions we get more macrophages/phagocytes activity, this may keep more immune activation even when virions will go down when we add nucs or pegintf

same thing with peginterferon, this drug enhances immune activity already in action before we start it, so even in this case it is best to have high vit d before treatment
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I started my vitamin d 4 days ago and taking 11200 iu per day
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it is great so we can expand our experience with inf + simvastatin and vitD.

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after 17 injections pegnano + Simvastatin 80mg + Vit D 20000
there is again an enormous drop HBS

Hbs quant : 895 IU/ml  down from 2848 IU/ml
Vit D         : 59.76 ng/ml
Creatinine : 13mg/l
Calcemie : 89mg/l

It is likely hard to inscrease vit D even with 20000 IU per day.

What do you think about the result stef ?





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very very results, this is not even 24 weeks and you already decreased 1log but what really matters is the number if you go less than 500iu/ml hbsag clearance at 48weeks is certain....well actually chances are very very high even now

i really hope we have found how to fasten hbv cure by sequential plus vit d plus sim, however we need a lot of members on this to reach scientific proof

calcium is perfect so you may increase vit d even more than 20.000iu daily if you like although creatinine is still high, did you check creatinine clearance by 24 hrs urine collection?you know blood creatinine test is of very little relevance, was it that elevated even before peg?
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9624973 tn?1413019730
Those are very good results, is there anyone that is currently trying combo with simvastatin so we can have a clear image if it works ?
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missed good, very very good results, i d say incredible if all members trying this sim add on get such decline of 1log or more before 24 weeks

we cannot say it is sim for sure because it is possible to get such results on sequential but i suggest all to try this add on and see since simvastatin is a safe drug with minimal sides
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otan tried it on peg mono and cleared hbsag by 24weeks

lagona is second member trying

i am trying this myself too but have no results yet

i dont remember if other members are on this, if so please share your results here
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thanks lagona for this wounderful sharing, as steff says we hope that this combo will we be speed up cure
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i think i will go for a combo if treatment will be needed . i will move to UK next month. and i am thinking if to treat in romania (as its my home and i could come for treatment) or uk, as romania just started to watch hbsAG and they treat by the book ...not personalized treatment, that is very bad for us . what are your suggestions ? as for italy, do you think the prices are acceptable if i would consider it ? i could come by 2,3 months .. ?
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if you can get residence in italy treatments are free in mono to get a combo free you need to find a very good hospital and liver specialists
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Yes Stef  my creatinine is upper high level of the range for years.
What can it be indicated with clearance by 24 hrs urine ?

Regarding to the combo I think simvastatin has play a key role in reducing HbsAg because when I start with the first 6 injections Pegnano + sim 40mg the Hbs drop only a thousand which acccount only 12% while my vit D is already 50ng/ml before INF.

After inscreasing sim dosage to 80mg there is a hug drop Hbs started.


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What can it be indicated with clearance by 24 hrs urine ?

kidneys function.creatinine in blood is normally high on high body mass or those making gym but creatinine clearance is not affected by this

studyforhope suggested another test i think urine  creatinine/albumine ratio, this shows early damage to kidneys cells before function goes down.

in case you have low kidneys function when you stop peg and clear hbsag you may go for fibroguard, liposomal resveratrol and curcumin, glutathione and see if function goes better and of course baking soda.if function is ok it is your normal creatinine values to be 1.3
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i hope i can confirm this data too
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My result up to date on 04-12-2014 after 27 injections :

GAMMA G.T : 53 U/L
ASAT : 76 UI/L
ALAT : 71 UI/L
Calcemie :  8.1 mg/dL
Creatine : 1.3 mg/dL
Alpha fetoproteine  : 1.73 ng/ml

HbsAg Quant : 257 IU/ml  down from 895 IU/ml

I am still on vit D3 25000 IU + Simvast 80mg + Tenofovir + Pegnano

Once again HbgAg drop alot.

Hope i will wipe out the virus soon.


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wow wonderful news at this point we are 99.9% sure you will clear soon since this incredible result in about 24 weeks

i think your hbv cure is based on these facts for sure:
number of years under antiviral before add on, 5 years
use of high dose vit d3
maybe the use of simvastatin but others must confirm this

did you also check vitd25oh and parathormone, this may help others to find the right balance of these two tests for response?in any case calcium is low so anything you find from vitd25oh will be safe, remember i am vitd25oh way higher than 1000ng/ml and no problems at all

as regards creatinine i think you should check creatinine clearance, it is probable that for your muscle mass your normal serum creatinine is normally higher than others with no issues.creatinine clearance will tell you the kidney function which i am sure it is optimal
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yeah stef I dont have the test on Vit D yet for the cost reason.

creatinine clearance is the test with Urine ? I will ask the doctor for next test and Vit D too.

