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Regarding HBV DNA quantitative test results
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Regarding HBV DNA quantitative test results

hi,
i am a male and was found positive for Hepatitis B about two years back. doctors say i am just a carrier. My recent LFT gave SGPT count as 56 which is out of the range of 13-40. so i got my HBV DNA quantitative test done. the result came out to be as "under detectable limit". what does this conclude?
i don't consume alcohol and am a healthy person as a whole.

1) Is the hepatitis B virus not replicating in my body?
2) Also i want to know the chances that my wife who has taken the vaccination for Hepatitis B gets this virus from me?
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Avatar_n_tn
As long as you are S antigen positive that means the virus is replicating. S antigen is released by the virus after replication.

So even though you are undetectable in your blood, the virus is still using your liver cells to replicate.

The good news is that this means you are generally non very infectious and liver damage is not as severe as having an active carrier condition where DNA counts are >100,000 (and sometimes in the billions!).

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Avatar_n_tn
so what are the precautions i need to take?
is there any way by which the test for hepatitis B shows negative results?

what about the tendency of getting it transmitted to others?
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Avatar_n_tn
The only way to show you don't have HepB anymore is when you test Negative for S Antigen and Positive for S antibodies.

Thats happens naturally to about 1% of the carriers every year.

You are considered (like myself) very low infectivity. I have had it since early childhood and  grew up with 3 brothers who roughed it up many times. They don't have it.
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Avatar_n_tn
thank you so much.

one more thing, is there any medicine or exercise that converts a positive patient into a negative one?
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Avatar_n_tn
If there was there wouldn't be 350,000,000 people on this planet with HepB!!!

There is some 'therapeutic vaccines' in the works right now. Those are vaccines for people that already have HepB. However even if they do work it will probably be 10 yrs before they go through the FDA approval process.


Just enjoy life and stay healthy and positive. I know it sounds rude but the odds are heavily in your favor you will eventually die from something else.
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Avatar_n_tn
Hey you seem to know you stuff on this Hep b.  I would really like to talk to you about this hep be info and ask you some questions?
I have a lot of them (questions).  you can E-mail me at joctorderry hot mail.  thanks man
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Avatar_n_tn
  
  We have the same case. i was exposed to these it was alarming to all of my families. After testing HBVdna the result less than 1000 copies non detectable.You  are not infectious.But still a carrier.It must be HBSag=non reactive, HBSab= reactive. You to Enjoy your life and We must always pray to God for healing and believe that we can be healed. Thanks to all the moral support.
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Avatar_f_tn
Hi,
i am a 24 yr male and was found positive for Hepatitis B recently. My two recent LFT gave SGPT/SGOT count as 26/31 (Dated 11-Dec) & SGPT/SGOT 39/43 (Dated 15-Dec).So i got my HBV DNA quantitative test (By TAQ MAN) done and results shows 23600 IU/ML (1 IU = 5.8 copies/ML).

I don't know that i am HBV + until 12-Dec
[ I have party on 11-Dec evening after my first LFT test, i think that second LFT showed SGPT increased because of that]

i dont know what to do?
i am scared of it.

Please Help me!
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Avatar_m_tn
check your liver damage by fibroscan, if no damage you can monitor or try interferon

i would not start antivirals because you are too young and they need lifre tx

for inactive carriers from childhood, i was same as you but made a mistake i checked alt/ast hbvdna once a year and biopsy every 10 years without fibroscan because alt/ast were 30-40, hbvdna und or low and liver damage mild f2.
now i am 40years old and checked with fibroscan and probably early cirrohsis, so my suggestion is to monitor alt/ast and fibroscan every 6 months all life because it may take very little time to develop severe liver damage after 35-40 years old even with almost normal alt.
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Avatar_n_tn
5.82 copies/IU is WHO standard for HBV DNA Test
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Avatar_m_tn
My hubby had his HBV DNA and d result was >110000000 IU/ml  >640200000 copies/ml.
The method used for HBV DNA Viral Load PCR is COBAS TaqMan HBV Test.
The detectable range with this method is 6 - 110,000,000 IU/ml
(35 - 640,200,000 copies/ml).
The quantification is homogeneous for all HBV genotypes tested.

Can u pls explain this to me in d most easiest way? We need to know because my hubby is a seaman & he was required to take Entecavir (Baraclude) for 3mos. Will this medication lessen the result.I want to know what will happen. We're very depressed right now because he can't work & we need to support our kids.
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Avatar_m_tn

heb is pos or neg?
the hbvdna load is very high and it looks like immune tollerant phase, what is level damage matvir?

check the load for 6 months and if doesn't decrease below 100iu/ml start combo with tenofovir because resistance happens is hbvdna is still high after 6 months
please be sure he has liver damage and he is not immune tollerant because the load is very very high
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Avatar_m_tn
Does this mean he's at high risk liver failure? What makes this to trigger? He's a stage2 obese right how. Does this make to worsen his hepaB. We're very depress because we're lack of financial to support his medication. He's the only one working in the family but now he need to stopped due to his situation.
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Avatar_m_tn
level 2 is nothing to worry about, alt are elevated which is nothing to worry about

as to the medication tenofovir or truvada if tenofovir doesn't work in 6 months are better

if you have finincial problems buy generic tenofovir which is cheaper and more potent than entecavir, it has also no resistant issues (entecavir has)

if you don't know how to get generics check the posts on the forum for generic tenofovir or send a PM to me

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Avatar_m_tn
thank u so much for ur advise. this lessen our worry and depression. One more question if you don't mind. after this medication, will the result makes chronic to non-chronic? will he be able to fit for work again? is there a possibility that this will make d result lessen after 3mos. so that he can  go back to work again. there is another prescription but we can't read the doctor's handwriting. this is kinda protection like silimarine. is taking essentiale forte help? what other meds does he need to take and what food is good and not for him. thanks so much again for responding. GOD BLESS U!
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Avatar_m_tn

when he gets hbvdna und there is no more damage to the liver and all present damage will be reversed
sylimarin is not good at this point because it interferes with antiviral plus liver damage is not severe so there is no need for it

after dna is und he should feel no fatigue, switch to tenvir so you don't have finiancial problems and buy many bottles because you cannot miss one day of the medication and check kidney function from time to time (there is 1% kidney damage on these antivirals but this is ultra rare, only 1%)
tenvir Em is truvada, is more potent and will get hbvdna und faster, truvada has also 11% hbsag seroconversion (clearance of hbv) per year
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Avatar_m_tn
Hi again! I've searched that truvada most likely cure HIV. Is the result of HBV DNA of my hubby shows that he had it. The doctor said that his Hepa B is chronic already. We're very confused right now. Sorry for asking too many questions. We're very thankful that u've been entertaining all of this. We really need some opinion and guidelines.
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Avatar_m_tn
that's just marketing to avoid use of more potent drugs with higher seroconversion, seroconversion means no more money for the company who produce antiviral.

truvada is tenofovir+embricitabine ftc and you will find hbv therapy under this combo and not under truvada but they are exactly the same thing, probably you save money with one pill truvada instead separate tdf+ftc.so that is just marketing exactly like they wrote for tdf until 2008 that is to say tdf doesn't cure hbv....while it was the most potent antiviral.marketing on these type of drugs is very disgusting

this combo tdf+ftc is used on hiv-hbv coinfection, on people who has mutated virus due to previous lam, adfovir or etv resistance mutation, on people on uncompendated cirrhosis on transplant list or on people on compensated cirrhosis

after you find all the trials writing tdf+ftc instead of truvada you see that it is used on the most difficult cases and where the damage to the liver is very severe.
it has also been used on off label combo interferon plus truvada on hbv-hdv coinfection and in one patient lead to seroconversion of both viruses in 10 months

you will find truvada on hbv guideline in one or two years....
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Avatar_m_tn
of course truvada is ok on people with very high viral load which doens't get und in 6 months by antiviral monotherapy and not on all cases
it might be also ok when hbsag is very low because this combo is higly active on cccdna/hbsag
i do not suggest this as a normal therapy for hbv now since if hbsag quantity is very high we don't know if it can lead to any seroconversion (it probably doesn't) and also do not suggest if one antiviral works getting hbvdna und in 6 months because we don't know sides after 10-20 years use of all these antivirals not only truvada and if hbsag seroconversion does not happen we have to use these antivirals for life
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Avatar_m_tn

forgot to mention hbv shares almost all drugs with hiv, they just stopped the trials for the lateset drugs on hbv, truvada is the last one that has already been tried from years on hbv trials
they stopped all trials on early 2009 when replicor tried rep9 ac on march, so i think they stopped all trials because they know they will not get any money from new drugs (also alinia has been stopped on 2009 for hbv)
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Avatar_m_tn
from the lastest conference in vienna today

http://www.clinicaloptions.com/Hepatitis/Conference%20Coverage/Vienna%202010/Tracks/Other%20Topics.aspx

check this link in a few days and data of tdf+embricitabine (truvada) will be pubblished for people with liver transplant and kidney function impairment so you will see if truvada is controindicated in liver disease....
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1282329_tn?1272077043
hi i m male and age 35,i came to know last year that i have a hep b positive,and my viral oad is 250000000/uml but after sixth month it came down to 53000 thousand only.my LFt lalso shows normal.can any one tell mee please that there is any chances to become total neagative,???????????
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Avatar_m_tn
you were immune tollerant (no immune response) and are now in clearnce phase, during this phase you might clear the virus so check with a doctor if this is the best moment for interferon or other therapy as research articles says or just monitor since after this phase you might stay inactive or develop mutant (precore hbe minus) and become active low replication again

a real inactive hbv is hbsag 200-300s/n or about 1000-1500iu/ml, hbeab pos, hbvdna undetactable, al less than 30, all others are active cronic (chronic) hbv which can stay active and inactive from time to time
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Avatar_m_tn
sorry al=alt
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Avatar_m_tn
Hepatitis B Antibody   0.02
Hepatitis B Antigen   0.45          // non-reactive
ALT SGPT 32 U/L
AST SGOT 27 U/L

HBV DNA <12 IU/ML
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Avatar_m_tn
can antbody expalin me my results. I m taking baraclude from last 3 yrs
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Avatar_m_tn
sorry the hbsag quantity for truly inactive carrier has been changed at last conference in vienna to a lower number <500iu/ml (200-300s/n should already be lower than 500iu/ml)


Hepatitis B Antibody   0.02
Hepatitis B Antigen   0.45          // non-reactive
which antigens hbe or hbs?antibody reactive?
ALT SGPT 32 U/L
AST SGOT 27 U/L

HBV DNA <12 IU/ML if you are on any nuc for more than 1 year this must be undetactable but i guess 12iu/ml is just the lab's limit of detection and you are well below it.
alt is still not normal so check alt more often, the normal range for men is now below 30, but also obesity diet and other factors can make it higher than 30 so check if that is the case
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Avatar_m_tn
Hi Stefano,
Firstly, Thanks to you,as i see you helping many people's questions in this forum

HI All, Can any one answer my questions below,please?

I have been detected with HBV with 295IU/ML in January 2010. Doctor told there is no english medicine available/effective at this stage.  Hence i have started using some ayurvedic medicine. I got a test again on May 20th and the count now is 1430 IU/ML.

Question1: Does this value still mean low carier. As per the trend it is increased 4 times. Does it mean it is going to continue and increase soon...

question2: my total billirubin is 1.9. ALT-26 AGT-20. Does this indicate anything.

