Genotype, Precore Mutation, Polemerase mutation have to wait about 2 weeks.
My alt, art is always a little bit high. My doctor already wanted to treat me and she said I have about 50% chance now if I make peg interferon treatment. But I told her I wanted to wait for the time being.
I think vitD3 or heptec or both helped me in dropping so much hbv dna.
my alt and art is high like this for about 2-3 years I think.
please check unit if ug/l or ng/ml.me, my sster and my father could get it higher than 50ng/ml only using more than 5000iu, anyway it may still increase by following months
Fibroscan -- 4.6 kpa
your goal should be keep fibroscan always between 4-5kpa, abnormal over 6kpa
HBV DNA -- 55,814 copies/ml
i would not care much about this, of course the lower the better but this doesn tindicate anything about infection
HBsAg (Quantitative) -- 2906.99 IU/ml
this is the test to keep an eye on and lower to 1000-1500iu/ml so that we have the highest chances to clear on interferon.if possible i'd use simvastatin and nitazoxanide (alinia) and see what happens to both hbsag and hbvdna and once hbsag is in the range 1500 start interferon
Get Your Vitamin D Levels Tested!
Have your physician administer a calcidiol test (also know as a 25-hyrdoxyvitamin D test). More important than your daily intake of vitamin D are your actual vitamin D blood levels. Optimal vitamin D blood levels are 50 ng/mL (125 nmol/L)‚ according to The Vitamin D Council.
you know these tests there are so poor sensibility that i'd have the ng/ml type directly, now i dont remember the best machine but the old vit d tests were very very poor reliability
most vitamin d tests are not reliable with results, if i remember correct the ones doing ng/ml unit are those with higest sensibility, in any case if we stay well over 50ng/ml we are safely in the correct range
I have collected my results as much as possible. I have been taking vitd3 and HepTec for about 8 weeks I think before I made my last test. I am also planning to take alinia after I get mutation and geno type results.
Results on 21.11.08
Albumin, Bilirubin(Total), Alpha-Foetoprotein --- Normal
Alt 55 ( Ref. 9-52 u/l ) ---- High
Ast 47 ( Ref. 14-36 u/l ) ---- High
HBsAG 6340 ( Ref. < 1.0 ) ---- Reactive
Results on 11.3.09
HBV DNA 446,574 copies/ml
Fibroscan -- 5.2 KPa
Results on 01.06.09
Albumin, Bilirubin(Total), Alpha-Foetoprotein --- Normal
Alt 62 ( Ref. 9-52 u/l ) ---- High
Ast 43 ( Ref. 14-36 u/l ) ---- High
HBsAG 5440 ( Ref. < 1.0 ) ---- Reactive
Anti-HBe 0.77 ( Ref. < 1.2 )----Negative
Blood Report-------- RBC, Platelet --- Normal
Thanks for the vit D sites. In-home testing kit might be very useful. I am thinking to buy one since it is also cheaper than the test in the hospital. I paid about 80 US$ for that test in the hospital.
I want to take alinia also after I know the mutation test results. Can you please give me the link of the company you order your alinia? Thanks, stef.
this looks polimerase mutants but they are too many, please ask studyforhope because i have these mutants reported differently at my hospital and i dont want to say uncorrect things.if all these are polimerase mutants i think it is best to use tenofovir+entecavir to be absolutely sure against any resistance or therapy failure
V 173 ---------wild type--- weakly intensity--- low
L180/A181---wild type--- strongly intensity--- high
N236 ---------wild type--- strongly intensity--- high
N236 ---------wild type--- strongly intensity--- high
T184 ---------wild type--- strongly intensity--- high
A194 ---------wild type--- strongly intensity--- high
S202 ---------wild type--- moderate intensity--- moderate
M250 ---------wild type--- moderate intensity--- moderate
Thanks for your advice.