Thanks

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My 48 weeks of treatement result :

Hbs Ag Quantitative (Cobas e601) : 82 IU/ml
GGT : 60
ASAT : 66
ALAT : 57
Creatinine : 1.3
PCR : Undetectable
Vit D3 : not avalable yet

I have decided to continue Interfereon for another 24 weeks + Vit D3 25000IU (daily) + simvas

Any comments are welcome
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very good choice, please when you check vitd25oh check intact pth too at same time, this is mandatory to understand if there is sufficiency
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nice results ! good luck ! :)
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Dont you people suffer from side effects from injections ? I was told these injections really work well when you very high viral load and comes with lots of side effects.
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stef2011 : PTH mean parathyroid hormone test?
I will try to find it out at the lab

rockla : I don't feel any suffer effect from the injection
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Please don t report here what you hear because thats complitely wrong, all the opposite, pegintf doesn t work with viral load with works best with undetectable
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Ok so PegIntf helps in lowering the viral load from Liver than from Blood
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Excellent result .you start interf with high hbsa value but you achieve a good result .i want realy try peginterf.now do you stop the injection or continue since you are in the 48weeks?
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flyinsky : yes i continue it for another 24 weeks.
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So do you support side effect?thanks
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Side effects from IFN are only listed on the packaging as an insurance against the maker of IFN. Some don't get any at all other than a fever the first injection. For me, I also experience very low WBC and neutrophils count.

To Lagona: Yes, your HBsAg is very low. Congrats. Instead of upping your Vit D3 dose, do you take zinc and selenium supplements as well? Hoped once your HBsAg becomes UNDETECTED, you developed surface antibodies simultaneously. Good luck!











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Hi Stef,

I finally got result from PTH test and Vitamine D Total and it took so long to have it done.

Vitamine D Total :  > 70 ng/ml
PTH  : 18,25 pg/ml

It is strange with Vit D result they cannot give me exact number when it is lower than 70 ng/ml

PTH : i dont know what it is shown ?

Any recommendation is welcome.

Thanks,

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they can not give you exact number when its higher than 70, not lower. If you supplement d3 or expect high result, you need to tell about it in the lab so they can dilute a sample and give you accurate result.
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PTH  : 18,25 pg/ml

this is still a bit high, what is the minimum range in this lab?when pth gts lowest range of norm we know vit d is enough in your tissues/cells.vitd25oh is not precise because it just checks blood and if there is receptors resistance it is useless

Vitamine D Total :  > 70 ng/ml

they need to dilute blood sample to get higher values but it is not important pth test will tell us when vit d is sufficient in tissues cells

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also keep an eye on serum calcium and urine calcium
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Hi Stef,

My lab PTH range it as normal from 16 to 65 pg/ml
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in this case you have now good amounts of vit d and you can keep vit d dose you are taking and  u should have max immun e modulating effect and see effects after 6 months on this stable pth values

the best range to keep pth is: around 10-16pg/ml for you, on lowest normal or little less than normal.keeping same vit d dose it should continue to lower but anyway even 18pg/ml is ok

keep an eye on calcium and urine calcium, no dairies diet and 2.5-3L of low ca water
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let us know if hbsag goes down, it should after 6-8months of those pth values because vit d n the cells should be able to help immune modulation
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my latest test result till present :

calcemie : 8,9 mg/dl (N : 8,1 - 10,4)

Creatinine : 1,3 mg/dl (N : 0,7 - 1,3)

HbsAg Quantitative (Cobas e601) : POS 27,71  IU/mL (N<0,05)

PTH : waiting for results in a few days

I am doubt if I could clear it at the end of the course 72 injections.

Right now there is only 7 injections left.

In case there is still no antihbs appeared should I continue with it?

I might have conflict with doctor if I insist to continue as doctor has no experience with the treatment last longer than 72 injections.

Welcome for your comments.


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you can supplement with about 3000-4000iu vit A retinoid type from cod liver oil per day to balance with vit d, this can reduce creatinine and make no vit d toxicity even if dose is too much
i already did this and my creatinine lowered from 1.3 to 0.68, at the same time i could reduce vit d dose and pth remained low norm range 17pg/ml (norm 10-80pg/ml)

if pth come less than normal range lower vit d dose
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thanks for quick response

OK let me find me find it out at the phamarcy for Vit A.