Question3: does it mean i should totally stop outside food now. zero oil food is must/required? In general i like outside food :(

question4: Is it true there is no good medicine required/available at this stage. I am not speaking about 100% good medicine but a promising one.

question5: Some other doctor told me i can try using 'Hepa-Merz granules'; any idea how is this.
Also any idea about wide claims in this link about a medicine virohep(which is based on Ayurvedhic herbs)
http://www.indiadivine.org/audarya/ayurveda-health-wellbeing/259775-indian-medicine-hepatitis-b.html


question6: I am feeling giddiness these days, a bit often. could this be related to hepatitis
In general from child hood i am not a great healthy person. Also i am not a very poor health person but keeps feeling weakness at times.

question7: My brother is negative. If i get him vaccination, will he be safe forever from this disease

question8: I am unmarried and aged 30. I am not sure if it ok that i can go for marriage having this disease. Though this is a personal decision i want to have a suggestion from the experienced. I am confused about the decision


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Avatar_m_tn
as posted earlier after you test hbsag quantity iu/ml, hbe/hbeab, hbvdna pcr, fibroscan for liver damage, an updated doctor can see if you have active or inactive disease, normal alt/ast are not enoguh to say you are not having liver damage since hbvdna is positive

if you are hbe negative and hbeab positive you can try nitazoxanide (alinia), we have seen hbvdna drops in some weeks, no sides, no resistance, and high rates of hbs seroconversion, off label drug

another option might be interferon, it may have heavy sides but now there is a 12week stopping rule so if you don't respond you stop immediately.no resistance, 1 year therapy

entecavir and tenofovir, i'd suggest these as last option but only if you have liver damage f3-f4.life treatment or maybe 15-20years, almost no hbs seroconversion, possible resistance

chck liver damage, hbs quantity so you can make a tretment choice or monitor every 3-6 months

1 it means you have cronic (chronic) hbv and although normal alt there might be liver damage, hbvdna is low but liver damage is what matters in this situation

2 no since we don't know your liver damage but usually you get f1-f2 liver damage in your situation not more

3 fresh and healthy food is the better choice but if you have liver damage 0 you might choose what you like

4 alinia might be good for you if hbsag is low, hbe negative/hbeab positive.there are good drugs on development, replicor, but not available yet

5 i don't trust herb with strange names although some might help with oxidative stress, always look for good studies and trials from institutions.no herb clear or cure hbv, some might help

6 common on cronic (chronic) hbv

7 yes, do it as soon as possible

8 if people around you is vaccinated your hbv is like water for them, nothing harmful
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Avatar_m_tn
Thanks much for your reply.
I have consulted the doctor today specialized for hepatitiz.
They say from my report it is hbe-ve and hbe+ve.
Also i have asked if i should take fibroscan for checking liver damage; he says fibroscan will not show useful results at this stage(if i want he said i can go for liver biopsy)
he suggested to take sgpt every 2 months

he mentioned it as "inactive carrier"

few questions:

question1
Do i still need to take any test to ensure liver damage is there?

question 2
what is means by "inactive carrier"

question3
now that mine is told as chronic, does this mean HBV count is definitely going to keep increasing. Or there is a chance it itself will drop off in future.

question4
I have asked him about the medicines, specifically about nitazoxanide (alinia),  He is not positive about using medicines.
I am not sure if you r a doctor by profession, hence asking the question again though sorry for it, do u still suggest to use alinia and it will have no sides. Is it available in medical shops of india? what is the dosage and exactly for how long


question5: what about this 'Hepa-Merz granules'; Is this a herb or some under research useful medicine?

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Avatar_m_tn
question1
Do i still need to take any test to ensure liver damage is there?
fibroscan is not good to know if you are f1 or f2 damage but increasing to f3 and cirrhosis it goes to more than 90% altogether with US.you just need it to see if you are f3 or f4 but probably your doctor knows you don't have that much damage so no need to do it.
biopsy is good to see f1 and f2 damage but it is not accurate at f3-f4 because liver damage is not the same in every part of the liver, plus there is a considerable error depending on the doctor who reads biopsy
so the doctor is right to avoid fibroscan for now

question 2
what is means by "inactive carrier", the immune system response is strong enough to stop the virus from replicating and making damage, it can be no replication or low replication.from latest conference a truly inactive carrier who doesn't need close monitoring and have 8-10% seroocnversion hbsab probability has hbsag<500iu/ml, hbvdna und, normal alt/ast
all the others is cronic (chronic) hbe negative hepatitis in inactive phase and can become active anytime or stay like this most of the life, so very close monitoring is needed

question3
now that mine is told as chronic, does this mean HBV count is definitely going to keep increasing. Or there is a chance it itself will drop off in future.
it can increase or decrease, it is not possible to know who will win, usually the hbv mutates so it can avoid immune system and become very aggressive so it is better to monitor until hbsag stays higher thn 500iu/ml (i'd monitor even at 10iu/ml...)

question4
I have asked him about the medicines, specifically about nitazoxanide (alinia),  He is not positive about using medicines.

I am not sure if you r a doctor by profession, hence asking the question again though sorry for it, do u still suggest to use alinia and it will have no sides.
i am not a doctor but i studied the illness and have same or more knowledge than usual doctor but i will never make without a doctor, a illness is not the all body and clinical experience is very important too.
my knowledge is very important to choose the best doctor-researcher (only doctors is not enough to my point of view) and choose the best drugs together with the researcher

all this said nitazoxanide is an antidiarrea drug which can be used on 1yo babies plus it has already been on hcv and small hbv trials, so it can't do no harm since it acts on immune system and host in general, not the virus, so no resistance can happen.
the best generics of nitazoxanide are made in india by lupin nizonide 500 and cipla nitarid, i am using lupin version.

Is it available in medical shops of india? what is the dosage and exactly for how long
yes it is available, i'd say 1-2years checking that hbsag keep decreasing, if it doesn't decrease after 6 months it doesn't work for you
dosage is 2pills per day


question5: what about this 'Hepa-Merz granules'; Is this a herb or some under research useful medicine?
never heard of it but i don't trust herbs without trials and production control at all.phillantus extracts have been found to suppress a little hbsag and hbv in general but i don't trust it
at the same time i don't trust lupin or cipla 100% as well so i sent pills for purity check so that i am sure i am using the best nitazoxanide production, but this is just for an extra security because compound is very easy to make
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Avatar_m_tn
They say from my report it is hbe-ve and hbe+ve.

please confirm:
hbe negative
hbeab positive

because on hbe positive results of ntz are weaker
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Avatar_m_tn
Yes. Hbe -ve
bheab positive

Sorry for the typo in the earlier post. Thanks for your answers
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Avatar_m_tn
Another question

Can you please explain the process of Vaccination for Hepatitis.

1. How many injections and in what durations
2. Any test needs to be taken in middle or end of vaccination period
3. Any normal doctor is ok to be consulted for vaccination. Or  a specialist needs be approached
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Avatar_m_tn

i am not expert since in my country it is mandatory at birth, this is what i found about italy:

adults: 3 doses, second at 1 month and third at 3 month, i strongly suggest to check hbsab antibody since on some vaccine doesn't work or needs more doses

i guess no doctor needed just the vaccine, somebody to shoot vaccine and blood check for antibody titer

vaccine can prevent hepatitis in 95% of cases, 5% will have hepatitis but not cronic (chronic) and probably mild

although protection should last all life it is better to chck hbsab antibody every 10-20 yeras and if titer is low make another shoot

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Avatar_m_tn

sorry:
adults: 3 doses, second at 1 month and third at 6 month (not third month)

http://www.levaccinazioni.it/informagente/vaccinazioni/epatite.htm (italian)

http://www.hepb.org/hepb/vaccine_information.htm (eng)
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Avatar_m_tn
hi i'm tested +ve for hep b virus. m results shows sag-elisa-12%. hbeag-0.51(negative).anti hepatitis b core -total-0.10%(positive).
can you brifly explain about this? but i know im a active carrier.
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Avatar_m_tn


I have tested +ive for HbsAg and -ive for HBeAg. My SGOT AND SGPT are also within the limits...... My HBV DNA count is 133 IU/ml........

Is it serious????
Do I need to take any medication?????.
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Avatar_m_tn

no you are in the inactive phase of hbv at the moment, so very safe but cronic (chronic) hbv works by flactuations you might stay inactive for years or life or fluctate from inactive to active and then back to inactive

you can monitor every 3-6 months (alt, hbvdna, ultrasound for liver cancer) or start ntz to make hbvdna und by a week and hbsag negative by 1-2 years, check the other posts in the community about alinia and nitazoxanide
hbsag is equal to hbv eradicated and no more liver cancer risk

there are no other durgs that can work for you since all drugs except nitazoxanide are active on hbvdna only and yours is almost zero
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1191262_tn?1366766621
Just for your information...The ALT (or SGPT ) new healthy range is up to 30 for men, not 40 anymore, for women it is 19 max. Good luck.
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Avatar_m_tn
Hi, I just got new results for hepatitis B, I've been inactive carrier for some time and would greatly appreciate your help to interpret the results.

Hbe Ag  : not detectable ( there are no units or range )
Hbs-Abs : 0.0mlU/ml
Hbs-Ag : 44.59 S/CO   ( =2 reactive)

HBV-DNA real time PCR  :  63 IU/ml   ( reference range <12 , its says also that the device limit is up to 110,000,000)

the chemistry ( in brackets is the normal range according to the lab)
total protein : 7.65 g/dl  ( 6.4-8.3)
Albumin :  3.89g/dl  (3.5-5)
Alkaline phosphates : 109 U/l (40 -150)
S.G.P.T :  44 U/I  (0 -55)
GAMMA GT :  90 U/I  (12 - 64)

so the only thing outside the range for the chemistry is the Gamma GT,  I did the same tests two years ago and my PCR was un detectable (<12) , all other test were normal including the GGT , my E antigen was never positive.

can you please tell me what does this mean, just before I did this test I was finishing an antibiotic course for a throat infection, could that have distorted the results ?

if the results doesn't necessitate a treatment I would still like to get your advice on something I can start taking in the hope to get rid of the virus all together.

I've read the above questions and your answers and two things struck my attention, you mentioned a new vaccine being developed for the people with the virus, how is that going? you also mentioned a medicine that I thought for people like me, i think it was  "nitazoxanide" , can you please advise me about this ?

Many thanks

sami  
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Avatar_m_tn
Hbs-Ag : 44.59 S/CO   ( =2 reactive)  this is qualitative test positive or negative, you must check hbsag quantity in iu/ml if lower than 500iu/ml you are totally inactive but since your alt are abnormal, the new range is <30 and maximum healthy alt is 2000iu/ml, liver damage detected by fibroscan more than f2
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Avatar_m_tn
Stafno,

thanks for the quick reply , my result for HepsAg is 44.95 S/CO , I made mistake regarding the normal values “as per the lab” for this test, it is stated that ( = 2 : reactive ) so my result is positive or reactive since its above 2 , I'm not sure though if its a high number or just a positive or negative indication.

in my second paragraph above I wrote my PCR test results ,, 63 IU/ml  , is that what you meant by the quantity ?

I didn't quite understand your last paragraph of your answer , " and maximum healthy alt is 2000iu/ml, liver damage detected by fibroscan more than f2 " do you mean the maximum healthy for PCR ? do you mean that I should be more than f2 liver damage now  or are you advising me to do a fibroscan?  please clarify.

the doctor said that I should re-do the ALT SPGT again to confirm the result , but I cannot understand why are these elevated even though the PCR is low "63 IU/ml"

can you please also give some advice on the drug "nitazoxanide"

many thanks

sami
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Avatar_m_tn
stefano,

there is something wrong in this post editor , for some reason it doesn't accept "more than" and less than signs so I'll re type my results for the HepsAg in words.

my result is 44.95 S/co , as per the lab  anything more than or equal to 2 S/CO is positive or reactive , less than 2 is negative . so I'm positive.

sorry for the confusion.

regards.

sami
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Avatar_m_tn
mistake
the new range is <30 and maximum healthy alt is <20, hbvdna<2000iu/ml, liver damage detected by fibroscan not more than f2
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Avatar_m_tn
if its a high number or just a positive or negative indication.

it's no number or titer just positive.for example i was 300s/n we later found out i was 5000iu/ml, my suster 335s/n and she was 17000iu/ml.thise numbers are not scale it is just stupid labs results they should write positve/negative nothing else

in my second paragraph above I wrote my PCR test results ,, 63 IU/ml  , is that what you meant by the quantity ?
yes this is a good value but not enough to say you are just a carrier, this is enough to say you are inactive in that moment, only hbsag<500iu/ml and hbvdna<2000iu/ml is for inactive carrier in immune clearance phase

do you mean that I should be more than f2 liver damage now  or are you advising me to do a fibroscan?
sorry made a mistake, f2 is the limite for moderate liver damage, higher than that damage gets severe so it is much better to start a therapy to make hbvdna und

the doctor said that I should re-do the ALT SPGT again to confirm the result , but I cannot understand why are these elevated even though the PCR is low "63 IU/ml"

there is no exact correlation between alt and hbvdna, the best is alt<30 hbvdna und

nitazoxanide: i'd suggest it if you are hhbe negative and hbeab positive, it can make hbvdna und and hbsag lower but i'd wait to see our results at 6 months at least, we are too early in our group and the minimum to say if it works better than any other drug is 6-12 months results

as to other drugs if your fibroscan is <f2 do not start any for now

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Avatar_m_tn
stefano,

thank you very much, its now much clearer however this triggered more questions

1- so my result of 63 is the DNA count compared to the healthy limit of 2000 , how do I get the HBsAg count to compare with the healthy count of 500 ? I thought its the same thing !! what is the test called ? is it the quantitative HBsAg ?

