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Normal vit D levels are associated with hbsag seroclearance.
Normal vitamin D levels are associated with spontaneous hepatitis B surface antigen seroclearance.
Mahamid M, Nseir W, Abu Elhija O, Shteingart S, Mahamid A, Smamra M, Koslowsky B.
Source
Mahmud Mahamid, Shimon Shteingart, Mosab Smamra, Benjamin Koslowsky, Digestive Disease Institute, Shaare Zedek Medical Center, Jerusalem 93722, Israel.
Abstract
AIM:
To investigate a possible association between serum vitamin D levels and spontaneous hepatitis B surface antigen (HBsAg) seroclearance.
METHODS:
Fifty-three patients diagnosed with chronic inactive hepatitis B and spontaneous HBsAg seroclearance were followed up in two Israeli liver units between 2007 and 2012. This retrospective study reviewed medical charts of all the patients, extracting demographic, serological and vitamin D rates in the serum, as well as medical conditions and current medical therapy. Spontaneous HBsAg seroclearance was defined as the loss of serum HBsAg indefinitely. Vitamin D levels were compared to all patients who underwent spontaneous HBsAg seroclearance.
RESULTS:
Out of the 53 patients who underwent hepatitis B antigen seroclearance, 44 patients (83%) had normal levels of 25-hydroxyvitamin vitamin D compared to 9 patients (17%) who had below normal levels. Multivariate analysis showed that age (> 35 years) OR = 1.7 (95%CI: 1.25-2.8, P = 0.05), serum vitamin D levels (> 20 ng/mL) OR = 2.6 (95%CI: 2.4-3.2, P = 0.02), hepatitis B e antigen negativity OR = 2.1 (95%CI: 2.2-3.1, P = 0.02), low viral load (hepatitis B virus DNA  8 years) OR = 1.6 (95%CI: 1.15-2.6, P = 0.04) were also associated with spontaneous HBsAg seroclearance.
CONCLUSION:
We found a strong correlation between normal vitamin D levels and spontaneous HBsAg seroclearance.
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Page 25 of 25
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Just have got december results

Date/25(oh)/hbsag/dna/vit d3/1,25 oh
July/58/1590/<20/10000
Aug/64/1426/<20/10000
Sep/70/1891/86/10000
Nov/34/1856/56/5000/82
Dec/48/1907/50/10000/89

Obviously if correlation will vit d3 and hbsAg exists it is negative...

Vit D suplementation did not help to decrease hbsag at least for me...




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Just have got new results

Date/25(oh)/hbsag/dna/vit d3/1,25 oh
July/58/1590/<20/10000
Aug/64/1426/<20/10000
Sep/70/1891/86/10000
Nov/34/1856/56/5000/82
Dec/48/1907/50/10000/89
Feb/22/1530/68/4000/75

Definately negative correlation vit D and hbsAg ....



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There seems to be only one available thing that has proven positive hbsag correlation. This thing is called Interferon.
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Sorry there was a mistake in dna

Date/25(oh)/hbsag/dna/vit d3/1,25 oh
July/58/1590/<20/10000
Aug/64/1426/<20/10000
Sep/70/1891/86/10000
Nov/34/1856/56/5000/82
Dec/48/1907/50/10000/89
Feb/22/1530/<20/4000/75

Definately negative correlation vit D and hbsAg ....

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http://bionews-tx.com/news/2014/03/06/arrowhead-receives-regulatory-approval-to-begin-phase-2a-trial-of-chronic-hepatitis-b-candidate-arc-520-non-texas-article/

Experimental Drug For Chronic Hepatitis B Cure ARC 520 to Begin Phase 2a Clinical Trial

Hepatitis B has been one of the leading causes of endemics throughout the world, with as many as 350 million cases reported. Among them, around 700,000 to 1.4 million cases have been reported in the USA alone, with an additional 5,000 to 8,000 cases of chronic infection being reported each year. Around one-third of the world’s population gets affected every year, with one million deaths reported annually. Once infected, the most common serological tests include those for the surface antigen of HBV (HBsAg), which is detectable within 1-6 months of infection, and the e antigen (HBeAg), which can be detected within 1-3 months from infection. Entecavir is one of the standard drugs used for treatment in HBV infections.

ARC 520 aims to deliver a functional cure for the HBV infection and restore the adaptive immune system with the help of its RNAi mechanism. It has been tested successfully in mice and chimpanzee models, where it has been shown to reduce the amount of viral DNA, HbsAg and HbeAg by as much as 90 – 95% , lasting up to one month or more.