Is there is any different kind of Vit A to consider?

Thanks
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Impressive results lagona.. Sim worked good for u but not on me. Hope u clear and share ur happiness
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yes the best vit A is from cod liver oil which is the retinoic type and natural, if you find it ifos certified, also double check there is synthetic vit A added but it is the natural one

but i suggest to consume animal liver, all livers are full of vit A, it is best just to try it in the diet first because vitA can also block vit D if it is not in the right balance and this is too difficult.

if you see that creatinine goes out of range then you may try the one from cod liver oil and see if it balances vit d and make nromal creatinine
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Y vit a blocks vit d?
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Impressive results ! hope you'll get hbsag negative soon :)
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Any bad side effects from peginterferon?
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Hi Elijah

I don't feel any side effects since the beginning.

everything is like normal as it is before getting inf.

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No side effects and such good response ? that's nice :) Maybe it d3 what helps.
I had some mild sites after first 4 shoots but now I feel normal.
How was your ALT during peginf thereapy ? What was the lowest/highest ?
Mine went up recently to 245 after 5 weeks.
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You could show your doctor results of studies where they tested Interferon therapy for 96 weeks. I know of a this one, there might be others but I am not sure:
http://www.ncbi.nlm.nih.gov/pubmed/22859496
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How old are you lagona?
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U should try zadaxin with ur last 7 injections. Y not give it a push. U r on the borderline. Ur virus seems stubborn to the extreme level but u should not give up coz it may relapse if u stop. U r on edge to win so try it.
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I'm thinking I should've tried peginterferon instead of tenofovir. But the horror stories from peginterferon scares me.
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Only peg can give u a chance to clear the virus not tdf
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Wow!! its great that things are working out for you.  So happy for you :)  Wish you the best!!
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Yes I know but I'm afraid of the side effects from Tenofovir
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What horror stories ? Most of the people have side effects but they are not very bad. I'm after six shoots and for now it's ok. Only first one was quite hard, high temp, shingles.
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all here are reporting minor sides effects, i think that the use we do of vitamin d is preventing heavy sides and boosting response, as more members will be on it this will be easy to confirm

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This week after 15th shot m feeling continuos nausea though :(
At 6-8th shots I had vomiting and abdominal discomfort
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Do a quick Google search of people that have tried peginterferon. Many people have side effects that didn't go away after treatment.
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that s hcv and it is different to hbv.


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How are the sides different from people with HCV?
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obviously are the sides effects of interfron are the immune activation not intf itslef, its another virus, a different immune activation and hcv gets cleared by few weeks most of the time, hbv takes years on the few that get some weak immune activation

intf activates immune system for hcv way much more than it does for hbv that is why it is cleared fast, the high immune activation makes much more damage on some
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this high immune activation, which makes much more damage and sides effects, clear hcv from a minimum of 50% to almost 80-90% of patients, nothing to do with the little immune activation on hbv 7% over 5years
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I really reading your comments very much.

stef : I try to add on animal liver (mostly pork liver) in my diet.

but I might not get it every meal.

thank u all
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Pork liver can do you more harm than good. Pork meat, especially liver is very unhealthy thing to consume, as pork are pretty much one of those rare animals that eat almost anything (all kinds of very dirty and unhealthy materials).

How old are you lagoona? Asking because of your good response on interferon...
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organic grass fed meat animals is the best choice although i dont know if countries outside europe has this easily available
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Agreed. Recently I trying to eat more fish...as it tends to be more healthy
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Yes Adusiki I am 35 years old.

anyway beside pork liver ot seems hard to find any other kind of liver to eat.

I might find the Vit A capsule instead.

thanks
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I think I will go for interferon myself, before I get to old for it.
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It was one of the reasons I've decided to try, I'm 36.
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Can you please post your baseline results, and then result on treatment if you have any yet, pls
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responded in my therapy thread
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my PTH  test come out

PTH : 21,98 pg/mL (N : 16 - 65)

It is increasing while Vit D level is not tested yet.


Any idea are welcome.
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Laguna...add black seed (grind it) and mix it with a big spoon of a quality organic tee. Eat that first thing every day, and then again the same late afternoon.
These two are known medicines since ancient times....prophetic medicines...I am pretty sure that will clear your hbsag in combo with 96 weeks of peginf.