2- so my dna of 63 suggest that I'm inactive "but not necessarily true carrier" ok , but what should I do then with the elevated ALT and SPGT ? what is the best line of action now ?

3- your last paragraph kind of gave me a the next action , which is to do a fibroscan , so if it’s less than f2 should I just ignore the elevated ALT and SPGT and live normal and re-test after 6 months.

4- I have not tested this time for HbeAb , but I did before "two years back" and it was positive , e antigen was always negative, if the nitazoxanide provides a chance to clear the virus and has no side effects then I would be really interested.


many thanks and really sorry for all of these qiestions. I live in UAE and its really hard to find a good hepatologist here. I think you know more than one anyway.

regards.

sami
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Just a thought here...ALT does not get elevated only due to HBV, if you drink  alcohol a lot for example or are suffering from another liver problem these may cause your ALT to go higher.
From what I can see, your results indicate that your HBV is not active. Ask your doctor about this one (elevated ALT), that is probably why he wants you to re-do the ALT test...

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thanks enolia,

can you tell what are the most common reasons for elevated ALT other than HBV? would consistent elevated ALT cause liver damage even if it’s not attributed to HBV ? if yes, is liver damage reversible?

thank you.

sami
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is it the quantitative HBsAg ?
yes but since most doctors and labs are ignorant on this and don t know the test i will write the machine, the kit and the process to be used by the lab.
abbott architet hbsag quantification in iu/ml, range 0.05-250iu/ml and if higher than 250iu/ml diluition 1:1000 is needed
so if you find hbsag<500iu/ml and you still have hbvdna at 65iu/ml you are inactive carrier in clearance phase

should I do then with the elevated ALT and SPGT ? what is the best line of action now ?
if alt are little elevated between 30 and 50 you might keep monitoring every 6 months or try alinia treatment if hbeag is negative/hbeab positive and hbsag low
alinia will make hbvdna und, alt normal and will lower hbsag and possibly make it negative by 1-2years

less than f2 should I just ignore the elevated ALT and SPGT and live normal and re-test after 6 months.
yes because the liver damage is very little but instead of just monitor i'd try alinia treatment

a good way to have normal alt and prevent fibrosis or reduce it:
153gr of bluberries everyday, 3 cup of coffee, cocao in powder without sugar from time to time you can make like liquid choccolate with no calories sweetner, no fats and all fresh food or frozen
alt can be elevated by unhealthy diet, alcool (elevated like cronic (chronic) hbv), a lot of excercise/gym/sports
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all damage can regress but the more fibrosis the longer to regress.only uncompensated cirrhosis cannot regress but in this case you are close to death and should never arrive at that point, cirrohis is f4 metavir scale or fibroscan higher than 12-13kpa
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my DNA count is 20IU/ML is it  high?what is normal range of DNA count?please help i m hbsag positive ANTI Hbe positive HBEAG negitive,am i healthy carrier?
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my DNA count is 20IU/ML is it  high?my hbeag is negitive ANTI Hbe positive.am i healthy carrier last  year i  come  to  know i  m hepatitis b positive pls  help.i  need any  medication or  not
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my DNA count is 20IU/ML is it  high?
no very very low

my hbeag is negitive ANTI Hbe positive
alinia (nitazoxanide) might help get hbsag lower or negative by 1-2 years therapy, the other option is monitor since all other drugs are not active on hbsag and can make only damage in your hbv phase

am i healthy carrier?
if hbsag is lower than 500iu/ml, hbvdna stayes lower than 2000iu/ml, alt normal you are a healthy carrier.if hbsag>500iu/ml your are in inactive phase and as long as alt are normal and hbvdna7kpa are to consider, values>10kpa severe liver damage, >12.5kpa cirrhosis)

i  need any  medication or  not
there is no drug active on hbv, they can only lower hbvdna when liver damage is severe and prevent more damage but as long as hbvdna<2000iu/ml you have nothing to worry and with hbvdna at 20iu/ml you are perfectly ok.do not strat nuc or interferon for now since these have sides and can only make damage to you now

the only option might be off label therapy with alinia, it is active against hbv and in hbe negative might get hbsag negative by 1-2years.when hbsag gets negative hbsab antibody gets positive and you have eradicated hbv (eradicated i mean immune system have total control), hbsab antibody blocks viral entry so hbv cannot enter liver cells and we can condier it as hbv cured



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Hi,
    Can anybody explain my results. Also i was tested for e-antibody and e-antigen. If my e-antigen was -ve will my surface antigen will be also -ve

Hepatitis B eAntibody   0.02        //+ve
Hepatitis B eAntigen   0.45          // -ve
ALT SGPT 28 U/L
AST SGOT 27 U/L

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Avatar_m_tn

you are cronic (chronic) in inactive phase so no drugs needed but you need to check also hbvdna and liver damage

if liver damage is f0-f1 or f2 and hbvdna<2000iu/ml you have nothing to worry and no therapy can help you improve

as said above the only chance for inactive carriers is try alinia for 1-2 years and see if hbsag lowers/gets negative, alinia has no sides
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Hi Stefano,
                   Thanks currently i m taking baraclude as per my doctor suggestion should i stop it or should i consult some other doctor and see what he says. Since currently i m in US and doctor who prescribed medication was in india.

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also my HBVDNA was undetectable. Also i m abt to get married i m afraid to tell my future wife and i m not sure if she was vaccinated will my wife get infected with my current status ?. Also if she gets 2 doses before we get married can she still get infected ?. Also is their any vaccination which does not require 3 doses ?
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if you are under baraclude (entecavir) that's ok to have blood results like that and hbvdna und, that's why you are inactive.
once started baraclude must be never stopped otherwise hbv can activate and mutate to a very dangerous form (even deadly according to liver damage) so never stop it, in 10-15years hbsag should get negative.be very carefull to never miss a pill

you might try to add nitazoxanide for 6 months and see if hbsag lowers, nitazoxanide might help get hbsag negative faster

since you take baraclude there is no need to check liver damage because if you have some it will regress complitely

as to your wife she must be vaccinated, you are still contagious especially by blood, only when hbsag gets negative you will be less contagious but blood will still be a risk.after the first dose of vaccine check hbsab, if it is higher than 10miu/ml (4weeks after shot) she is protected 100%, usually at least 3 doses are needed.
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Thanks stefano. I m not sure if my wife is vaccinated properly. Though she has been living in US since she was 2 years old so i guess chances are very good she must be vaccinated but i m planning to get her all the 3 doses just for being on safer side and since she also cant recall if she has vaccination. Is their any adverse affect if she is already vaccinated and she again gets all the 3 doses. Also my all my liver tests are very good. As per my health do u see any risk for my health for next 5-10 years ? . I will meet one of the doctors here and discuss with him for medication which one he suggests.

Regards
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Hi Stefano,

2 weeks ago, I got my HBV DNA checked and it is showing 12880 IU/mI = 74962 copies/ml. Do I need to start medication?
I was diagonised HBV +ve in 2002 and at that point of time it was only 20 IU/ml. So, far I have been reasonably fit and without any drug. But offlet I have been feeling heaviness in stomach and I feel little less energetic.

Brij
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Before getting here re-vaccinated, do a blood test and you will find out if she has been vaccinated or not, she would have developped HBV antibodes if she was vaccinated.
Good luck,
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as long as you keep hbvdna und and alt lower than 30 you will be perfectly healthy and regress any damage (only uncompensated or advanced cirrhosis do not regress but any way stop progression)

remember to ccheck hbvdna for resistance every 3-6 months (3 is better) although very unlikely on etv naive
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2 weeks ago, I got my HBV DNA checked and it is showing 12880 IU/mI = 74962 copies/ml. Do I need to start medication?

since 43 years old you should, cirrhosis and liver cancer become more frequent after 40yo

if hbvdna doesn t lower to 2000iu/ml or lower you should start therapy, interferon and after tenofovir or tenofovir are the best and most potent drugs, you might add in combo nitazoxanide is hbe is negative to clear hbsag
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My brother has been recently detected with chronic hepa b...

Can you help interpret the following results as the doctor did not give much explanation to my brother:

HBe Ag = 0.476
HBs Ag = 2.899
HBc Ab = 0.026

HBV DNA (PCR) >110000000

1)  How bad is the chronic illness for this type
2)  Is there a chance of recovery
3) Would you have an idea on the degree of liver damage?
4)  My brother will have ultrasound tomorrow, what questions should he ask the doctor to assess his status
5)  They have been trying to have a baby for 5 years..could this be a reason for them not being successful?

Looking forward to your answer.  He really just detected this when he is processing to work outside the country, in a way it is a blessing.  But we would really like to understand this so we can help and support him dealing with this setback.

Jean
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alt and fibroscan are missing to confirm he is immune tollerant, such high viral loads are present in immune tollerant or asians.immune tollerant is the best condition for a cronic (chronic) hbv and there is no damage

he must not start any treatment because first they don t work and second they are not needed in this phase

if alt are lower than 30, fibroscan detects almost no liver damage, and hbvdna is in the millions he is immune tollerant and  just needs to monitor

i don t understand these doctors they just make some markers that mean nothing when alone, see here for more info on tests and immune tollerant phase:
http://www.medhelp.org/health_pages/list?cid=153
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Hi Stefano,


Thanks for your response.  I will get my brother to ask his doctor for ALT and fibroscan test.

Actually, he had around 3 tests already - blood test, full hepa b profile not sure about the other one....should ALT test have been part of one of these?

Anyway, I will let him check.  Thanks, your feedback ease some of our worries...

BR
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A lot of Thanks.

Your advice will be of great help to me.

Warm Regards,
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Pls help to interpret with this result:

I already have a viral load test and the result is;

< 6 IU/ml < 35 copies/ml The method used for HBV DNA Viral Load PCR is COBAS TaqMan HBV Test. The detectable range with this method is 6 - 110,000,000 IU/ml (35 - 640,200,000 copies/ml). The quantification is homogenous for all HBV genotypes tested.  

Can you help me tell what is the meaning of above information.

Thank you so much.
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info here:
http://www.medhelp.org/health_pages/list?cid=153

if also hbe negative nitazoxanide treatment at 1,5-2g dose might make hbsag negative
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Please also help to interpret me this result. I already consulted to my doctor my did he say that no need for medication since the viral load is low my body will fight the virus and produce anti bodies. will that be possible? Please help coz I am worried. :-(


IMMUNOLOGY

Anti HBe (CMIA) 0.020  C.O.V. 1.000 REACTIVE
Reactive arthritis

AHBe count below the cut
Cuts and puncture wounds
-off~value is
considered REACTIVE
Reactive arthritis


Anti HBs (CMIA)  0.000   C.O.V. 10.000 NON-REACTIVE

HBeAg (CMIA)  0.388 C.O.V. 1.000 NONREACTIVE


HEMATOLOGY

Prothrombin
Prothrombin time (pt)
Time

PT Patient 11.00 sec 10 ~ 14

PT Control  12.70 sec  11.79 ~ 14.23

% Activity 98.90

INR 0.92

< 6 IU/ml < 35 copies/ml The method used for HBV DNA Viral Load PCR is COBAS TaqMan HBV Test. The detectable range with this method is 6 - 110,000,000 IU/ml (35 - 640,200,000 copies/ml). The quantification is homogenous for all HBV genotypes tested.  

