Aa
My story
Hi, I am of 32 years. I am from Pakistan. I diagnosed with HBV chronic in 2009. I went to the doctor. Due to heavy load of virus ( that was in billion) he suggested me to start pegassy injection. I got six month inject (one in a week) after six month virus didn't decrease too much. Then he started Tenofo tablet (one per day) which decresed immediately my viral load. During the treatment I came in Canada for study purpose. After using 4 years of Tenofo he suggested me by email that you can stop taking tenofo now. I have stopped in January-16 after 4 years.
I didn't go to doctor here and cannot go to the lab without the doctor.
what should I do now? can I continue with tenofo-b after the gap of three months again?
I don't have insurance here in Canada so that will be very expensive for me to start my treatment here. I can get insurance in October and than can go for treatment. Can I wait for 7 months more without any test and treatment. But I can ask someone from my country they can send me the medicine for one more year here. Please help me. I am sorry it's without any test result. Last time one year ago my PCR quantitative was not dectective and ALT was in normal range.
Please help me with advice.
I didn't go to doctor here and cannot go to the lab without the doctor.
what should I do now? can I continue with tenofo-b after the gap of three months again?
I don't have insurance here in Canada so that will be very expensive for me to start my treatment here. I can get insurance in October and than can go for treatment. Can I wait for 7 months more without any test and treatment. But I can ask someone from my country they can send me the medicine for one more year here. Please help me. I am sorry it's without any test result. Last time one year ago my PCR quantitative was not dectective and ALT was in normal range.
Please help me with advice.
HBV Chronic is not cure. you take free medicin ETV Or Tenvir Govt Of Pakistan Hepatitis control program .
Thank God I'm happy for you try not to miss your medicine it could be very dangerous!
I think it's very important to find out if pre-existing conditions will be covered by the canadian health insurance. If not, there is really no point waiting for it since you will have to pay for treatment anyway.
Secondly, the only person qualified to assess and recommend next moves on a treatment is a specialist, who can only do so once he sees complete lab results, and especially hbv dna. It's also important for him to have a record of all your past medical history and lab tests (so do get these shipped from pakistan)
Since you have been on tenofovir, then I assume you have read the documentation that comes with it, including the warnings of what could happen when tenofovir treatment is stopped. (http://www.drugs.com/ppa/tenofovir-disoproxil-fumarate.html)
The risks you take without proper lab tests and medical consultation if you self medicate.
- damage your liver irreversibly
- possibly make the virus resistant to one of the best medicines on the market. (to date, nobody really knows much on this aspect, since tenofovir has only been approved for chronic hepatitis b treatment in 2008-US)
bottom line: Yes, it's dangerous if you take it on your own without any medical supervision.
Assuming you take it anyway...then what could happen/will happen is this: in the 7 month period where you say you have no insurance coverage but want to retake tenofovir, you will miss essential blood tests that show whether you are liver-wise stable, improving if liver readings have shot up, or not, in which the doctor might prescribe a different course of treatment. Without lab tests and a doc who could assess the pros, cons, risk and safety of your treatment, you could make things worse for yourself. You may find it's too expensive to do what's necessary now...but what if you land in the hospital three months down the road anyway? you would have doubled your personal costs.
As for financial constraints, check out your options: canadian community health center, foreign student's office, charitable organizations, student organizations, local Pakistani community. Just pay for the doc and lab fees, and if he says continue tenofovir, then get tenofovir shipped over from Pakistan where it is cheaper to buy. This way, you can save some costs.
This may seem some blown up scenario, but I personally wouldn't want to mess around with the health of my liver. It's the only I've got. I am sure they have really good liver specialists out there in Canada and can help you substantially while it's still early (in the sense of you having stopped tenofovir only this past January). Don't wait for that time period to get any longer before you see them.
Good luck out there!
Secondly, the only person qualified to assess and recommend next moves on a treatment is a specialist, who can only do so once he sees complete lab results, and especially hbv dna. It's also important for him to have a record of all your past medical history and lab tests (so do get these shipped from pakistan)
Since you have been on tenofovir, then I assume you have read the documentation that comes with it, including the warnings of what could happen when tenofovir treatment is stopped. (http://www.drugs.com/ppa/tenofovir-disoproxil-fumarate.html)
The risks you take without proper lab tests and medical consultation if you self medicate.
- damage your liver irreversibly
- possibly make the virus resistant to one of the best medicines on the market. (to date, nobody really knows much on this aspect, since tenofovir has only been approved for chronic hepatitis b treatment in 2008-US)
bottom line: Yes, it's dangerous if you take it on your own without any medical supervision.