On completing animal trials, a phase 1 human double blind, placebo controlled, dose escalating trial with a combination of ARC 520 and Entecavir was proposed and successfully executed. Arrowhead’s CEO and President, Dr. Christopher Anzalone, commented that, “We successfully completed enrollment in a Phase 1 clinical study in healthy volunteers with initial data indicating that ARC-520 is generally safe and well tolerated in humans. We will be filing with Hong Kong regulatory authorities this quarter to enable a Phase 2a study in patients with chronic HBV infection.”

The clinical trial will focus on an escalated intravenous dose of ARC 520 with a combination of Entecavir. The escalated dosage would have strengths of 1 mg/ Kg and 2 mg/Kg, and each will be used in cohort studies with 8 people, with 6 receiving ARC 520 and 2 receiving a placebo. The target demographic will be people aged between 15 – 65 years with immune active chronic HBV infection, HBV e antigen negativity, and ongoing Entecavir therapy.

The primary objective of the study will be to check the depth and duration of the decline of viral antigens and products in response to a stronger dose of ARC 520 along with Entecavir. Other factors to be tested through this include pharmacokinetic properties (safety, tolerance of patients) and pharmacodynamic properties (effects of the drug on HBV DNA serum titers and antibodies against HBV surface antigens).
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Thanks for sharing.

How many years do we have, What do you think?
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my sister's experience:
vitd25oh>100ng/ml from sept 2013
oct 2013 150ng/ml
dec 2014 103ng/ml
apr 2014  108ng/ml

used gcmaf for about 2 months before starting tdf

started tdf dec 2013, baseline values: hbsag 13700iu/ml, hbvdna 1.600.000iu/ml

13 jan 2014 hbvdna 490iu/ml
08 apr 2014 hbsag 9000iu/ml, hbvdna und

response has been ultrafast on both hbvdna and surprise on hbsag too
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Thanks for posting it Stef. Excellent, I wish her fast recover and seroconversion,it would be nice advice for our future
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we will see how it goes by keeping high levels of vit d plus tdf

i actually never thought such a fast response, hbvdna 490iu/ml by about 5 weeks is not usual, and also hbsag decrease on hbeag negative, genotype D is not usual
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SEVERE 25-HYDROXYVITAMIN D DEFICIENCY IDENTIFIES
HCC PATIENTS WITH A POOR PROGNOSIS
F. Finkelmeier, V. Ko ̈berle, B. Kronenberger, J. Bojunga, S. Zeuzem, J. Trojan, A. Piiper, O. Waidmann. Internal Medicine, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
E-mail: fabian.***@****
Background and Aims: We performed a prospective cohort study to investigate the relation of vitamin D levels to stage and the prognosis of HCC patients.
Methods: 200 patients with the diagnosis of HCC presenting at the Department of Internal Medicine 1 of the Frankfurt University Hospital outpatient clinic were consecutively enrolled into the present study. 25-hydroxyvitamin (25(OH)D3) levels were quantified. Patients were followed until death or last contact. The primary end point was overall survival (OS).
Results: The mean follow-up was 322 days + 342 days with a range of 1–1508 days. 19 patients underwent liver transplantation and 60 (30%) patients died within the observation time. 34.5% patients had 25(OH)D3 levels below 10ng/ml (insufficient), 38% had levels between 10 and 20 ng/ml (deficient) and 27.5% patients had levels above 20ng/ml. 25(OH)D3 levels differed significantly between Child Pugh stages and showed a negative correlation
with the MELD score. Patients with decompensated liver disease had significantly lowered 25(OH)D3 levels. There were significant differences between stages of HCC according to BCLC and CLIP score. Patients with severe 25(OH)D3 deficiency had a significantly shorter OS (hazard ratio (HR) 2.631, (CI) 1.354–5.113, P = 0.004). In a multivariate Cox regression model 25(OH)D3 levels 2 were independently associated with shorter OS. Conclusions: We show that 25(OH)D3 serum levels differ between HCC stages and correlate with the severity of liver insufficiency. 25(OH)D3 levels below 10ng/ml were associated with a higher mortality risk in univariate and multivariate analyses.
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. I would never know for importance of vit d if it wasn't this forum and you Guys,especially Stef, I began to take vit d only 2 months ago because i saw my levels was 33, and only because of you. Doctor didn't say nothing. We have to be aware of every detail. Thank you
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this important thread up