Thank you for your help,

Loner25

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Avatar_m_tn

well your doctor is not aware that alinia owers hbsag, all other drugs dont clear hbsag they are only active on hbvdna
if you are cronic (chronic) (hbsag pos more than six months) your chances are 1-3% to clear hbsag

i guess it didn t even check hbsag quantity to say if you are inactive carrier and have 10% chances to clear instead of 1-3, many doctors have a lot of fantasy......

i have been in your state most of my life but my hbdna was und (less 104c/ml) but now i have cirrhosis because i also met doctors with fantasy saying yoou are inactive, no damage with alt so low without checking deeply, i admit this fantasy until 2000-2004 because there were no tests but not now
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Hai,
I have infected Hepatitis B past 5 years.
Initially my doctors  ask me to check HBsAG Titre value (Usually it comes n numbers--0.525 to 3.00). So i have periodically checking the titre value . the range will be 1.0 to 3.0 till nuw). recently i consulted the Liver specilist , and he was told to take HBV DNA Qualitative test . My Liver fuction test results are in normal.I also checked the Liver biopsy . it also showing normal range only.
My question is,
What is meant for HBsAG titre value? What can we undrestand the Titre value test?
Is it necessary to do that?
.if you answer my question, it will be very helpful for me

By
Rajagopal.--India
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0.525, is it in iu/ml?if so you will seroconvert 100%, ntz make it in a couple of days if you are responder.
if it is coi, s/co, s/n it has no meaning it is not hbsag quantity but reagent quantity

HBV DNA Qualitative test
they doesn t exist anymore, at least in advanced countries, all test are quantitative and the most sensitive pcr realtime gets qualitative in the range 1-20iu/ml

Liver fuction test results are in normal
these are normal also in compensated cirrhosis or liver cancer, when they get abnormal especially if hbvdna und/low already it means end stage liver disease

What is meant for HBsAG titre value?
test in iu/ml, abbott architet machine.hbsag below 10iu/ml probability of seroconversion very close to 100%, lower than 20iu/ml very probable

What can we undrestand the Titre value test?
stength of immune system , probability of seroconversion, virus quantity or better cccdna quantity



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Hai, Thanks for your response.

I will come back to you (May be 07th or 8th ) when i receive the result of HBV DNA Qualitative and doctors opinion.

Thanks
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Rajajivr,
hai,

From initial onwards,

Am taking Treatment. Initially Lamivudine then Adefovir dipovaxil. But the HBsAG value is up and down.The result does not have units.Then he prescribed Entecavir 0.5mg for 1 month. But no improvement .
He decieded the improvement basis of the HBsAG titre value.
Now am taking Adefovir dipovaxil tablet 20mg every day.

inspite of taking this drugs, and liver function test value are normal,
1.)Stil i may have liver abnormalities or cirrhosis.
Please suggest me.

Rajajivr--India
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Lamivudine then Adefovir dipovaxil
both bad choice even if combo of both, too weak and worsen disease by resistance, if hbvdna is not less than 1-10iu/ml you have probably resistance mutation already, i'd change doctor right away guidelines do not include these drugs since 2008 due to the resistance problems, only etv and tdf can be used but now if you developped resistance you might not respond or respond less to these drugs and there are no others, your only chance in case of mutation is etv+tdf, th only security of mutation test by 100% is biopsy with cccdna test but probably even blood resistance tests not available in india

these drugs have no effect on hbsag and usually increase it, they only make hbvdna und and must make it fast otherwise hbv mutates

Then he prescribed Entecavir 0.5mg for 1 month. But no improvement .
you cannot use etv alone since you have used lam and etv is useless with lam experienced, be careful this doctor is crazy he is making the virus mutates on all drugs acting like this

He decieded the improvement basis of the HBsAG titre value.
he is absolutely ignorant, drugs do not change hbsag, if you are hbe negative etv increase it very much but since he is so ignorant he is reading the reagent for sure, not even hbsag

Please suggest me.
start etv 1mg+tdf combination this way you are close to 100% security virus will not mutate (etv and tdf cross protect each other from their respective mutations), you have to use etv at 1mg because you have used lam in the past

you might add also nizonide500 by lupin (ntazoxanide) this is active on hbsag mainly and also active on lam and adv mutants.you have to try 1,5 and 2g dose and check which one lowers hbsag, on hbe neg we have seen hbsag lowering 2500iu/ml by 5 weeks, once you find active dose do not change it or hbsag relapse to baseline values (we have all made this mistake...)


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Thanks for your valuable suggestion.

I will come to you after test results

Thanks by Rajagopal-India
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Hai,,
Hru?

This s rajagopal(rajajivr).

I have tested HBV DNA Qualitative test. The results is NOT DETECTED. The method is Multiplex PCR with PreS and PreX primers are used in assay.Sencitivity of assay enables detection of 1000 viral copies per ml of sample.

What could be your suggestion nuw?
Should i take treatmet anyway? or just monitering is enough?
for monitering, what i have to test.

Please suggest me.

By,
rajagopal.-India
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Avatar_m_tn

sorry but test is very old and not valid anymore, sensitivity needed is 1-10iu/ml not 172iu/ml which is equal to 1000copies/ml

to monitor a therapy hbvdna must be able to dectect even 5 or 9iu/ml because resistance happens even at values <12iu/ml, you should reach an hbvdna und state much lower than what can be detected in serum (an hbvdna 1iu/ml in serum continuatively under antiviral mean liver has a high level of intraepatic hbvdna)

also a pcr real time with detection until <20iu/ml is ok, they can usually detect until 1iu/ml but without numbers


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hi stefanno, i found your advices very helpful. would ypu please let me know your take on my situation.
Six months ago my HBV-DNA quantitative numbers were 51000 iu/ml now they are 78500 iu/ml my doctor suggested that i take entecavir would you please tell me if i should be on it?
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you must check liver damage too possibly by fibroscan and hbe/hbeab, if damage is>7kpa better start otherwise you might monitor too

start alinia first and then add entecavir 12 weeks after so etv will be very fast
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Thanks for your quick response!
my doctor prescribed 0.5mg entecavir is there a reason why he didn't prescribe 1mg? isn't the 0.5mg less potent? you suggested that i take alina first, is alina supposed to weaken the virus or is it supposed to make it easy for entecavir to defeat it? please tell me everything that way I will be educated when i see my doctor soon. Thank you so much again

below is my LFT test result the test was done a couple of months ago from this result i am not sure how damaged my liver is.

ALBUMIN    4.5 g/dl
ALT             42 iu/l
AST            28  iu/l
ALKALINE POSPATHASE    59 iu/l
BILIRUBIN, DIRECT             .30 mg/dl
BILIRUBIN, TOTAL              .70 mg/dl
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hi,

i have HbsAG +ve and Hbeag -ve. i had some tests. here is the value.

HBV/DNA 4825/14ML
ALT 19
HbeAG -ve

what does these values means?
pease help me and tell me what is my condition at this time.?
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there is no much difference between 0.5 or 1.0mg etv although 1.0mg might have higher genetic barrier, i have started with 0.5mg and we will switch to 1.0mg only if we see a big hbsag decrease to 1000-1500iu/ml which is the level that confirms immune controll of hbv and immune clearance to boost it.
so i'd start with 0.5 etv once resistance tests confirms no polimerase mutants present prior etv therapy start

alinia (nitazoxanide) weakens the virus so that you will achieve hbvdna und very fast, in combo with etv will decrease hbsag especially if hbe is lready negative

it is not possible to say the damage of your liver by blood tests, only fibroscan or biopsy can tell, i'd check that before starting etv and if there is liver damage recheck by fibroscan every 6 months to see if therapy is working.therapy is needed to make hbvdna und but even more important regress liver damage and fibroscan is the only tool to measure that

hbsag negative by etv only is almost impossible while etv+alinia can make it negative in a couple of years if hbsag decreases within 6 months from start of this combo



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those tests canot say much about your condition n general, they make a picture of the situation in this moment, that's to say hbv has low replication and low liver damage, but we dont know your previous condition and previous liver damage accumulated, to know your condition you need more tests.

hbsag quantity, if lower than 500-1500iu/ml while hbvdna lower than 2000iu/ml and alt lower 30, it means you have immune control of hbv as inactive carrier and about 11% chances to clear hbv per year.if values are higher you have cronic (chronic) hbv with flactuating replication with active disease/inactive disease periods

fibroscan or liver biopsy to confirm if you have no liver damage and you are an inactive carrier

if those tests are not available you can also check alt/hbvdna every 3-6 months, if alt stays lower than 30 and hbvdna lower than 2000iu/ml the liver damage even if present should regress in a couple of years

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Hi Stefano,

If you have these levels of resut is it necessary to take madication or just have a healthy diet and exercise?
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healthy diet and exsercise are good for general health but useless for hbv the only thing to keep hbv without making damage are antivirals
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hi gud day! i just had my hbvdna test last nov 26 and we got the results just today and unfortunately my doctor was out of town so he is not yet available to interpret the result for me he'll be back by wednesday next week but i really wqanted to know what's the meaning of my result.. my result stated 41 IU/mL.. it would be alot of help if oyu can try to explain what this means.. and if there is any medication that you can suggest that would help me to be come a nonreactive with hsbAg.. thank you so much and God Bless you..
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hi gud day! i just had my hbvdna test last nov 26 and we got the results just today and unfortunately my doctor was out of town so he is not yet available to interpret the result for me he'll be back by wednesday next week but i really wqanted to know what's the meaning of my result.. my result stated 41 IU/mL.. it would be alot of help if oyu can try to explain what this means.. and if there is any medication that you can suggest that would help me to be come a nonreactive with hsbAg.. thank you so much and God Bless you..
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my result stated 41 IU/ml

this test alone is useless you need all tests to say, see here:
http://www.medhelp.org/health_pages/Hepatitis/HepB-Introduction--Welcome-Page/show/34?cid=153
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good day.. i got all my test results here please help me to understand them.. please explain to me what bthese means..

my hepa profile states;

HbsAG 245.92 reactive by MEIA with sample rate of 1440.58/5.20
HbeAg 0.50 nonreactive by MEIA
Anti Hbe 0.03 reactive by MEIA

and my hbv dna result states:
HBV DNA VIRAL LOAD (REAL TIME PCR)

Result: 41 IU/mL

Remarks:
- HBV DNA viral load (real time PCR) detection Limit:
           6-110,000,000 IU/mL (35-640,200,000 copies/mL)
-specimen with less than 6 IU/mL (640,2000,000 copies/mL)is above the defined rasnge of the test..

please help me understand all of these it would be a great help..
please let me know aLSO if there is any chance for me if my HbsAG woulkd be non reactive.
and if there is any medication that you can recommend for my status today..
thank you so much
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Geetha

My facther has infected by hepadities B and the liver has damaged. His HBA DNA is Below 20... Doctor said no need treatment... Tablets only enough... His life time is 3months to 2 years.. Is it true sir?
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hi gud day! i just had my Hepatitis Markers & Enzymes Test results : HBeAg (Serum/CMIA) - NonReactive (0.519) & HBsAg(Serum/CMIA) - Reactive more than 250) (reference value - reactive => 0.05 IU/ml) & SGOT = 22, SGPT = 38

Please clarify & how to come out from this stage to normal.
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his life time is 3months to 2 years.. Is it true sir?
i think you didn t go to a doctor, only inoperable liver cancer can be deadly evn end stage cirrhosis can be managed by antivirals or transplant.i see now you are from india, we have a lot of bad doctors here too in indian is probably even easier to find them

did you check liver damage by fibroscan or biopsy?go to a very expert doctor, among the best in your contry and if there is a suspect of cirrhosis do not make biopsy

hbvdna 20iu/ml or copies/ml?alt/ast?
with such a low value there is no need of treatment as long as hbvdn stays so low.

what is liver function tests results?if they are good you might use nizonide500 (nitazoxanide) 3 or 4 pills a day with food until hbsag gets negative, since hbvdna is low low it might work even monotherapy.the only side can be very mild diarrea (diarrhea), if it happens take probiotics
if liver fnction is very bad and there is end stage cirrhosis this drug might not be ok but i dont think this is the case of your father
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good day.. i got all my test results here please help me to understand them.. please explain to me what bthese means..