Assuming you take it anyway...then what could happen/will happen is this: in the 7 month period where you say you have no insurance coverage but want to retake tenofovir, you will miss essential blood tests that show whether you are liver-wise stable, improving if liver readings have shot up, or not, in which the doctor might prescribe a different course of treatment. Without lab tests and a doc who could assess the pros, cons, risk and safety of your treatment, you could make things worse for yourself. You may find it's too expensive to do what's necessary now...but what if you land in the hospital three months down the road anyway? you would have doubled your personal costs.
As for financial constraints, check out your options: canadian community health center, foreign student's office, charitable organizations, student organizations, local Pakistani community. Just pay for the doc and lab fees, and if he says continue tenofovir, then get tenofovir shipped over from Pakistan where it is cheaper to buy. This way, you can save some costs.
This may seem some blown up scenario, but I personally wouldn't want to mess around with the health of my liver. It's the only I've got. I am sure they have really good liver specialists out there in Canada and can help you substantially while it's still early (in the sense of you having stopped tenofovir only this past January). Don't wait for that time period to get any longer before you see them.
Good luck out there!
Thanks for everyone. I have received Tenofo for one year and have started yesterday. Thanks again.
I got my LFT. Those were in normal range. Please suggest me what should I do now
3 Comments
You should restart tenofovir immediately. Since you started with a high viral load, chances are high that the virus will rebound a few month after stopping, unless you seroconverted to e antigen negative. This status and a dna level test is what is truly needed to assess your current status, but you are unable to get this as you say. The viral load goes up first, the immune reaction often follows, which will then drive your LFT beyond the normal range.
Stopping should only be done with careful monitoring, your current situation does not seem to allow for that.
Stopping should only be done with careful monitoring, your current situation does not seem to allow for that.
Hi, I am getting the Tenofo-B tomorrow. Can I start immediately? any suggestion because i am starting it with the gap of 3 months. please.
Considering your overall situation, there is no reason not to start immediately.
Hello,ok, now I understand. An LFT test would normally give you a good indication of the state of your liver. If the results of LFT show very high ALT and AST than the upper level of normal, then this means there is inflammation going on in the liver. But it is not appropriate for me or any other member here to recommend to you medication, as we are not doctors, and do not know your health situation closely.
Besides, if you are staying and studying in Canada legally, why should you wait until October to get a health insurance? May be you need to look for information about the health services in the province you are living in?
Besides, if you are staying and studying in Canada legally, why should you wait until October to get a health insurance? May be you need to look for information about the health services in the province you are living in?
Hello qasimgill,
I found your message a bit contradictory: in the beginning you said "...without the health card & insurance there is no doctor who can see me and no lab will test me"; then you said "I will go tomorrow morning for Blood test (LFT) and will get the result on Saturday". If you have found a doctor who can take a blood test for you, then what is the problem. He can just take the tests recommended, such as ALT, AST, hbv Dna,etc and find out about your hepat.b status. Then if the tests show your condition needs treatment, then the doctor may recommend you to resume your medicine.
I found your message a bit contradictory: in the beginning you said "...without the health card & insurance there is no doctor who can see me and no lab will test me"; then you said "I will go tomorrow morning for Blood test (LFT) and will get the result on Saturday". If you have found a doctor who can take a blood test for you, then what is the problem. He can just take the tests recommended, such as ALT, AST, hbv Dna,etc and find out about your hepat.b status. Then if the tests show your condition needs treatment, then the doctor may recommend you to resume your medicine.
2 Comments
Dear Bro, he will do it in another way. I find a Indian Doctor. He will take my blood test and according to my request he will do it on his behalf. I don't know how.
He promised for LFT for the sake of my life as i requested and tell him all the story about me.
My dear friends and respected members,
My issue is this that without the health card & insurance there is no doctor who can see me and no lab will test me. Its government policy in Canada. I will get my health card and insurance in September.
Unfortunately, I have stopped Tenofo B in Jan-15 as I took just for one year. I been to the doctor and upon my request he has agreed for my LFT (ALT etc). Will it fine for this time? I have asked my brother if he can send me Tenofo-B for one year more.
I stopped in Jan-15 and If i can start In the end of this month like 31st March. Will it be dangerous for me? I will continue and then can go for test after October?
I have only these options. The other option is that I will go back to my country immediately.
My questions are: I will go tomorrow morning for Blood test (LFT) and will get the result on Saturday.
Can I re-start Tenofo-B?
Please for your kind suggest and advice please according to my situation.
I am feeling bad and scared after reading this.
My issue is this that without the health card & insurance there is no doctor who can see me and no lab will test me. Its government policy in Canada. I will get my health card and insurance in September.
Unfortunately, I have stopped Tenofo B in Jan-15 as I took just for one year. I been to the doctor and upon my request he has agreed for my LFT (ALT etc). Will it fine for this time? I have asked my brother if he can send me Tenofo-B for one year more.
I stopped in Jan-15 and If i can start In the end of this month like 31st March. Will it be dangerous for me? I will continue and then can go for test after October?
I have only these options. The other option is that I will go back to my country immediately.
