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Need advice on liver biopsy results
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Need advice on liver biopsy results

I am a 36 years old female and have chronic hepatitis B for 20 years. Have been feeling fine. Had a liver biopsy due to an elevated alt (100) and ast (49). The virus DNA is 3860. The biopsy results show mildly active (grade 2 of 4 ) with focal portal fibrosis (stage 0-1 of 4). My doctor wants to put me on Viread. Read about the side effects and seems like if I stop taking it at some point, it will make the hepatitis worse.
I am contacting another doctor for a second opinion, just curious if anyone have any suggestions or comments. Thanks,

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Avatar_m_tn
without those tests starting tenofovir is a rip off because you dont know where you are going and why......

also keep in mind that we have only one hbv cure which is sequential treatment by tenofovir for 1-3years and then pegintf add on but to monitor this cure we need hbsag quantity which reflects number of infected cells in the liver and your immune response towards hbv.

when hbsag is around 1000-1500iu/ml there is little suppression of your immune system by hbv so pegintf has the highest chances to clear hbv definitively

the basis of sequential treatment is that human trial showed:
50% hbsag clearance by 48weeks of peg add on after 3 years of antivral monotherapy
90% response with hbsag lowering to less than 300iu/ml by 72weeks of combo.hbsag at less than 300iu/ml is usually inactive and drugs can even be stopped with no infection reactivating
10% no response but this patient used weak antivirals not used today

tenofovir monotherapy is able rescue specific hbv cd8 immune response and pegintf killer cells, both arms are needed to clear hbv....search this study by search box it has been posted recently
4 Comments Post a Comment
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Avatar_m_tn
that doctor is crazy to do a biopsy today and for a alt rise plus biopsy results do not justify the use of viread i think he just ripped your money

first of all you should have:
regular fibroscan monitoring which is more useful than just a biopsy which showed no liver damage anyway

hbsag quantity in iu/ml, to know the status of the infection and the possibility to clear hbv once and for all by pegintf

hbv genotype and mutations precore/bcp if available

hbeag
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Avatar_m_tn
without those tests starting tenofovir is a rip off because you dont know where you are going and why......

also keep in mind that we have only one hbv cure which is sequential treatment by tenofovir for 1-3years and then pegintf add on but to monitor this cure we need hbsag quantity which reflects number of infected cells in the liver and your immune response towards hbv.

when hbsag is around 1000-1500iu/ml there is little suppression of your immune system by hbv so pegintf has the highest chances to clear hbv definitively

the basis of sequential treatment is that human trial showed:
50% hbsag clearance by 48weeks of peg add on after 3 years of antivral monotherapy
90% response with hbsag lowering to less than 300iu/ml by 72weeks of combo.hbsag at less than 300iu/ml is usually inactive and drugs can even be stopped with no infection reactivating
10% no response but this patient used weak antivirals not used today

tenofovir monotherapy is able rescue specific hbv cd8 immune response and pegintf killer cells, both arms are needed to clear hbv....search this study by search box it has been posted recently
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Avatar_m_tn
Stefan. If she is in the US then they like here do biopsies left and right. Insurance companies pay 100% for it. Some crook doctors like to do this procedure in their office. So they dont have to share payment with the hospital.

I mean this is really what is going on. We are cattle to some of these people.

Sequential therapy is good yes. But here they will tell you there is no proof it works and second health insurance company will say Not Medically Necessary! And that is it. You will go crazy writing  grievance letters to them.  
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Avatar_m_tn
So yeah if you are a patient that is not in the know which we all were in the beginning we are taken for a ride.

It is a total bedlam with Eugenics written all over  it. I have never thought that I will experience all this.

As I said we should stop talking about nucs and interferons. They have better drugs that we need to push them to release.

The reasoning for saying we should wait till 2017 till patents expire should get you all guys mad.

As for for doctors yes it is  sad to see that most of them became drug salesman and insurance interest cronies. that is why many people have stopped going to doctors they are disgusted with the situation for only being sucked out of money and fooled around with.
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