Is Entecavir (Entegard) safe? What are the disadvantages?

[jul_21]

Good day!

I just had my Hepatitis B profile last month and found out that I am a Chronic Hepatitis B carrier. Most likely, I probably have it since I was young and just found out after the test. I haven't experienced any symptoms related to this disease. I had my liver ultrasound and the result is perfectly fine,nothing is wrong, and it is normal. I went to a gastroenterology doctor and she suggested me to undergo medication because my viral load is quite high. She suggested to take Entecavir ( Entegard) .5mg for a daily basis. Is it fine to take this medicine base on the lab results below? I really need to get my HBsAg reactive to become non-reactive. Please I need your pieces of advice. Thanks!

RECENT LAB RESULTS:


Test    Cut-off Values     Patient Value/Result

HBsAG 1.0             4108.23  Reactive

Anti-HBs 10.0             0.84 Non-Reactive

HBeAG 1.0             0.375 Non-Reactive

*************************************************************************************************
Test              Result             Normal Value

ALT/SGPT       47.0             21.00 - 72.00 u/l

**************************************************************************************************

HBV DNA VIRAL LOAD (Real Time PCR)

Result  :  8,101,945 IU/ml

Remarks:  1.) HBV DNA Viral Load (Real Time PCR) detection limit:
                        8 - 110,000,000 IU/ml (35-840,200,000 copies/ml)
                
                2.) Specimen with less than 6 Iu/ml (640,200,000 copies/ml) is above the defined range                              of the test

************************************************************************************************************************************
LIVER ULTRASOUND RESULT

The liver is normal in size. Parenchymal echogenicity is homogeneous. No solid mass or cystic lesion is noted. No parenchymal calcifications are seen. The intrahepatic ducts and vessels are not dilated. Negative for ascites.

IMPRESSION:
                    SONOGRAPHICALLY NORMAL LIVER

***********************************************************************************************************************************

Questions:

1. Is it required for me to take Entecavir (entegard) .5mg based on the lab results above?
2. If so, is it safe to take it without any scary side effects like renal or kidney problems?
3. I'm planning to take it only for a month and have my HBV DNA again it the medicine works, is that even possible?

Please, I really need your pieces of advice. Thank you!

[hepb1985]

Hi can i ask question? I was also a hbsag reactive since 2010 and high hbv dna normal alt. but now year 2014 i am hbvdna undetected, hbeag non reactive, anti hbe reactive, hbsag non reactive 0.33 ui cov is 1.00 nd anti hbs reactive 12.79 ui cov is 10.00. I know that i am chronic but can i still have the vaccination for hbsag? Is there a possibilty to get again the virus. Thank you

[jul_21]

Yes, I understand you Stephen. I might as well continue taking this medicine and then talk to my doctor on monday.

[StephenCastlecrag]

I am not a doctor. It would be grossly irresponsible to give you any medical advice. I understand your delimma. Please discuss your situation with your doctor.

[jul_21]

When is the right time to stop taking the antiviral? Right I feel like not taking the medicine after the one last night because Im afraid it might get worse my situation if I couldn't longer afford to buy the medicine. What should I do? Should I stop taking this medicine? I bought 34 pieces of the medicine. Please advice.

[StephenCastlecrag]

Yes, it is only undetectable because of the drug. This is what the drug is supposed to do. You need to keep taking it to keep the viral load undetectable. After several years, your own immune system MAY be able to keep the viral load undetectable/low without the drug.

[jul_21]

It will still rise even if for instance you miraclely have undetectable hbv dna?

[StephenCastlecrag]

If you stop taking your medication after three months, your viral load will most likely rise again and the disease will progress. You may like to get cheaper Entecavir from India. Join the Yellow Warriers Association in your country and petition your government to subsidise the drugs.

[jul_21]

Thanks a lot for that information! I'm afraid I couldn't sustain taking this medicine for years. I plan to take it maybe up until 3 months and have my HBV DNA again. What if I'm lucky ,I hope, and my viral load becomes undetectable,is it alright to stop the medication? I wouldn't have known this if I didn't have the profile because I haven't had any symptoms at all. As you know, Hepa B in SouthEast Asia like Philippines is rampant so in that case being ignorant is somehow lucky. What do you think?

