Is this a good result, for Stef and Stefan

[FlyingHippo]

Brothers,
I just posted my 5 months PEG interferon result a week ago and details:

Before 1st injection:

DNA>5x10^7 (upper limit of the device is 5x10^7, so don't know the exact number, perhaps over 10^8)
HBsAg=33000iU,
HBeAg=1000iU
ALT=200

After 8th injection:
DNA>3.3x10^7
HBsAg=9900iU,
ALT=58

After 12th injection:
DNA=4.89x10^6
HBsAg=5900iU,
ALT=57

After 20th injection:
DNA=2.2x10^7
HBsAg=3400iU
ALT=50

I was a bit upset because the DNA was going up from 4.9x10^6 to 2.2x10^7 in recent 2 months, but today I got my new HBsAg result, it's going down continuously, from 33000 to 9900, then 5900 and now it's 3400!

My concern is why HBVDNA is going up while HBsAg going down? Is my latest result a good sign?

[FlyingHippo]

No, all relevant test result are still good right now, I got nearly no side effect, just keep the injection every week, and have the test one or two months.

[mustthinkpositive]

Just a suggestion. However, the key result here is the rapid drop in HBsAg, which IMO a better result than a drop in HBV DNA.

Maybe there is a typo. It should be log 5 instead of 7. Regardless, still a good result.

FlyingHippo, no problem with the neutrophils level?

[StephenCastlecrag]

If you look at the results of the clinical trial comparing ETV pretreatment, ETV add-on, and just mono PegIFN, the authors did not find any differences in the final outcome.

[FlyingHippo]

Thank you, I will be reporting my next result soon in 20 days.

[FlyingHippo]

I am not sure, what I know is, the same doctor, the same hospital, the same test method. Let's see next result.

[stef2011]

do you know if same machine was used?using different machines gives very different results even 1log higher or lower

[mustthinkpositive]

Interestingly, your ALT went down from 200 to 50. That is from a high baseline. We do want to keep ALT at over 100 during IFN treatment.

The correlation is quite weird. Sometimes there are people that report a drop in HBV DNA and a rise in HBsAg and then in your case vice versa. Adding ETV or TDF might be an option?

Good luck !

[stef2011]

keep going good results, hbvdna may go down at next test, check also vitd25oh and intact pth so that you can boost immune system correctly

[FlyingHippo]

Thank you Stephen, the result is a kinda strange, anyway, there is no doubt I will be going on with the PEG. I will be posting the result continuously here.

[StephenCastlecrag]

I am no expert. It seems for HBeAg negative patients, stopping rule depends on changes in hbvdna. At the moment, we seem to have only stopping rule, that is, some patients should stop and not complete the whole course as they are unlikely to achieve SVR. Personally, I think a fall in serum HBsAg should lead to a fall in hbvdna.

[FlyingHippo]

My doctor told me usually HBVDNA is going down first but in some patients the HBsAg is going down firstly before HBVDNA, anyway, HBsAg reduce is the key, right?

[StephenCastlecrag]

According to the current stopping rule for HBeAg positive patients treated with PegIFN, those with HBsAg > 20,000 iu/ml at week 24 should stop. Obviously you do not belong to this category of patients and you should continue and complete your course.
All the best.

[FlyingHippo]

I take vitD3 10,000IU everyday, I know that matters a lot!