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https://www.youtube.com/watch?v=hOfO29rL-gI

dr coimbra and experience on more than 2500 patients treated by high dose vit d3

during this long interview (portuguese plus italian subtitles) i have learnt a lot especially on our resistance to vit d due to our chronic infection, our vdr types, our nagalase and other factors.they use a very simple test available everywhere to see biological activity of vit d and see the level of resistance by PTH

vitamin d suppresses PTH, so as biological activity of vit d increases the pth goes down to low end of normal

when we supplement and increase vitd25oh we can check serum PTH and we have to make it low end of normal, at the point we know we have got around the vit d resistance problem

for example i found out:
my sister with vitd25oh 150ng/ml (max safe level while on no diaries diet) has PTH to 39.3pg/ml (range 11-67).if there was no resistance PTH should have been to very low
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Hi Stef, are you on combination therapy (peg + tdf) now?
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my sister's experience:
vitd25oh>100ng/ml from sept 2013
oct 2013 150ng/ml
dec 2014 103ng/ml
apr 2014  108ng/ml

used gcmaf for about 2 months before starting tdf and then stopped when started tdf

baseline: hbsag 13700iu/ml, hbvdna 1.600.000iu/ml
dec 2013 tdf+vit d3
13 jan 2014 hbvdna 490iu/ml
08 apr 2014 hbsag 9000iu/ml, hbvdna und
19 may 2014 hbsag 7000iu/ml, hbvdna und

hbsag keeps going down, vitamind25oh is kept 100-150ng/ml, calcium stays low, pth doesn t go down but stays stable at mid normal levels
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very good, impressive results :)

What is your sister's HBeAg status?
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negative
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Thank you for the answer.
In this case the results are even more impressive. :)
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Thanks for the update
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How much Vit D does she take daily? 10,000 iu??
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it is not the dose but keeping vitd25oh between 100-150ng/ml, for her 10.000-15.000iu daily are enough to reach this.
i need 20.000iu daily for example just to keep the levels and loading dose of 50.000iu daily to reach 150ng/ml
lately i lowered to 10.000iu daily thinking it would keep the levels, in few months vitd25oh got back to 90ng/ml...

so you have to find your dose to get to high levels and monitor pth too, to see if vit d is biologically active.both me and my sister have vit d interference and resistance since pth does not get to low levels despite such high values of vitd25oh
when vit d is very high pth must go to very low normal range if the vit in your blood is biologically active, some must care to keep low norm levels but not undetectable.low norm range pth is healthy but undetectable is not good
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Hi Stef
Below is my latest test reports

Date             HBSAG       HBV DNA   Anti HEV Ig M     Vit D25OH
17-Feb-14         944         3190                Not done                  16
22-Apr-14          831         364                 10.71                       124
26-Sept -14        674        1080                  1.80                       83

Hbsag is in IU/ML ( Quantitative ) and HBV DNA also in IU/ML & D25 in ng/ml

Now Iam only on Vit D 20000 IU . No other medicnes from last six month.

Will Hbsag levels go further down from here on .

Thanks
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If you can convince your doctor to give you PegInterfron then you might have a chance to clear since your HBSAG is <1000 iu/ml
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Your vitd25oh 124ng/ml looks the most effective on hbvdna, get vitd25oh to 150ng/ml and pth 10pg/ml and lets see if the trend of hbsag keeps the decline

of course nodiaries,2.5l of water and calcium in urine 24hrs test every 3 months
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Is vit25OH of 45.8 ng/ml enough? I'm taking 4000 iu of d3 daily
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no it is not enough at all for us, it is low.you also have to check intact pth because most of us have receptor resistance and vitd25oh doesn t tell us the level of vit d
pth lowest value of normal range means there is enough vitamin d
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Sir, what is the target range of vit25OH?
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there is no target for us on vitd25oh brcause it does not measure vit d, the target is intact pth below lowest of normal
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Ty sir
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the target is intact pth below lowest of normal

we need exactly lowest value of normal range, never close to undetectable because pth so low makes hypercalcemia
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Not hypocalcemia?
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no not hypo, hyper
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Ty stef
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update on my use of vitamin d:

after taking antibiotics this winter i got a increase of creatinine (antibiotics are toxic for kidneys and some brand may even lower creatinine clearance while on it, it happened to me), this is not resolving with creatinine 1.2 high range of normal.since also tdf is toxic on kidneys with damage i will stay off vit d for one month and restart full heptech protocol to make it as before antibiotic use 0.8