What's about peginterferon+etv+alinia+vitd3+heptec instead of tnf+heptec?
tnf reduces the bone density, right? I have osteoporosis so this one might not be good for me. I know about side effects of peginterferon but may be I might have higher chance of cure???
if you want to control hbv replication and no clearance, use only tnf+heptech
vitd3 and calcium can prevent osteoporosis and gcmaf might even cure it if your vdr is not ff/BB
if you want to clear hbsag, and i d try this one because you have about 2000iu/ml:
peginterferon+tnf+alinia+vitd3+simvastatin+heptec without fibroguard or no heptech
fibroguard lowers inflammation and in case you want to activate immune response by interferon it is better to keep inflammation too
entecavir may be used instead of tnf if you get sides on kidneys.as regards the combo of interferon+etv no clearance has been reported on the little clinical cases or trials available while interferon+tnf has many clinical cases and trials with hbsag clearance
Thank , stef.
I'll discuss with my doctor here in my home country for peginterferon + tnf tx.
I'll post on different thread to let the other members know the higher risk genotype c has with bcp/cp mutants. May be studyforhope can comment on my results also for the knowledge of other members.
You mentioned about your sister in the other post....
"by the way my sister gave up alinia, no response and increased vit d3 like you...she has decreased hbvdna to 88000iu/ml from millions in a couple of months
before this flare of hbvdna she had hbvdna stable for years at about 300000iu/ml, so both vit d and low choles might be helping on this "
I am happy to hear the news. But I am thinking to take alinia and now I am having the second thoughts.
she used it monotherapy, until now we have data alinia can work only with interferon, it boosts interferon response probably it is able to decrease the interference viruses can make on interferon.using it with interferon is a very good thing since we have data on it
and of course like for interferon we have seen alinia monotherapy working for low hbsag carriers like 1500iu/ml
there is a common pattern on all alinia users, mono or nucs combo, a decrease of hbsag about 50% in first months of use and then a relapse, probably the virus is able to adapt to this interfernce, so like on hcv studies it makes sense to start alinia before interferon for 4-12 weeks then when hbsag reaches the lowest level add the interferon before the relapse.
the combo alinia+interferon probably helps to block the virus interferonce on interferon pathways.
interferon responders are very low and the reason is hbv is able to stop interferon pathways, so any mean to weaken the virus before addition of interferon is good and we know:
high vitamin d >50ng/ml for both hbv and hcv
low cholesterol by simvastatin for hbv, fluvastatin for hcv (tot chol<150,ldl<70 while hdl value has little effect as interferon booster)
alinia for both hbv and hcv
coffee for both hbv and hcv
may be we will find in the future that also gcmaf can help repond better to interferon
you are still vit d deficent, the max value is 100ng/ml, possible increase of calcium after 350ng/ml (possible)
my god your doctor is incrdibly ingnorant, you are still vit d deficent, he doesnt even know the scales in nmol/l and ng/ml and doesnt even know what the normal values are and what toxicity is.
definitely change doctor or study the subject yourself
avoid tests in nmol/l, they are very old and not accurate, 105nmol/l is a low value, nmol/l is much lower than ng/ml and it is still used just to make confusion
how to make changes from ng/ml to nmol/l
you must drink water only if calcium is high, not if vitamin d is high, drinking water has no effect on vitamin d but only on calcium.
as i said before check vit 25oh in ng/ml and calcium, if calcium gets over 15 you need to drink water.normal calcium is until about 10.5-11 but it is dangerous when it gets higher than 15
another thing to be stress, it doesn t exist vitamin d toxicity, there are only health problems due to low vitamin d in serum
please stop this stupid panic from drug makers to keep low vit D, there is no study that shows vitamin d toxicity, it just doesn t exsit.
there are only one or two reports of patients taking millions ui per day of vitamin d for over 6 months with an increased of calcium after having vitamin d 450-500ng/ml.they had no damage even from this
you are talking like if vitamin d is a poison, people on cirrhosis and cancer must take vitamin d and make it high.IT IS ONLY BENEFICIAL and also studies in san francisco has just proved how it protects from poisons and blocks cirrhosis development
if you see colombatto you can discuss everything about vit d with him, he of course knows how to deal with vit d and when it can be good or not
you can also test vit d when you are in pisa if it is not free in UK, in italy it goes from 16euro to 25euro according to the machines used.most of machines are not accurate in counting vit d accurately the newest and most accurate use something called chemioimmunescence or similar name but you can understand it those are the ones used because the range in updated to normal range 30-100ng/ml (some have still normal range 11-100ng/ml)
i have also found a few machines with normal range 30-60ng/ml, but again do not worry too much about those ranges, the latest normal range are 40-100ng/ml
unfortunately much scum and influence from drug makers has happened in vit d filed and we have to read studies ourselves to avoid the confusion.when vit d patent was rejected they did confunsion on studies and ranges and try to push use of synthetic vit d2 which is useless
the important thing is:
hbsag stays about the same so you are sure to get good results on treatment
do you have plans on alinia, tenofovir and interferon?