my hepa profile states;

HbsAG 245.92 reactive by MEIA with sample rate of 1440.58/5.20
HbeAg 0.50 nonreactive by MEIA
Anti Hbe 0.03 reactive by MEIA

and my hbv dna result states:
HBV DNA VIRAL LOAD (REAL TIME PCR)

Result: 41 IU/mL

Remarks:
- HBV DNA viral load (real time PCR) detection Limit:
           6-110,000,000 IU/mL (35-640,200,000 copies/mL)
-specimen with less than 6 IU/mL (640,2000,000 copies/mL)is above the defined rasnge of the test..

please help me understand all of these it would be a great help..
please let me know aLSO if there is any chance for me if my HbsAG woulkd be non reactive.
and if there is any medication that you can recommend for my status today..
please help us understand what the results means this will be a great help for me and for my family. please help us understand so that we can know what's the best thing to do.. we'll be waiting for your reply..
thank you so much and god bless.
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HbsAG 245.92 reactive by MEIA with sample rate of 1440.58/5.20
useless for cronic (chronic) carriers, cronic (chronic) carriers need abbot architect for hbsag quantity in iu/ml and not ultraold elisa or meia useless tests, those are not good for blood donations too not senstive enough

Anti Hbe 0.03 reactive by MEIA
good for the use of nitazoxanide with good results

HBV DNA VIRAL Result: 41 IU/mL
very very low, you might use nitazoxanide monotherapy

if my HbsAG woulkd be non reactive.
you need quantification by abbott architect in iu/ml to say if you have good chances to clear with nitazoxanide or interferon, without drugs possibility is 1-2% per year, that's to say zero

start ntz like indicated in our nitazoxanide/alinia posts, 3-4pills a day with food and check hbsag every year to see if it has become negative, hbvdna will be negative in a copule of weeks/months.use generic nizonide500 by lupin which is cheap

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thank u so much.may i please ask if there is any website wherein we can check the corresponding equivalent of meia for abott architect.and how does the nitazoxanide therapy goes.and is this available here in the philippines and may u please give us an idea of how much this cost. than u so much
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Avatar_m_tn
corresponding equivalent of meia for abott architect

there is no correlation the number in meia is not hbsag quantity it is the reagent quantity.if you are in the philippines everything is missing there you should move to hongkong, singapore or japan if you can afford that

how does the nitazoxanide theraphy goes
it lowers hbsag if the pill is taken every 6-7hrs with food (only common side mild diarrea (diarrhea) that you can avoid by probiotics if happens) , you can order from india, i don t know if it is available in the philippines
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Avatar_m_tn
HVA DNA mentioned in report is BELOW 20 IU/ml.

ENZYMES :
SGOT - 81.0 IU/L
SGPT - 32.0 IU/L
SALP - 247.0 IU/L

SERUM BILIRUBIN

TOTAL - 4.6 mg/dl
Direct - 2.3
Indirect - 2.3

Doctor informed as liver was completely damaged and the possibility is liver transplantation only....

Is My father is in dangerous stage? and want to know his life time pl....

Geetha
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Avatar_m_tn
there is no test to measure residual liver function, a person can feel ok even right before death, there is no way to quantify this, bilirubin is quite bad and means liver is not working

if liver is really so damaged you might slower complete liver failure and death by hepatitistechnology (just google it and ask them if they can help) and NAC acetyl cysteine which is sold over the counter for bronchitis too
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Avatar_n_tn
will using Viagra dangerous for hepatitis b patients
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Avatar_n_tn
my dna quantitative range is 16000copies/ml(2759IU/ml)
HBSAG positive.
HBeantigen negitive
liver biopsy staging 0/6
my mother died of cirrhosis of liver.
my SGPT was 58 and now SGPT is 16 and SGOT is 14
doctor said no treatment for now. asked me to come after 6months
i never drank or smoked but have used viagra with my partner. i have not slept with anyone else.
so wish to know how my viral load increased.
doctor says spicy and oily food.

any suggestions from you and all welcomed.

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Avatar_m_tn

no idea about viagra but i'll avoid that, any drug has some toxicity for liver

as to treatents only alinia and interferon has shown to eradicate virus on some, all other drugs  0,5% eradication which is equal to 0%
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Avatar_n_tn
thank u stef for your quick reply.so do u think with my viral load of 16000+copies/ml
there r chances of this to go zero and become hbsag negitive.
i am least bother of being positive or negitive. all i want is this viral load to be zero and cause no danger to my life.
is it possible in today's medical scenario.
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Avatar_m_tn
hai,  This is rajagopal. i have infected Heb-b last five years, initially i have taken Lamivudine and adefovir. Due to resistance, nuw am taking Entecavir 0.5mg. recently i checked my HBSAG by CMIA method , they given the results more than 250 IU/ml. not specified the exact number. I asked them, then they replied , by the same method(CMIA) confirmation can be done. But thr also they mentioning as numbers only without unit.
Pls tel me BY CMIA method , can we get exact viral copies
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Avatar_m_tn
This is rajagopal.
What is the difference between HBSAG Quantification by CMIA method and HBV DNA Quantification method. Pls suggest me
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Avatar_m_tn
if you did nothing you were healthier now, you have mutated the hbv virus with useless and damaging drugs

now add tenofovir+entecavir+alinia combination or you will find yourself high risk of untreteable virus

they give result more than 250iu/ml because that's the range of the machine automatically, they must make diluition because no cronic (chronic) carrier has such low hbsag.ask for diluition and correct value of hbsag.all this because the tech are lazy to make diluition or ignorant

you are on a time bomb, be aware that with lamivudine resistance entecavir doesn t work and mutations are at least 50% at 5 years

tenofovir is free of resistance and alinia will help lower hbsag and make mutations even less possible.so with entecavir+tenofovir the 2 drugs will protect eachother from resistnce
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Avatar_m_tn
Hai ,This is rajagopal(Rajajivr).

I have tested HBsAG confirmation test by CMIA and got 530 in numbers. i already test by CMIA method for confirmation purpose ( Result is > 250IU/ml).

As per the confirmation value, since my HBsAG quantification value, still should i take combination of Entecavir + Tenofovir

What will be the suggestion from your side.
Please update.

Regards,Rajajivr
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Avatar_m_tn
Please go to Hitech Labs, Chennai - Kilpauk

ask them HbsAg Quantitative test if you want have exact test, As far as my knowledge they are only guys who does HbsAg Quantitative even not thyrocare labs
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Avatar_m_tn
Hai,

Do u have any idea about which method they are  following for HBsAg Quantification test?

Regards,
Rajagopal(Rajajivr)
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Avatar_m_tn
They are using ECLIA Method which is same as Abhott . So you can trust that one .

Also try lalpathlabs.com . But I'm not sure which test they are using
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Avatar_m_tn
Hi Stef ..
Two weeks ago, i did blood tests and ultrasound.
The results were:
HBsAg  reactive
HBsAb  Borderline
HBeAg  nonreactive
HBeAb  reactive
PCR  5200 iu/ml
the ultrasound does not show any problem in liver, as per lab report.

What is best treatment to start? Tenovovir, entecavir, telvuin, nitzaxodine, or what?
What borderline for HBsAb means?

Thank you, and i appreciate your effort for knowlege and advices ..
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Avatar_m_tn
HBsAb  Borderline

very very good, test this with abbott architect which gives the titer from 0.1 up

hbsag
test this with abbott architect which gives the titer of hbsag in iu/ml.if 2000iu//ml or 1500 or even lowerr immune modulators are sure to work and eradicate with hiest chances

What is best treatment to start?
nitazoxanide (alinia) with or without interferon all the others have no effect on hbsag.i' d start with ntz and then see if hbsag goes down
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Avatar_m_tn
Thank you Stef for your valuable replies, you are good man,

You said: test this with abbott architect .. Is this the same meaning of HBsAb Quantitive?

What is the name or symbol for HBsAg which gives number like 2000 u/ml or 1500 u/ml?
The result for HBsAg is either Reactive or Nonreactive .. Is there difference between the numbers result and reactive/nonreactive?

Thanks Stef ..
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Avatar_m_tn
Two weeks ago, i did blood tests

HIV Negative
Anti-HBe Negative
HBe-AG Positive
AST  29
ALT 48
GGT 19
HPBDNA > 110,000,000 UI/mL  > 640, 200,000 copies/mL

What is best treatment to start? Tenovovir, entecavir, telvuin, nitzaxodine, interferon, or what?


Thank you, and i appreciate your effort for knowlege and advices ..


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Avatar_m_tn
Two weeks ago, i did blood tests

HIV Negative
Anti-HBe Negative
HBe-AG Positive
AST  29
ALT 48
GGT 19
HPBDNA > 110,000,000 UI/mL  > 640, 200,000 copies/mL

What is best treatment to start? Tenovovir, entecavir, telvuin, nitzaxodine, interferon, or what?
What borderline for HBsAb means?

Thank you, and i appreciate your effort for knowlege and advices ..


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Avatar_m_tn

what is hbsag quantitty?
hbcab igm?
hbcab igg?
hbsab quantitty?

ultrasound and fibroscan?

are you overweight and weist less than 90cm?
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Avatar_m_tn
   AG AUSTRALIANO/HBsAg REACTIVO      *
   ANTI-HAV Total REACTIVO
   ANTI-HAV Total >60.0 < 20.0 Negativo UI/L
   ANTI-HAV IgM NEGATIVO


   ANTI-HBe NEGATIVO
   HBe-AG REACTIVO

ultrasound and fibroscan?
i don't have.


i have 84 kg and 175.26cm. i am not owerweight.
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Avatar_m_tn
Hi stef2011, thanks for your time and attention .please can  I ask you about your job,if possible.
Iam from Iraq and my neighbor(48 y.,78kg.,170 cm)  discovered accidently to have Hep.B by routine checking on traveling 9 months ago.
Invsetigations:
HBsAg(ELISA) :+ve (1980.6).
Alt:14     , ast: 10    ,  alk.phosphatase: 88    ,   TSB: 9 umol/l(5-17).      
Ultrasound :          normal
Fibroscan : not  available
One doctor prescribe him interferone alpha 2 injection /week along 6 month.
PCR HBV DNA 100,000 000 copies/ml.(so expensive).
I need your advices about:
1/best treatment(even outside Iraq).
2/follow up.
3/prognosis.
Thank you and I appreciate your cooperation.
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Avatar_m_tn
if these below are the results for your friend he is immune tollerant and he is healthy, no treatment needed and all treatments can only make damage

Alt:14     , ast: 10    ,  alk.phosphatase: 88    ,   TSB: 9 umol/l(5-17).      
Ultrasound :          normal
PCR HBV DNA 100,000 000 copies/ml


he has to wait for alt to rise and hbvdna lower

and about the doctor...not a doctor, just a dangerous ignorant who can make a lot of damage to patients
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Avatar_m_tn
hi Stef2011

AG AUSTRALIANO/HBsAg REACTIVO      *
   ANTI-HAV Total REACTIVO
   ANTI-HAV Total >60.0 < 20.0 Negativo UI/L
   ANTI-HAV IgM NEGATIVO


   ANTI-HBe NEGATIVO
   HBe-AG REACTIVO

ultrasound and fibroscan?
no available

are you overweight and weist less than 90cm?
i am not overweight.
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Avatar_m_tn

as long as alt are normal and hbvdna in the millions you must not treat, you are in the immune tollerant phase
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Avatar_m_tn
thankyou very much, i will tell him that .
iwill send you any new investigation.
thanks
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Avatar_m_tn
thankyou very much,

take care
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Avatar_m_tn
hey  some of my test results regarding hepetitis (hepatitis) B are..............

         HBe ANTIGEN    +ve
         ANTI HBe            -ve
          SGOT                28
            SGPT              37
       HBV DNA quantitative   5062460 iu/ml
   what these result shows?  do i need any other tests? i am perfect healthy now,,,,,, eating habits r also perfect,,,,,
Can any one help me regarding my results..............

