Is is possible and What the results means ?

[MdWaqas]

Hi, My sister was found positive of HBsAg 1.5 years ago after 6 months we have a visit to specialist he recommended the following Test and their results are

Anti Hbe: Reactive
HbeAg : Non Reactive
HBV DNA By PCR Quantitative: 4400 IU/ml

Doctor tell us that currently no medicine required but and Now after 1 year we do the same test from same lab and the results are

Anti Hbe: Non Reactive
HbeAg : Non Reactive
HBV DNA By PCR Quantitative: Not Detected

What is it mean is the virus has gone my sister is safe now or not ...... if save is virus has chances to come again please guide me thanks

[stef2011]

First of all the doctor isnot a doctor and understands nothing of hbv, so look for a real liver spe ialist first

second have a fibroscan to know if liver is ok, this will tell you if your sister needs a treatment, not blood tests only
then test hbsag quantitative in iu/ml and hbsab

hbvdna has nothing to do with clearance of infection, it is just to see response to antivirals together with hbsag quant

[MdWaqas]

Thanks for helping us

I also want to know your suggestions on my question please

Question is at top
"Hi, My sister was found positive of HBsAg 1.5 years ago after 6 months we have a visit to specialist he recommended the following Test and their results are

Anti Hbe: Reactive
HbeAg : Non Reactive
HBV DNA By PCR Quantitative: 4400 IU/ml

Doctor tell us that currently no medicine required but and Now after 1 year we do the same test from same lab and the results are

Anti Hbe: Non Reactive
HbeAg : Non Reactive
HBV DNA By PCR Quantitative: Not Detected

What is it mean is the virus has gone my sister is safe now or not ...... if save is virus has chances to come again please guide me thanks"

[stef2011]

in your case peginterferon was the treatment to lower hbsag.anyway keep taking etv and check hbsag quant monthly, if it goes down keep etv for about 1 year than add peginterferon to it to clear hbsag and hbv definitively

your chances to cure hbv are 91% with this schedule since your hbsag is very low less than 1000iu/ml.in a low percentage of cases very low hbsag is cleared by etv or tdf monotherapy too

[paak]

I already started taking Entecavir since last 4 days as Tenofovir wasn't available for time being and it is also expensive than Entecavir in Pakistan. Meanwhile, I got reports of my HbsAg quantitative today and it shows patient value of 393.18 IU/ml. Following note is written on report:
(HBsAg Quantitative Test is reliable method for the detection of HBsAg. At Chughtais Lahore Lab this test is performed on the fully automated and integrated Abbot Architect Ci 8200 system utilizing Chemiluminescent technology. The assay has a sensitivity of <0.05 IU/ml. The numerical value of the patient’s result represents viral load and can be used to monitor therapy for hepatitis B.)

Remember my HBV DNA was 51,800 copies per ml at end of Oct. LFT were in normals range, ALT is 25

Please comment on my prognosis and the possible outcome of this treatment. Please also advise if i need to get further tests, if so, which one and when? Thanks in advance.

[stef2011]

afp means only that the liver is inflamed, most cancers have normal afp

Do i need to get further tests to rule out the cancer?
cancer is only detected by ultrasound repeated every 6 months, not by afp alone

Analgoues such as TDF or ETV can also be used if tumor is already present?
they must be used, without them hcc gets even worst and after resection there is more cases of hcc again.also low hbsag is very important

start directly with tenofovir because cheaper and especially because more potent

[paak]

What do you think my AFP indicate? Does it certainly mean that i have already developed the cancer or does these level indicate the active presence of viral replication? Do i need to get further tests to rule out the cancer? Analgoues such as TDF or ETV can also be used if tumor is already present? Regarding choice between ETV or TDF, if i start with ETV, wouldnt it be possible to shift to TDF after couple of months? I am seriously thinking to immediately start with either ETV or TDF from today and will look for (more) tests eg HbsAg quantitative in the coming days? Or I can not start until further diagnosis is not made? Please advise.

[flyinsky]

hi
iral load not detected is good sign her immune system is well done
try to do hbsag test maybe she is cleaning without this test you can t know really what is hapenning

[stef2011]

There is another member from pakistan who cleared hbv by following our suggeztions, look for it and ask him where to test for hbsag quantitative and hbv gentoype.these are mandatory tests to cure hbv

as to choice etv or tdf definitely tdf because the most potent unless you have kidneys disease.

once we have hbsag quant and genotype we can choose if to go directly for peginterfero n or choose tdf and add peg after 3 years

[SafiSifa]

is it certain that you have a tumor?

I think you start taking medicine because your HBVDNA across the limit (20000)

[paak]

I am 27 years old male from Pakistan. I was first detected with HbsAg+ in 2004 in screening. I got checked for LFT which was normal. Once a year I kept on monitoring LFT and it remained normal. In 2009, first time I got tested for HBV DNA by PCR which was negative with normal LFTs. HbeAg was negative. Same was in 2011. In NOV 2012, my HBV DNA was + and quantitative PCR resulted 4,180 copies per ml. LFT was normal. My hepatologist advised starting Entecavir 0.5 mg once a day. I wasn't convinced on this prescription, so I went to another hepatologist, who advised me not to start treatment yet, but to wait. In May 2014, I again got tested and PCR result showed only 850 copies per ml and LFT were normal. I didnt go to dr then.
Now, in last week of October 2014 I have again  tested, and LFT are normal (ALT is 25, AST is 22) but Qualitative PCR showed HBV DNA Detected. I then got quantitative PCR which showed 51,870 copies per ml. At the same time, I got AFP done, and the result is 11.7 IU/ml (while Tumor Marker is <5 IU/ml). I am also feeling milk pain in upper right quadrant for over a year now but this pain is not always. In between, I was also declared as fatty liver (in 2012) and i took some medicines too. Now, i want to know whether I should start Entecavir or Tenovofir? Can somebody, especially, steef2011, please guide me. Thanking you in anticipation. Regards,

[sppc2k]

Now you must test her for HBsAG and HBsAB. If the results are HBsAG - Negative and HBsAB - Positive, then she has developed an antibody and cured the infection.


Best of luck!!