i hope hbsag will at least stay stable around 800iu/ml but anyway with cuban vaccine close to available this year and rep9ac advancement and my low hbsag i think i need not to worry about hbsag anymore
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i am interested in the heptech protocol for kidneys. i have a creatinine of 1.3 and was wondering if the heptech will help with it. Were you at 1.2 creatinine before and dropped it to 0.8?
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i ve had issues due to my cirrhosis since 2010 and creatinine increased also on etv.i was suggested fibroguard and it made creatinine normal by 1 month so i could use tdf too
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dont know if it can work on anybody, i took it few weeks after creatinine increased so very early intervention
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10915849 tn?1415116528
Hi Dear stef

How are you?

Is the cuban vaccin a theurapetic one or?
Did this vaccin passed all the trials stage?
When is it going to be available ?

Thank you
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it was posted on another thread, should be on the market in cuba by this year and south america next year.
combo with nucs or peg should help immune system clear hbv, they have not published hbsag quant data so difficult to say how much it can help
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10915849 tn?1415116528
Thank you
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update on my use of vitamin d:

because of the issues with creatinine, i also checked my pth and it had gone to 5pg/ml (norm 10-80) too low, so i lowered my dose to 100.000iu daily, then to 50.000iu, then 40.000iu and then stopped for 3weeks

then i restarted with 15.000-20.000iu daily which looks enough to keep pth 17pg/ml, i added also vit A (not in betacarotene type), creatinine is now 0.68 (norm 0.6-1.3)

the fact that now i need normal vit d levels to lower pth means that now my vdr receptor is working different and much better.i dont know if this reflects a new balance with hbsag since i dont have yet results
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How much vitamin k2 mk7 would you take with 10000-15000 iu vitamin d? It seems like vitamin k2 mk7 makes my eye twitch and gives me a sickest feeling. I take 100 daily. I was trying to take 200-300 a day but couldn't handle it.
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with such low dose i take 200mcg but also 90mcg is ok

an expert doctor on coimbra protocol suggested 600mcg for 50.000-100.000iu doses

vit d3 needs magnesium, vit a but low max 3000iu daily, vit k2 mk7, none of these have sides unless there is a deficiency among these or the brand has rancid oil or emulsions with vit d

try to supplement 400mg of magnesium daily, i use drbest which has a type of mg easily absorbed, i dont remember its name
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wanted to update my sisters hbsag decline on tenofofvir and vitamin d3 10.000iu daily (sometimes a little more when she is sick)

baseline 2012 from 18.000 to 21.000iu/ml
started vit d supplementation in 2011
before tdf dec 2013 about 13.000iu/ml
end of 2014 9000iu/ml
2015 8000iu/ml
jun 17 2016 5000iu/ml

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Great. very good decline on just TDF and Vit D 10k. Great results. Will she switch to TAF when it becomes available?
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Great. very good decline on just TDF and Vit D 10k. Great results. Will she switch to TAF when it becomes available? Any plans to add INF?
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no not interested to change anything, she s having zero issues from tdf, kidney function perfect, she feels immensely better than before using antiviral

Any plans to add INF?

no intf, she tried intf when experimental when she was a teen and sides were so bad she didn t even make any tests for decades or doctor's visits.she doesn t care about hbv, she only cares to feel well
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Very nice decline, keep posting about her ! Did Fibroscan also went down when she started TDF ?
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baseline fibroscan was 8.7kpa in aug 2013, she did about 3 months of gcmaf and then started tdf, the next fibroscan in feb 2015 was 4.6kpa

this could be due to tdf but i don t think so because antivirals are no so fast,i think that if we checked few months after gcmaf it was already low
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of course there are cases of fibrosis going down so fast on nucs too but they re not usual
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Wow, from F2 to F0 in 1.5 year, great. Did she took anything except tdf and gcmaf in that period ? Fibroguard or sth ?
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i m sure if we did fibroscan after gcmaf it was already low because all her response was superfast thanks to gcmaf/vit d according to me:
hbvdna baseline 1.600.000iu/ml hbsag 13.000iu/ml
started tdf 3 dec 2013
hbvdna 490iu/ml 13 jan 2014
hbvdna und         8 apr 2014  hbsag 9000iu/ml
                       19 may 2014 hbsag 7000iu/ml

then lost response on hbsag, i think she lost the effect of gcmaf.she has felt incredibly good on gcmaf but she stopped it because she didn t like injections and the fact it s a blood derived product
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