My questions are: I will go tomorrow morning for Blood test (LFT) and will get the result on Saturday.
Can I re-start Tenofo-B?
Please for your kind suggest and advice please according to my situation.
I am feeling bad and scared after reading this.
after stopping tenofovir you would have to closely monitor your ALT, also DNA. It is possible to get a strong flare after suddenly stopping tenofovir or entecavir, a flare that can be very dangereous...
You must test your ALT immediatelly now.
Based on what did the doctor tell you to stop? Did you become hbeag negative while on treatment?
You must test your ALT immediatelly now.
Based on what did the doctor tell you to stop? Did you become hbeag negative while on treatment?
5 Comments
nothing .. he just told me go for quantitative if that is zero then you can stop taking tenofovir. I cannot go to the doctor as I don't have insurance here in Canada. But i am going for doctor who can write blood test for me.
could you please tell me which test i need now? so i can ask him
please tell me sir how many tests i need now ..... i need detail please
Hi qasimgill,
The best would have been fro your doctor in Pakistan to send you your medical records, so that eventual doctors in Canada could look at them and have an informed decision.
At least you need the following blood tests to monitor your hepatitis b: liver function tests such as ALT, AST; hepatitis b viral DNA status and quantitative; HbeAg status; HbsAg status and quantitative if possible.
You may also take a liver FibroScan and ultrasound if you have the possibility to do so.
The best would have been fro your doctor in Pakistan to send you your medical records, so that eventual doctors in Canada could look at them and have an informed decision.
At least you need the following blood tests to monitor your hepatitis b: liver function tests such as ALT, AST; hepatitis b viral DNA status and quantitative; HbeAg status; HbsAg status and quantitative if possible.
You may also take a liver FibroScan and ultrasound if you have the possibility to do so.
My dear bro. My issue is this that without the health card & insurance there is no doctor who can see me and no lab will test me. Its government policy in Canada. I will get my health card and insurance in September.
Unfortunately, I have stopped Tenofo B in Jan-15 as I took just for one year. I been to the doctor and upon my request he has agreed for my LFT (ALT etc). Will it fine for this time? I have asked my brother if he can send me Tenofo-B for one year more.
I stopped in Jan-15 and If i can start In the end of this month like 31st March. Will it be dangerous for me? I will continue and then can go for test after October?
I have only these options. The other option is that I will go back to my country immediately.
My questions are: I will go tomorrow morning for Blood test (LFT) and will get the result on Saturday.
Can I re-start Tenofo-B?
Please for your kind suggest and advice please according to my situation.
I am feeling bad and scared after reading this
Unfortunately, I have stopped Tenofo B in Jan-15 as I took just for one year. I been to the doctor and upon my request he has agreed for my LFT (ALT etc). Will it fine for this time? I have asked my brother if he can send me Tenofo-B for one year more.
I stopped in Jan-15 and If i can start In the end of this month like 31st March. Will it be dangerous for me? I will continue and then can go for test after October?
I have only these options. The other option is that I will go back to my country immediately.
My questions are: I will go tomorrow morning for Blood test (LFT) and will get the result on Saturday.
Can I re-start Tenofo-B?
Please for your kind suggest and advice please according to my situation.
I am feeling bad and scared after reading this
I have asked someone for Tfd. Could u please tell me if I can re-start it after one week. I stopped taking from 15th of January. Can I re-start it in the end of this month. Is there any side affect of this gap? I can go for blood test in October then. Will it be fine? Please advice me
Hello,
It is not wise for you to wait seven months without testing your hbv situation. As you may know, there is a risk of increased liver inflammation or flares after stopping with nucs. Hence it is important for you to monitor your liver status and blood work. It seems that you do not have a problem of getting an eventual tenofovir drugs sent to you from Pakistan; the only thing you need to do is find a doctor in Canada who could prescribe for you a lab test, so that you know about your hbv status.
PS. Do not re-start medication without a new lab test, and against the recommendation of your doctor.
It is not wise for you to wait seven months without testing your hbv situation. As you may know, there is a risk of increased liver inflammation or flares after stopping with nucs. Hence it is important for you to monitor your liver status and blood work. It seems that you do not have a problem of getting an eventual tenofovir drugs sent to you from Pakistan; the only thing you need to do is find a doctor in Canada who could prescribe for you a lab test, so that you know about your hbv status.
PS. Do not re-start medication without a new lab test, and against the recommendation of your doctor.
1 Comments
Dear Bro. thanks for your email. i cannot go to doctor without health insurance etc... Can i restart the medicine after one/two week. Will it be dangerous or any side effects of this medicine?
get your family to ship tdf from india or pakistan where its just 20-100usd per month
2 Comments
Dear Stef, I can ask to my family and can get it within seven days. Can I re-start medication??? the same tenofo-b further...?
Can I re-start it with three months gap... and should I ask them to send me one or two year medicine?
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