    
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Avatar_m_tn

you need to check the following:

hbsag quantity
fibroscan to see liver damage

according to these results repost, check posts in the community to know where to do those tests in india, there are only 2 clinics that have these new tests
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Avatar_m_tn
thanks for replying...............
now, i am just 22M,,,,,,,,,,,,,do i really need fibroscan?? i mean you wrote that it is for liver damage. and also how may i know that i am a carrier or not?
and also i can be sexually active?
by the way ,,,,what is the cost (approximately) of these tests yar?????
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Avatar_m_tn
HBV DNA quantitative   5062460 iu/ml

......you dont need to know if u are a carrier we already know you are full of virus, we just need to know if there is liver damage made by ur immune system (the virus itself makes no damge)

and also i can be sexually active?
you must wear condoms and be careful with deep kissing, hbvdna is high.it is better if all other people is vaccinated

i have no idea about the costs in india, check posts in the community by the serach box
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Avatar_m_tn
Results of latest report
LFT
Billirubin total 35.4
             direct 20.5
sgot  127
sgpt 38
alkaline phos adult  217
protein   7.4
albumin   3
globulin    4.4
alb/glob ratio   0.68

hbv viral load by taq man(dna quantitative)   195 iu/ml

please tell me how much infection is in the liver, what the precaution I should take.
thanks & regard

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Avatar_m_tn
Results of latest report
LFT
Billirubin total 35.4
             direct 20.5
sgot  127
sgpt 38
alkaline phos adult  217
protein   7.4
albumin   3
globulin    4.4
alb/glob ratio   0.68

hbv viral load by taq man(dna quantitative)   195 iu/ml

please tell me how much infection is in the liver, what the precaution I should take.
thanks & regard

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Avatar_m_tn
Dear Sir,

I real appreciate and respect to you by having to see your clear answer for every one's question.
I am a medical doctor however not practicing as General Practitioner.

Just let me get your suggestion like other people too because unfortunately my wife also having HBV positive.

My wife is 54 Yrs old, around 150lbs in body weight and having HBsAg as positive since last 3 yrs ago and didn't take any treatment yet.

Since last 2 to 3 weeks ago, she was often suffered a intermittent pain around in Liver area and sometimes feeling difficulty in breeding and abdominal distension like an undigested person.

Then I bring her to do Ultrasound abdomin (abdomen) and Report was described as below.
Liver = slightly enlarged, margin= bluntted, Echogenicity = increased.
Others are normal and diagnosed as a Chronic Hepatitis Case.

Then, I tried to do the following investigations for her after that.

Blood Investigations:
Blood for CP = all are in normal range
Lipid Profile = Cholesterol- 4.7, TGL-1.3, LDL-2.8,HDL-1.3(Low)

LFT : Total BIlirubin = 10, Alkaline Phosphatase = 98, ALT/SGPT = 22, AST/SGOT = 20,

Urea Test = 3.6
Creatinine = 53
Fasting B. Sugar = 107mg/dl

Antigen/Antibody Test Report:
HBsAg = Positive
Anti-HBs = Negative
HBeAg = Negative
Anti-HBe = Positive
Anti-HBc = Positive
Anti-HCV = No reactive

Fibro Scan Report :
Stiffness (KPa) = 14.6
IQR (KPa) = 5.2
CS(KPa) = 20
Success Rate = 91%
Fibrosis stage according to Metavir score is F3 to F4.

Tumor Markers Result:
AFP (Quantitative) = 2.04 IU/ml

HBV DNA quantitative test = < 29 IU/ml
inclusivity = HBV genotype A - G & Pre-Core mutant

ECG = Normal
CXR = Normal

I think, all most all the necessary Investigations are done already and the results are as above.

Kindly let me know your answers from you for my following question which I want to get your kind suggestions.

1. How is her status? Threatening to her life because her fibro scan is resulting as F3 to F4 stage?
2. According her other results and HBV viral load result (29 IU/ml), will she be classified as infectious as carrier stage or non-active stage?
3. What should I do for further steps? Do I need to bring her to a hepatologist to start treatment since now?
4. How about her prognosis based on her results. Currently, she is quite well and no other Diabetes or Heart disease tool.

I will highly appreciate and great thanks if you could kindly answer in detail about my wife case.

Thanks again for your kind attention.
With regards,
wk
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Avatar_m_tn
Dear Sir,

I real appreciate and respect to you by having to see your clear answer for every one's question.
I am a medical doctor however not practicing as General Practitioner.

Just let me get your suggestion like other people too because unfortunately my wife also having HBV positive.

My wife is 54 Yrs old, around 150lbs in body weight and having HBsAg as positive since last 3 yrs ago and didn't take any treatment yet.

Since last 2 to 3 weeks ago, she was often suffered a intermittent pain around in Liver area and sometimes feeling difficulty in breeding and abdominal distension like an undigested person.

Then I bring her to do Ultrasound abdomin (abdomen) and Report was described as below.
Liver = slightly enlarged, margin= bluntted, Echogenicity = increased.
Others are normal and diagnosed as a Chronic Hepatitis Case.

Then, I tried to do the following investigations for her after that.

Blood Investigations:
Blood for CP = all are in normal range
Lipid Profile = Cholesterol- 4.7, TGL-1.3, LDL-2.8,HDL-1.3(Low)

LFT : Total BIlirubin = 10, Alkaline Phosphatase = 98, ALT/SGPT = 22, AST/SGOT = 20,

Urea Test = 3.6
Creatinine = 53
Fasting B. Sugar = 107mg/dl

Antigen/Antibody Test Report:
HBsAg = Positive
Anti-HBs = Negative
HBeAg = Negative
Anti-HBe = Positive
Anti-HBc = Positive
Anti-HCV = No reactive

Fibro Scan Report :
Stiffness (KPa) = 14.6
IQR (KPa) = 5.2
CS(KPa) = 20
Success Rate = 91%
Fibrosis stage according to Metavir score is F3 to F4.

Tumor Markers Result:
AFP (Quantitative) = 2.04 IU/ml

HBV DNA quantitative test = < 29 IU/ml
inclusivity = HBV genotype A - G & Pre-Core mutant

ECG = Normal
CXR = Normal

I think, all most all the necessary Investigations are done already and the results are as above.

Kindly let me know your answers from you for my following question which I want to get your kind suggestions.

1. How is her status? Threatening to her life because her fibro scan is resulting as F3 to F4 stage?
2. According her other results and HBV viral load result (29 IU/ml), will she be classified as infectious as carrier stage or non-active stage?
3. What should I do for further steps? Do I need to bring her to a hepatologist to start treatment since now?
4. How about her prognosis based on her results. Currently, she is quite well and no other Diabetes or Heart disease tool.

I will highly appreciate and great thanks if you could kindly answer in detail about my wife case.

Thanks again for your kind attention.
With regards,
wk
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Avatar_m_tn

i think fatty liver is the problem maybe with previous hbv activations or without, please check with US technician if this is the case,US cannot detect severity butt i'd not make biopsy for this

first of all check:
vitamin d 25oh serum level to be higher than 50ng/ml, the higher the better by d3 supplements just follow calcium, creatinine, vitd25oh every 3 months.only kidneys disease might be a problem with making hi vit d
insuline resistance by homa

please check that lipid profile is within these ranges, i am not familiar with US/UK units
tot chol<150
ldl60

to increase hdl which is a very bad problem both for hbv and metabolic diseases like fatty liver and so on:
take liposomal glutathione from livonlabs.com and pantethine 1300mg daily, do not consider niacine for this since it may have sides on liver
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Avatar_m_tn
Creatinine = 53
i am not familiar with this unit, using european units a value lower than 1.00 is better

Fasting B. Sugar = 107mg/dl
needs to be lowered, bitter melon tea 1 liter per day after meals.also vit d will help solve this in case it is lower than 50ng/ml

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Avatar_m_tn
Fibro Scan Report :
Stiffness (KPa) = 14.6
IQR (KPa) = 5.2
CS(KPa) = 20
Success Rate = 91%
Fibrosis stage according to Metavir score is F3 to F4.

this is very bad, if you can affor start immediately hepatitistechnologies products, plus the supplements i said above
they will be able to reverse damage.you can easily see the scientists involved in this project for the credits

check also how i reversed my fatty liver and my diet by search box.the diet was based on black rise and bluberries mixed with berries fruit
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Avatar_m_tn

the base of diets are antocians, also excercise and bmi<25 weist less than 80 are a must, this is also for general health

HBV DNA quantitative test = < 29 IU/ml
inclusivity = HBV genotype A - G & Pre-Core mutant

monitor hbvdna every 3 months and just keep an eye on gcmaf results, interferon lambda to be available
check also hbsag quant iniu/ml by architect, if hbsag is very low a combo of interferon lambda+alinia+simvastatin+vit d if deficnet would be very good but not now it is better to reverse the liver damage first and inf lambda is not available yet

the high fibroscan can also be inflammation so monitor every 3 months for now to see if it goes down fast, as you probably know if detects fibrosis+inflammation+fatty liver so it may not be cirrhosis but just inflammation+fatty liver, since hbvdna is und and alt almost normal  for women inflammation should resolve

if fatty liver is confirmed add also vitamin e 600ui (200ui are in hep tech products) but a mix of natural thocoferols, not synthetic vitamin E because that is useless
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Avatar_m_tn
sorry for the puzzled answer and uncorrect writing, i am not good today, yeasterday i had heavy swimming butterfly....so today i am a little broken....
i hope you get a clear picture of my thinking making all answers together.

1. How is her status? not bad, there are no nodules on US so itis very early cirrhosis or just inflammed+fatty liver.
from 11kpa the risk of cirrhosis is high, from 8kpa the liver cancer risk is increased

Threatening to her life because her fibro scan is resulting as F3 to F4 stage?
no, adding full pack hepatitistechnologies she will reverse all damage to zero in a 1-2 years, just follow my example on diet and suggestion.of course every liver might have different healing process, slower or faster, but as long as hbvdna is zero and heptech she will improve
the pain should go away by 1 month, there are others taking heptech and improvment was by 4weeks

2. According her other results and HBV viral load result (29 IU/ml), will she be classified as infectious as carrier stage or non-active stage?
she is infected as long as hbsag is detactable, just low replication phase now.treatment withinterferons is a good choice when fibroscan gets lower than 8kpa because geno A has good chances of eradication and the mutants are a risk for liver cancer so i d try to clear hbv later on
do check hbsag quant, if hbsag is lower than 1500iu/ml and hbvdna und there are very high chances to get rid of hbv fast especially with alinia, vit d and sim combos
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Avatar_m_tn
3. What should I do for further steps?
vitamin d 25oh check, heptech full pack started as soon as possible (low dose first week and then go full dose), diet, excercise at least 40min a day (swimming is very good if she likes it)

Do I need to bring her to a hepatologist to start treatment since now?
no, she needs to reverse some damage, make sure vit d, cholesterol and sugars are in the best ranges to try interferon later on or when lambda will be available

4. How about her prognosis based on her results. Currently, she is quite well and no other Diabetes or Heart disease tool.

she is very good to me but the liver has something....hbv makes damage both changing oxidative stress/lipids/sugars or directly by replication....whatever the case check insulin resistance and fatty liver
US result of Liver = slightly enlarged means inflammed
Echogenicity = increased...thismeans fatty liver, just recheck with technician or liver specialist

do not take drugs if hbvdna stays undetactable, regress liver damage first and consider interferon later on, as you may know interferon may trigger more liver damage and it is not safe on cirrhosis or f3-f4
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Avatar_m_tn
Thank you very much for your kind and detailed reply which really show me a way what to do for her.

Thanks again for it Sir.

With rgds,
wk
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Avatar_m_tn

forgot to menthion a biopsy would confirm anything especially severity of fatty liver or fibrosis or cirrhosis.....but whatever the case the therapy is the same

so my thinking is to avoid useless smll liver damage and risks of biopsy even if very low
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Avatar_m_tn
Hi,

I am  28 yrs old man, found hepa B+ in 2009 incidently in pre employement checkup and by that time my viral load was 7180iu/ml now recently on 5/9/11 i checked its 10800, my sgpt & sgot is coming normal my fibro scan is 10.2KPA. i never taken liver biopsy but this time my doctor saying go for it.

Please help and suggest

Also does Meditation helpfull in this case?