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p.s. find a quality black seed as well
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It s good keep it aroun 20 (16-20)
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So only one person on here cleared with the help of black seed?
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Hi Stef

Please check your private messages
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Black seed : It is in the form of capsul, liquid or what?

I never heard people in my country (Cambodia) talk about it before.


Actually I take turmeric power with black pepper (a coffee spoon of turmeric per day) knowing it from a friend to reduce stressed.

And I drink it with mineral water.


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You just buy it as seeds and then grind it like you grind salt (with a small grinding machine)
You can mix it with honey in a spoon and drink it in morning (don't take it too much as if taken a lot can be toxic)
It goes under various names:
Black seed
Nigella sativa
Black cumin
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It's toxic when it's 25 grams or more but who would even think about taking that much?
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Still checking it, there s no proof at all it can make any difference to clearance but since it is not harmful we r trying it

We have 2 reported that cleared in combo etv or tdf, but can be just coincidence and they were to clear on their own or by the nuc
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Hi Stef and All,

It is likely interferon has a little effect on me during the period of the final course 72 injections INF ( now i am on 71st)
Here the result after 71 injections 09-10-2015 :

Phophatase Alcaline : 175  (N<270)
GGT : 59
ASAT : 46
ALAT :43

HbsAg quantitative (Cobas e601 ) : 22,8 IU/mL down from 27,71 IU/mL (26-Aug-2015)

RIght now there is only one injection left and the doctor recommended me  to stop the treatment Interferon + Tenofovir  and suggest the examination control every 3 months to see if it will be relapsed.

He think below 100 IU/mL will be cleared by post-effect-interferon after the stop.

Anyone can recommend ?

Thanks,
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He think below 100 IU/mL will be cleared by post-effect-interferon after the stop.

i do agree with him but best keep tenofovir after you finish peg, new drugs like cuban vaccine or replicor when available will clear your hbsag in a bit

stopping tdf too can have 2 results:
hbvdna will rise immune system will see it and activate and clear hbsag

hbvdna will rise and hbsag will relapse and you get back to baseline and peg use is wasted

we also have a member who used tdf for many years and used tdf+gcmaf sublingual+ vit d3 with a baseline hbsag like yours around 20iu/ml, he cleared hbsag by 6 months
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thank stef

so I should continue tenofovir + Vit d3 and finish INF according to ya recommendation and I am thinking that way too.

I will discuss it with doctor whether he agree because I don't want to waste what I did with interferon.
thanks
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After 7 months of stopping interferon  my HbsAg is relapse to 1610 IU/ml.

Does it means the post effect of INF is not strong enough to counter the 22IU/ml which is left before finishing INF.

Do you think it will continue to rise till the stat before INF treatment?
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Did u keep taking tenofovir after stopping Pegasys?
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Yeah I keep taking tenifovir daily
But somehow it goes up so rapidly.
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this is a big dissapointment  coz u got so close to remove the infection but bad luck. Like everytime wait with the time.
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Yeah I am really unlucky to recover from this disease. So time will tell with the future treatment.
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too bad we didn t monitor closely enough to restart intf or other immune modulators to prevent relapse now better wait for cuban vaccine or replicor to be available or if you like retry intf if it had zero sides effects with something to boost immunity when hbsag very low like gcmaf and zadaxin
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Thank for response,
Personally I prefere to wait for the next version of treatment.

Beside INF, gcmaf and zadaxin are hard to find in my country even most of doctor are not aware of it.
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Hi stef2011,
Do you think it will relapse till base line as before treatment of INF?

With much surface antigent in liver, does it will impact the liver or  make more damage to it?
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hbsag level makes no difference, just slightly more hcc risk compare to hbsag less than 1000iu/ml but i would not worry too much now about it, what about hbvdna and alt?
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My result :
Phophatase Alcaline : 82 UI/L
Alpha Foetoproteine : 1.86 ng/ml

ASAT  : 37
ALAT : 32
GGT : 37

HBsAg Quantitative (Cobas e601) : 1610 IU/ml

HBV DNA : Undectable
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keep using vit d and wait for better drugs, i also had 1400iu/ml at the end of peg add on, 699iu/ml few months later and then up and down between 1300 and 1100iu/ml, i think more rounds of peg are needed but it doesn t worth the damage peg can do
better wait new drugs unless peg is zero sides effects, for me it was too heavy  maybe 46yo is too old for pegintf without any damage
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Thank Stef for comment.
I will restart my dose of Vit D for 10.000 IU/ml
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