[StephenCastlecrag]

Entecavir is one of 2 first line medications, the other one is tenofovir. Just keep taking it for several years, it will reduce your viral load and stop any disease progression. By that time, new medications or treatments should be available to cure, we hope.

[jul_21]

No, I don't use those supplement for the gym.I go to the gym for the sake of keeping my body fit and eat lots of vegetables. I also into a one day meal like eating a big lunch and that's it! In the morning,I drink a glass of instant milk with two pieces of bread then go to the gym after. When I come back from the gym, that's the time for my oatmeal with raisins and soy milk before having a big lunch in between 2-3 in the afternoon. I hope what I am doing will help for my healthy lifestyle. Thanks a lot SafiSifa!

[jul_21]

As of yesterday, I started taking Entecavir (entegard) as suggested by my doctor. Is it alright taking this medicine in my case? I know that my viral is very high and I really need to lower it down and if possible make it undetectable. Is that possible to achieve by taking this medicine? I think I have this virus when I was young and didn't get rid of it. Thank you for your enlightenment.!

[StephenCastlecrag]

Normally HbeAg negative and anti-hbe positive is good, patients in this state should have very low viral load and normal ALT. However, your viral load is very high, even though your ALT is only slightly elevated. I would definitely monitor your HBeAg status, viral load (hbvdna) and ALT closely and get treatment if necessary.

[SafiSifa]

Do not use any supplement for fitness (like protein powder etc.)!!

It is good.  

[jul_21]

Thanks a lot safisifa!.I have been living a healthy lifestyle and always go to the gym.My anti- hbe is reactive, is it good or bad?

[SafiSifa]

If you need treatment, that means you are not a health carrier.

HBV patients are divided into 2 groups:

1. Acute  Hepatitis B patients (who are cured naturally in the end of 5-6 months of illness) - luck group

2. Chronic Hepatitis B patients (who are not cured naturally in the end of 5-6 months of illness and the virus hosts into liver cells) - unlucky group

Chronic HBV patients are also divided into 2 groups:

1. Chronic Inactive Hepatitis B patients (also called healthy carriers. They do not need treatment. They have very low level of virus load and ALT.) - lucky group of unlucky group.

2. Chronic Active Hepatitis B patients (They need treatment. They have high level of virus load like you) - unlucky group of unlucky group.

I am sorry but you are chronic active hepatic b patient like all of us here. Your viral load is high. That is why you need treatment. But do not worry about that. Take your treatment and eat and live healthy.

WHAT IS DRUG RESISTANCE?
If you give up the treatment. Your viruses eventually get an ability to eleminate the positive effect of your treatment. And the treatment cannot do anything to the virus to get rid of from your body. Sometimes drug resistance occurs even you do not stop the treatment.

Entecavir and Tenefovir are the potent drugs and very low percentage of drug resistance if you do not give up.

[jul_21]

what do you mean by drug resistance? how does it affect the virus? based on my lab results, am i a healthy carrier?

[jul_21]

what will happen if you decided not to take it anymore? will it get worse even you considered as a healthy carrier?

[bigmoviebuff]

once you take it, you will need to take it for the rest of your life unless you are cured.
That is the sad reality we all are facing.

[jul_21]

what do you mean by drug resistance? how does it affect the virus?i believe im a healthy carrier base on the results, am i right?

[SafiSifa]

You should take continuously. Otherwise you may develop a drug resistance. But you talk to your doctor about it.

[jul_21]

Thanks for your reply Safisifa! Can I just take the medicine for 1 month then wait for more 2 months  to get tested for HBV DNA or I should continously take the medicine for 3 months?

[SafiSifa]

1. Absolutely Yes

2. Yes. However, it depends on patient. Eat healthy (more fresh vegetables and fruits)

3. Wait at least 3 months to see the net results. 1 month is not enough.