My healing on peginf

[sorte]

I've started interferon 5 weeks ago, I will try to keep updating in this thread and put related questions here.

week 0:
ALT 30
HBV DNA 700 IU (few months earlier 5600 so fluctuating)
HBsAg 13.000 IU
HBe-
Fibroscan 5,8 F1/S0
Bisopy F1/A2

week 2: ALT 90
week 5: ALT 245

My doctor said last ALT is from one side good (cleaning infected cells) but from other side he's worring that it has raised so fast. I have to check it in two weeks. He said if it will raise to 400 he will decrease peginf dose to 135mcg cuz he's worring that fulminant hepatitis may occure.

[Jason_256]

You said there were no sides from peg just a couple of weeks ago. Which one is it?

[sorte]

Week 59. Poor decline after extra 3 months of peginf:

HBsAg: base 13000 | 7450 | 7200 | 4200 | 3600

I'm gonna stop peginf after last shoot will take next week and will observe.

[sorte]

week 54:
ALT: 94
other morphology results similar like month ago

[elis1]

Powodzenia!

[sorte]

unfortunatelly it's very average response, but I will keep trying next 3 months

[cure4life]

Its great to see you are responding well!!!  You are doing great.

[sorte]

ok, got 12 weeks extra and we will see if it makes sense to continue more

[Aduiski]

I don't see why should he continue.

[Aduiski]

but if absolutely no side-effects then it could perhaps make sense

[Raj185]

I think you should continue.
my HBsAg Quant:
Base line:30000
after 48 week(Feb 2016): 9800 (Stopped PegIntf)
after 56 week April: 5400
after 64 week June: 7400

my doctor said the same thing not enough decline we should stop pegIntf. Currenlty continuing on Entacavir.
You should continue and see how it responds.

[sorte]

Recent update, week 46:

ALT: 113
HBV DNA qualitive: und since week 12
HBsAg: 4200 (base 13000 | 7450 | 7200 | 4200)

Probably my doctor won't decide to continue peginf, because too low HBsAg decline, but will try to insist.

[stef2011]

remember that the most effect of pegintf is the second year, since you have an hbvdna response and high alt i assume you might see more on the second year

i remember pisa researcher told me 1 case about the adv+peg add on trial and the patient with the highest response had no hbsag decrease on 1 year of combo, while cleared hbsag and developed the highest hbsab the second year (it was 2 years peg+adv trial)
this is a single case and nothing scientific to apply to all but since no sides and hbvdna response it makes sense to keep it

[Aduiski]

It reduces the severity of the disease...

This was my theory which i got it confirmed recently on my latest appointment with my hepatologist - one of the leading hep b experts in Australia. She has connections with big pharma companies and is involved with a number of important clinical trials regarding hep b, so she should basically know this.

Reduction of the severity of the disease must then, in my opinion, lead to the reduction of HCC risks as well as other negative effects of hep b.

In my opinion, the degree of the reduction of the severity of the disease probably corresponds with the response.

If you want to show some concrete data to your doctor about the prolonged effects, take a look at the Lampertico's presentations on either last year Paris conference or this year Singapore hepatitis conference.
One of his slides comes with the data of hbsag loss up to 20 years after the end of the interferon treatment....thus clearly showing delayed effects of interferon.
While you yourself probably won't be clearing hbsag in next 10 years based on your 24 weeks result, i believe that you will benefit from peginterferon down the road, maybe not to a great extent but benefit should be there as your hbsag is already reduced (and hbsag levels themselves directly correlate with the severity of disease), as shown by a number of studies (you can search for these as well to show them to your doc)

[sorte]

Of course I'd like to continue because at the moment I almost have no sides and last alt was 140.
Could you list me please what are those prolonged pefinf benefits (hcc risk decrease ? fibrosis decrease ?), so I will have some arguments in discussion with my doctor in case he will want to cut it.

[stef2011]

i also think that if no sides at all it is good to go on for 48weeks, hbvdna undetectable should be enough to keep it according to european guidelines.

[Aduiski]

Do you have any side-effects?
If you don't have them you could finish the full 48 weeks, as peginf does have prolonged effects in reduction of the severity of hepatitis even if it doesn't clear hbsag. It is the decision you should make in consultation with your doctor(s).

The good news is that your dna is negative.

[sorte]

Unfortunatelly on week 25 almost no change in HBsAg in compare to week 12,  7450 IU -> 7180 IU
Not sure if peginf will be continued in that case, although hbv dna qualitive is still negative since week 12.

[stef2011]

pth/vitd25oh is definitely very strange during peg, if everything was fine with receptors your pth should be lowest normal while despite vitd25oh over 100ng/ml pth is still mid normal range and not low

so in the end your tissues are still vit d deficient despite all of that vit d, i d go to 10.000-15.000iu daily according to what we see as hbsag result

[sorte]

Other results from today:

Creatinine 87,00 µmol/l [62,00 - 106,00] 3 months ago 76
TSH 1,65 µIU/ml [0,270 - 4,200] 3 months ago 2,55
FT4 1,13 ng/dl [0,93 - 1,71] 3 months ago 1,11

[sorte]

Notice that my base d3/pth levels before starting supplementation was
d3 23 pth 27
that test was made after almost 3 months of the winter, so not much sun

[sorte]

Good point, I forgot to include it, so:

3 months ago: d3 123, PTH 57 (supplementation 7000-10000 IU)
today: d3 118, PTH 36 (supplementation 5000-7000 IU)

[stef2011]

do you also have intact pth?it will tell us where vitd25oh really is

i bet pth will stay high while on peg even if we have a lot of vitd25oh in blood, its like all vit d is used and run out fast

[sorte]

week 25:

ALT 143

Vid D 25(oh) 118,80
Calc total 2,34 mmol/l [2,15 - 2,50]
Phosphor 1,09 mmol/l [0,81 - 1,45]

Other params similar to the results one month ago. HBsAg quant result in 2 weeks.

[sorte]

Week 20:
ALT 134, so a bit lower than 5 weeks ago (was 150)
All other params like neutrophils etc low but stable.

[Aduiski]

I would again advise u though to get on black sees and raw honey, together with lots of fresh fruits and vegetables...daily and regularily. You got to push it with these to reap the max benefits.