Please advise
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Avatar_m_tn

why go for biopsy, fibroscan is pre-cirrhosis, are you obese so that fibroscan cannot be reliable?do you have fatty liver by ultrasound?if you have fatty liver fibroscan value maybe increased due to fatty liver

if you have no fatty liver start tenofovir or entecavir and hepatitistechnologies to regress fibrosis as soon as possible.

bmi>24 and weist>90cm damages liver, if so you need excercise and diet

Also does Meditation helpfull in this case?
absolutely useless, you need action on fat if you are fat or liver is fat, or hbv treatment if you are slim and liver is not fat

normal alt or hbvdna undetactable have no meaning regarding liver damage, it can be present anyway, but fat food, meat and being fat can make same damage as hbv or more
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Avatar_m_tn
hi everyone
how everyone today?
I have question about my test result from  hbv real time pcr quant  I'm infected with hepatic B
my test results are
my viral is now at 1.4 million
HBV as IU/ml     1437260
log1o HBV as IU/ml  6.158
HBV as copies?ml 8364900
log 10 HBV copiies/ml 6.922

the reportable rang for this assy is 20 to 170,000,000  IU/ml  (116 to 989,4000,000 copies/ml

my would like to know what should I do? do i need treatment ? it's my viral to high?
any answer will be appreciated

Thanks
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Avatar_m_tn

check the other posts, hbvdna is a useless test alone and has no meaning.hbsag quant in iu/ml and fibroscan are more important after these two come all the other complementary tests

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Avatar_m_tn
thank you stef2011
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Avatar_m_tn
hi,,, i have already gave these readings 3 months before and got a satisfactory answer,,,actually problem is i m taking this decease very casually and didn't go for any further testing,,,,i also didn't stop drinking beers,,,,i m 22 yr old  and have very low awareness about HeptB....just 3 questions..............
1) whether there is a chance that i will die coz of Hept.B within 35??
2) Should i stop my drinking habit?
3) what about being sexually active?? i mean what precautions should my partner take?? is it  wrong for a +ve HeptB guy to have sex???

As this forum suggested i will go for fibroscan as soon as possible...


         HBe ANTIGEN    +ve
         ANTI HBe            -ve
          SGOT                28
            SGPT              37
       HBV DNA quantitative   5062460 iu/ml
  
    
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1. It depends, but all chronic hepb people have higher risks of dying from liver related problems in the future. Usually, when u reach 4o+ is when hepb carriers start feeling the effects of hbv, some even as young as 3o.

2. Stop. Alcohol = poison

3. Its not wrong but u r endangering lives. If u must then use condom and have her checked and vaccinated if ur planning to be with this person for a long time.
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Avatar_n_tn
i am a 40 yo male was found  in 2007 a chronic hbv carrier {hbsag+.hbsab-. hbcab+}ever since i have a yearly follw up with my doctor the lab results as follow (2007,2008,2009,2011)
hbvdna    (<100 /500 /150 /4051) copies/ml (after my recent lab result my
albumin   (        /  4.4 / 4.2 / 5.2 )   doctor order an other hbv dna within a
bilirubin    (       /  0.5 / 0.7 / 0.6 )    week & show 1177iu/ml =6850cp/ml)
alkl phos  (       /   80 / 95 /  90  )     please advise thk you so much
alt            (       /   25 / 25 /  19  )
ast           (       /   22 / 23  /  23 )
lymf          (       /       / 2.1 / 3.2 )
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Avatar_n_tn
the last US i had in 2009 shows everythg is fine
my new doctor did not order US & he is planning a therapy for me base on hbv dna increase . please let me know what do you think? should i look for a second opunion before i start any therapy? if you say so should i see an infection desease doctor or a hepatologist? thank u your help is allways needed stef.
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Avatar_m_tn
My brother aged 29 years married on 9th September 2011 . on 10 November 2011 he came to know his wife is Hbsag possitve.with normal liver function she were also Hbsag positive Hbe negative,non reactive,DNA less than detectable on 10 November 2008 when her brother died of liver cirrhosis due to Hepatitis b.My brother is not vaccinated for HBV.He lastly come into sex exposure with her wife on 8th November 2011.At once he tested for Hbsag with negative result.and started the vaccine first dose at once

Her wife today on 22th november tested for HbeAg  ,Anti Hbe ,HBV dna quantitative test..reports of that is awaited..my brother is now separate with her wife.
what are the chance of getting infected of my brother...and if infected what outcome may be..blood group of my brother o possitive...
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Avatar_m_tn
My father blood test shows following results

HBsAg ( By CMIA Method) : 250 IU/ml

Anti HCV ( CMIA method) : .14 IU/ml

HBV DNA : 69600 IU/ml

SGOT : 54

SGPT: 79


Doctor says 40% liver is damaged and he stared Tenofovir300 mg.
1. Pls suggest above mentioned blood result meaning.
2. is HBV DNA managable?
3. should i take second opinion.
4. do I need for other advance test.

Pls help. Look forward to hear from you.


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Avatar_m_tn
Hello,

My husband is 35 yrs has been a hepatitis B chronic carrier since birth. He only started getting regualar blood counts in the last 3 years when we moved to UK and up until then his virus count has been almost undetectable.  Then about 1 year ago it went upto 4000 and now recently the doctor says its gone up to about 9000.  

All his other blood tests (ALT etc) and ultrsound are normal, but they are saying they want to do a liver biopsy to see if treatment is necessary- does this sound right? my husband is really not keen on having one, are there any alternatives?

  Thanks in advance
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Avatar_m_tn
Doctor says 40% liver is damaged and he stared Tenofovir300 mg.

did you have fibroscan to check the liver damage?how can the doctor say liver damage?anyway after 40yo of age it is better to start antivirals because liver cancer risk increases too much anyway, tenofovir is the best hbv drug with no resistance, hbvdna has no meaning it just got to get undetactable by 6 months since you start antiviral to show antiviral is working.hbsag quantity in iu/ml shows if the virus is being cleared not hbvdna

so the choice to start tnf is good and it must not be stopped until hbsag positive, when hbsag gets negative you can slowly stop tnf.

1. Pls suggest above mentioned blood result meaning.
they say very little, there is an hbv infection, alt must get lower than 30 and hbvdna und by 6 months of tnf

your father had also hcv infection, he must check hcvrna to know if the virus is still present or cleared

2. is HBV DNA managable?
yes by tnf, when hbsag quant gets 500-1000iu/ml interferon add on can clear hbv

3. should i take second opinion.
no

4. do I need for other advance test.

fibroscan every 6 months to see if liver regresses fibrosis
ultrasound every 6 motnhs to prevent liver cancer
creatinine to check that tnf has no kidneys toxicity
hbsag quantity in iu/ml every 12 months to see if you reach low levels that clears with interferon add on.this may take 6-8 years or more according to baseline value

hbsag result that you have say hbsag>250iu/ml (> means superior), the sample has not been diluited to see the actual quantity of hbsag..lazy or ingnorant lab tech
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Avatar_m_tn

UK has the wrost healthcare system in europe but fibroscans should be available even there.biopsy is no longer used, find a fibroscan to see liver damage

hbvdna has very little meaning and in any case 9000iu/ml is low, hbsag quantity in iu/ml is much more important, if lower than 1500iu/ml hbv can be cleared by interferon or interferon+tenofovir

hbsag quant is not available in UK, you need to move to france or any other european country to have it.if you find fibroscans also not easy to find move to have that too, france, germany and italy have fibroscans every where even at priviate small doctors clinic, it is also cheaper than biopsy and there are no risks

biopsy can also give results lower than real because it takes just a small part of liver.for example you can be f3 fibrosis which is severe but take a part of the liver with f1- f2 fibrosis and have  low false result
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Avatar_m_tn
Thanks for the fast reply. My husband spoke to the registrar today who is telling him he should have a biopsy. He asked her exactly on what basis she has made that decision and she said it was soley based on the viral count...  He asked her what exactly they were looking for that required a biopsy and she just kept saying 'damage'.. I am guessing our only option really is to look privately for somewhere offering fibroscan and  fibrotest.. would you recommend this?
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Avatar_m_tn

fibroscan absolutely

fibrotest no, it is all wasted money, even advanced cirrhosis can have normal blood tests, it is totally unreliable, just another way to steel money.fibroscan is the more accurate on relevat liver damaged and the most accurate for cirrhosis.it is good both for monitoring off therapy or during therapy

biopsy is good when also steatosis is present or if bmi>27-28 or alt flares over 200.in these cases fibroscan cannot read correctly
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Avatar_m_tn
Hi Stef
I have changed my vit d3 (1000 iu/ml which My doctor  prescribed )  I ordered from Detoxpeople  
* (5000IU) - Dr's Best - 360 softgel's (taken 10,000 iu/ml per day fro almost a week ----- No sleeping Problem
* Liposomal Vitamin C - 16oz (96g vitamin C liquid) Taken 3 grams per day.

* The Result of My Liver Function Test came back BACK  and is all normal

* HBV DNA 56 IU/ML

Though I request HBSAG Quantity but it seems that they do not do here or even some doctors told me that it is not Important, Burt what I confirm from one of the best Private Hospital treated liver disease in here (Cromwell hospital) that  they not familiar with the test of HBSAG QUANTITY

Therefore if you can assist me to get an appointment to Pissa Hospital  I would like to come Pissa In order to have the following test:
HBSAG QUANTITY
HBVDAN QUANTITY
MUTUTATION TEST
GENO TYPE TEST  

Finally as I am taken vit d3 and Vit c as you advice is there something else which I can ADD IT.

As HBVDNA IS QUITE Low do you think hbsag will be low as well
My alt is 27 (August 28) and AST IS 23 (August 22
thanks stef
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Avatar_m_tn
do you monitored you serum blood test before and after you start to take vit d/c.. I'm wandering if some changes are visible.
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Avatar_m_tn
do you monitored you serum blood test before and after you start to take vit d/c    YES  i CHECKED MY VIT D 250H AND BECAME 32ng

I have been taken Only almost one week and i feeling much better, NO knee pain back pain still there but I think its improving, I can get up morning without problem
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Avatar_m_tn
do you monitored you serum blood test before and after you start to take vit d/c    YES  i CHECKED MY VIT D 250H AND BECAME 32ng

I have been taken Only almost one week and i am  feeling much better, NO knee pain , back pain still there but I think its improving, I can get up morning without problem
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Avatar_m_tn
i was refering to all serum tests (hbv dna, qhbsag, alt ...).
what was your vit d base line ? (now is 32 as far as I understand)
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Avatar_m_tn
hbvdna is 56iu/ml
hbsag not available in uk I will try somewhere else
My alt is 27 (August 28) and AST IS 23 (August 22
VIT D is 32ng
thanks
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Avatar_m_tn

what 4est meant is: what is the trend of all tests after taking supplements, are they all going towards improvment?

to me it is too early to say, vit d 32ng/ml is still deficent, the cancer prevention  happens in the range 50-70ng/ml and also immune system boost is probably around those levels
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Avatar_m_tn
i have hbsag test on 12-05-05 the value was 2120.0 reactive then i have hbsag test again on this day 12-01-11 the value was 24.363 reactive....what does it mean is it increasing?
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Avatar_m_tn

nothing that's a crap old useless test for cronic (chronic) carriers, have abbott hbsag quantitative in iu/ml, the number that you have is a reagent and has no unit so it counts nothing
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Avatar_m_tn
hello there

my
HBsAG(ELISA)   -- 3245(POSITIVE)
Anti HBc-IgM(EIA)   58(NEGATIVE)
Anti HBc-IgG           27(POSITIVE)
HBeAG                50(  NEGATIVE)
Anti-HBe              340(POSITIVE)
Anti Hbs                24(  NEGATIVE)
RAPID HCV          NEGATIVE


MY
TOTAL PROTEIN         7.1 gm/dl
ALBUMIN                   4.2 gm/dl
GLOBULIN                 2.9 gm/dl
SERUM BILIRUBIN        
TOTAL                       0.90 gm/dl
DIRECT                     0.50 gm/dl
INDIRECT                  0.40 gm/dl
A.G. RATIO 1.45:1
S.G.P.T(ALT)           17 U/L