dont worry too much about hbvdna it has little or almost no meaning unless totally undetactable or close to undetactable, while hbsag is the most important
also high alt is important, it means your immune system can see the infected cells and kill them
i'd check again in 2-3 months and if hbsag rises i'd definitely start alinia and tenofovir and then just follow hbsag quantity for about a year and add interferon when hbsag gets close to 1500iu/ml or lower
the key is to keep an eye on hbsag and start a treatment before it moves to higher values which has no response to interferon.
hbsag values between 10.000 and 20.000iu/ml are almost sure to be non response to interferon as regards hbsag clearance
You are right, it can be very disappointing and depressing.
I'll check everything including fibroscan in March again and I'll probably start the treatment with entecavir which the doctor said I should start. I have ordered the alinia already; I'll receive them soon.
You mentioned somewhere that hbsag quantity relaspe after taking alinia for some time. Is it because of mono therapy?
My plan right now is in March I'll start with antiviral entecavir or tenefoir and about a year later add interferon. Just shortly before peg-interferon (may be 4 weeks before) I'll take alinia. The planning of how to start tx is really stressing me out.
At the moment I am taking Vit D3 8000iu and HepTec all 4 types.
Thank you, stef.
I take altogether 8 pills after breakfast and dinner only. Lunch time I take milk thistle and vit d3. Since you have a fibroscan result of only 2.3 kpa, just HepTec and Fibroguard should be working for you.
Yes, vit d3 is also in HepTec. I take only vit D3 5000iu. With vitd3 from HepTec and calcium tablet which also contains vit d3, I consume about 8000iu of vit d3 a day.
My asthma is 99% gone now. This must be because of vitd3 and/or HepTec.
After long discussions and thinking, I am going to start treatment this Saturday, Pegasys + TDF treatment for 48 weeks. As Stef suggested before I'll add Ntz also. (this would be without doctor's knowledge) and Vit D3.
@ stef..I have Nizonide 500 from Lupin. I should take 1 tablet a day after food right?
no 1 tablet would be just 500mg, not enough for antiviral effect.ntz stays in blood about 5hrs and effective doses were about 3g daily, so it is 1 pill at meals breakfast, lunch,dinner, before going to bed
ntz can have an effect on gut bacteria too so those with weak gut may have diarrea for a few days (i was among these) so it is best to take probiotics or yogurt before starting ntz.i used home made bifidus yogurt and another probiotic i dont remember the name...it was used in ntz trials, the name is in old posts
well the 4 weeks lead in was on hcv trials, maybe it ll work the same on hbv even if starting all at the same time
as regards ntz i checked all trials done on this drug and it was very safe, the higher dosages had the highest response they just did not approve the 3-4g daily dosage because of the costs of big trials required by FDA but one trial in new york used the 4g daily dose on severe aids patients for over an year, soi think you can do just as i did and try doses between 3-4g daily by starting at around 2g daily and slowly increasing to 4g daily and see if you get any sides on gut or creatinine
i had both gut problems, solved by live probiotics and creatinine increase solved by use of fibroguard or coq10+nac antioxidants
as a reference this is data from a guy adding ntz to intf, he started intf mono and had no response from intf, it looks like he ven had an hbvdna/hbsag increase
ntz add on looks like made an immediate effect on hbvdna, hbeag (hbsag not tested but when hbeag goes down hbsag goes dwon the same)
his doctor thought it was intf having this effect and put him on max intf dose, the sides were so heavy that this guy stopped all therapies, too bad we have such stupid doctors around.
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