PLEASE GUIDE MY WHAT SHOULD I DO
thank you very much in advance
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Avatar_m_tn
hello there

my
HBsAG(ELISA)   -- 3245(POSITIVE)
Anti HBc-IgM(EIA)   58(NEGATIVE)
Anti HBc-IgG           27(POSITIVE)
HBeAG                50(  NEGATIVE)
Anti-HBe              340(POSITIVE)
Anti Hbs                24(  NEGATIVE)
RAPID HCV          NEGATIVE


MY
TOTAL PROTEIN         7.1 gm/dl
ALBUMIN                   4.2 gm/dl
GLOBULIN                 2.9 gm/dl
SERUM BILIRUBIN        
TOTAL                       0.90 gm/dl
DIRECT                     0.50 gm/dl
INDIRECT                  0.40 gm/dl
A.G. RATIO 1.45:1
S.G.P.T(ALT)           17 U/L



PLEASE GUIDE MY WHAT SHOULD I DO
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Avatar_m_tn

again crap useless tests, you can do nothing with these tests, these tests can be used on acute hbv only, totally useless for cronic (chronic) carriers

answer go have tests for cronic (chronic) carriers nothing can be said about hbv by these tests, you are wasting money on something useless

HBsAG(ELISA)   -- 3245(POSITIVE)
Anti HBc-IgM(EIA)   58(NEGATIVE)
Anti HBc-IgG           27(POSITIVE)
HBeAG                50(  NEGATIVE)
Anti-HBe              340(POSITIVE)
Anti Hbs                24(  NEGATIVE)
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Avatar_m_tn

tests for hbv cronic (chronic) carriers in order of importance:

fibroscan
hbsag quant by abbott architect in iu/ml

all the rest useless without these main tests and complementary after these two main tests
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Avatar_f_tn
hi, im pregnant and so as a routine i got all the tests done. my hbsag shows non-specific reactive(biorad;2.715) but my anti-hbc is negative... the hospital repeated this test three times in a span of 2 months and found the same result. my LFT is normal, infact alt and ast are at the lower side....  can you explain this kind of results?
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Avatar_m_tn

you probably have hbcab negative cronic (chronic) hbv, check hbvdna pcr and hbeag

i'd definitely take tenofovir to prevent the baby to be infected and fail the vaccine, another concer may be there is no data on hbv vaccine efficacy on the hbcab negative type

there are any types of hbv mutations hbcab negative is just one of the many.hbsag negative is another one for example
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Avatar_m_tn
Hi Stef
I am Hbsag Positive,
Hbeag Positive ,
Hbv Dna Load Quantative is 3040 IU/ml
Can u pls help interpret these results and what to do next?
Doctor suggested Liver Biopsy .Is it really necessary to do biopsy as i am asymptotic
and all other results are fine.

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Avatar_m_tn

if you have fibroscan in your contry or close country this is much better than biopsy because you can monitor liver damage.
biopsy can have fatal problems even if rare, mistakes, and can t be done very often because it does damage to the liver.i d definitely avoid it

we dont know what is your status or liver damage unless fibroscan or biopsy performed

hbvdna is low but it tells nothing of infection status you need hbsag quantity in iu/ml, you also need genotype and bcp/precore mutants to define status

as to therapy we already know tdf+interferon has the best clearance results at about 40% especially by making hbvdna und by tdf first and then interferon add-on for 96 weeks or more depending on hbsag decrese

it is useless to wait for other results from interferon+tdf or etv combo, since clearance is pratically none on antivirals monotherapy and about 10% on interferon mono it is already clear that tdf+interferon is the only cure available for hbv at the moment while all the rest is not a hbv cure (except interferon mono on 10%)
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Avatar_m_tn
Thank you for your earlier replies.  Well today my husband (35yr old) who has had HepB from birth had his appointment with NHS consultant - his hbvdna was close to undetectable 1 yr ago, rose to 4000 iu 6months year ago and now is 9600 iu. About 2 yrs ago it was 2000 so clearly fluctuating. All his ALT's are normal..and it is because of the rapid increase in viral dna that consultant advises a biopsy to search for liver inflammation and the new higher value.

He says if there is signs of moderate inflammation he wants to start combo therapy on nucelosides (he mentioned lam, ade and ent I think) and when asked for how long he says long term 15-20 yrs! I know Lam is no good surely (old drug / high mutation) and that soon there may be better options? Being on drugs for this long term just going to make virus mutate...his mother has had hep B all her life (not sure whether from birth or not) - she now lives in Canada and has only started having monitoring in last few years and has never required treatment..although her hvdna lvl is admittedly low.

What is your advice please? The consultant says his approach is to start treatment before fibrosis even occurs...I want an second opinion for sure and so considering looking for a private specialist who will do a bigger selection of blood tests and give us the actual results?

I want to try to pinpoint the stage of Hep B he is in. I assume we are looking at reactivation of inactive carrier state?   I am assuming my husband is now HBeAg negative (he is Asian with hep B from birth and before I knew he was hep B he didn't manage to pass virus to me even before though I was not immunised, indicating long period of inactive carrier?) - I even asked consultant to confirm this and he said he 'assumed that he must have seroconverted by now' which makes me think they don't even have result of this test?

If therapy is indicated would interferons be better option or is his lvl too high? - I just don't know at this stage, but last thing we want is for him to have to start long course of drug therapy unnecessarily which creates more problems in long term.

Thanks in advance
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Avatar_m_tn

drug menthioned by doctor are all out of guidelines except entecavir, i dont see any point about using that combo since latest data shows hbv is cured by tenofovir and then interferon addon.clearly most doctors dont even bother to update and just follow drug makers consulants indications.....

anyway find a doctor for this sequential combo strategy to clear hbv, doesn t matter too much liver damage for this because we try to clear hbv once and for all.to have an idea of success we need hbsag quant in iu/ml and follow this during tdf and then tdf+interferon

having a low hbvdna is a chance of having low hbsag too, but often it is not so, hbsag will tell both chances of clearance and if inactive carrier.hbvdna quant is useless to know clearance chances
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Avatar_m_tn
Thanks again for your reply,

I don't know why this consultant is even talking about these drugs as there are newer ones now available that display greater efficacy and have a lower risk of resistance, so I shall definitely be looking for a newer doctor regarding this.

Also, I do try to keep up with the literature regarding treatment options and prognosis for long term HBV chronicity - are there any particular recent articles/journal reviews etc. that you would recommend reading/can provide links to - I would greatly appreciate this.

Many thanks again
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Avatar_m_tn
http://www.multiwebcast.com/aasld

but there is no need to look too much because only one strategy has shown to cure hbv until now as i posted:

2-3 years of hbvdna undetactable by
tenofovir or entecavir (tenofovir more potent)

interferon addon for 96weeks, alinia off label will boost response and may turn non responders to responders

hbsag must be monitorred during these treatments since goal is to make it undetatctable or lower than 100iu/ml so that the virus is totally inactive even without drugs

all the rest did not cure

a very good italian liver specialist (not researcher) will make a sum of liver meeting 2011 results in some days, just check there and use chrome for authomatic translation from italian

http://forum.corriere.it/fegato/archivio.html

in italy good liver specialists and researchers are already doing interferon+tdf or interferon+etv from 2010


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Avatar_f_tn
Hi
Can someone tell me the meaning of
Hepatitis B virus DNA PCR - detected
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Avatar_m_tn
hi, my name is sajid 25male.
i m HBs anitgrn positive and then i tested PCR which shows hep B virus not detected.
s.total bilrubin 0.3mg/dl
s.direct bil 0.1mg/dl
s.indirect bil 0.2mg/dl
gamma GT 52iu/l
ALT 110 iu/l
alkaline phosphtase 74iu/l
platelets 137*10Ep/L
              now feel pain in right hypochondrium. bt i feel healthy and no any problem except pain.
what does mean abt postive HBs Ag and HBV DNA not detected.
what treatment i use.
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Avatar_m_tn

very little meaning because hbv replication cycle is not based on hbvdna, if undetactable it means no liver damage, less cancer risk while if detactable it may mean many things and nothing

on therapy it is used to see if antivirals are working

hbv is used together with hbsag quant in iu/ml and firboscan, the 3 tests altogether can have a meaning
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Avatar_m_tn

check hbcab igm if positive you are clearing hbv and no therapy needed.hbv has no symptoms even close to death, it is extremely rare to have symptoms

you are probably clearing hbv because high alt with hbvdna und are correlated with clearance
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Avatar_m_tn
now what further tests i do? and what treatment i start?
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Avatar_m_tn

hbsag in iu/ml by abbott architect machine or hbsag roches quant machine
hbsab
hbcab igm

and wait.

there is no treatment active directly on hbv so you ave to wait, hbsag is cleared in 6-12 months

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Avatar_m_tn

by the way check for all other hepatitis viruses too just to exclude possible coinfections with hdv, hcv, hev, hav
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Avatar_m_tn
i have tested hcv  and hdv which is negative.
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Avatar_m_tn

just check hav too and that should rule out coinfections
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Avatar_m_tn
interferon injection or limvudine or adifovir which is the better treatment regarding my condition
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Avatar_m_tn
silymerin has some effect on this disease.?
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Avatar_m_tn
my fathr is affected by HBV nd the DNA is detected....the result is 823copies/mL  ( 123IU/mL).........we are very tensed.... is it severe??? what should we do?? isn't there any treatment??? :( :( :(
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Avatar_m_tn
my fathr is affected by HBV nd the DNA is detected....the result is 823copies/mL  ( 123IU/mL).........we are very tensed.... is it severe??? what should we do?? isn't there any treatment??? :( :( :(
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Avatar_m_tn
silymerin is antioxidants and helps reduce liver damage while it has zero effect on hbv

hbvdna is useless to monitor hbv infection, only a reduced hbsag quantity can reflect less infected cells, more immune system response and hbv clearance.

hbvdna undetactable means only less liver damage but infection goes on and more cells gets infected even if hbvdna is und
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Avatar_m_tn
limvudine or adifovir

out of guidelines for hbv, they worsen infection and make hbv mutants

the best therapy is sequential treatment with tenofovir 1-3 years and then interferon add on for 96weeks

the only drugs for hbv on guidelines are:
interferon
tenofovir
entecavir

of these 3 entecavir still has a resistance risk and 1.2% of patients develop mutations and resistance on it
tenofovir and interferon zero resistance

lamivudine, telbivudine, adefovir are not firstline and should not be used on hbv anymore
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Avatar_m_tn
Hi, my result was tested with following results(futher testing on the way);

HBsAg pos
anti-HBsAg neg
HBcore Ig pos
HBe neg
HBe Ig pos

We have been together for 7 years, what are the odds i am infected. Does this mean she has been infected for a long time or is it something recent ?

Thx,

John
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Avatar_m_tn
Pls disregard last post.


--cross posted--

Thx

John
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Avatar_m_tn
Hi,

I got diagnosed with Hep B in 2003. It was in inactive stage at that time. I took it lite. I got tested it again 2008. It was still in inactive stage. I was happy. I got diabities in 2010. I did my best to keep Alc in control. Now it came down below 5.6 in my last annual test. But I got bad news that Hep B is active report says

QN, REAL TIME PCR

Hep B Virus DNA - 110 H  (<20 IU/mL)
Hep B Virus DNA - 640 H  (<116 copies/mL)

I take alcohol weekly once (4 Pegs)

Can you explain me my situation and what I need to overcome it?
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Avatar_m_tn
WHat this means my result in Hapatitis B quantitative test is 24IU/ml ??
help me to understand this.
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Avatar_m_tn
Hi Stef;

I am male (26 yrs) , I got diagnosed with HBV during blood donation test in 25/12/2011 below is my results:
HBsAg +ve
HBeAg +ve
HBeAb -ve
HB Core total +ve
HB Core IgM -ve
GBT 22 ( normal range is between 0--47)
GOT 23 ( normal range is between 0--37)
HBV DNA Quantative by (TaqMan) > 170000000
Real time Abdominal Ultra-sonographic is Normal.
I don't have any symptoms and feel healthy.
A hepatologist advised with Baraclude .5 mg for 3 months and do the PCR test again , is it OK for time being or Not ?
another Question:
reference to above is there any indication about the time I got infected ?
Thanx in Advance

  
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