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Seroconversion and antibodies
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Seroconversion and antibodies

I have chronic HBV and after about 1 year on tenofovir, I was told today that I have seroconverted.

I also take 2 milk thistle capsules a day, don't drink alcohol, and drink a lot of cranberry juice and detox teas - so the doctor told me to keep up with whatever I am currently doing.... so to my questions:

What is the relationship between seroconversion and developing antibodies.  Does seroconversion mean that I am developing antibodies OR have developed antibodies to HBV?  Any tips on helping maintain / strengthen the seroconversion stage?  How long after seroconversion does one develop antibodies?

Thanks for your responses in advance.

25 Comments Post a Comment
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Avatar_m_tn
Seroconverted to E-Antigen Negative or Surface Antigen Negative? Very, very BIG difference.
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Avatar_m_tn
Seroconversion is just a technical term to describe the losing of an antigen and the gaining of its antibody. I think a true seroconversion should mean not just losing the antigen but also the gaining of the antibody. Some people will lose the antigen without gaining the corresponding antigen immediately.

HBV produces several antigens. The two most tested are the e and s antigens.

To help gain the  HBV s-antibodies after losing the s-antigen, some patients would try immune stimulant such as the HBV vaccine. No all doctors would concur as the s-antibody may develop naturally but just delayed.

Just my opinion.
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Avatar_m_tn
...just called today + he was referring to being Surface Antigen Negative, as the virus has been undetectable for the last 3 months.  He stated that this is rare 1 to 3 % of all cases.  I personally feel all of the "alternative" therapy has helped a lot (milk thistle, cranberry juice/detox tea to keep everything flushed out).
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Avatar_m_tn
...of course thinking positively helps a lot as well.
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Avatar_m_tn
Thanks for your response.  My chronic status was found out AFTER my hbv vaccination was not producing antibodies.  Further testing revealed that I was already infected.  So maybe this has helped in my response?  Who knows?
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Avatar_m_tn
if you were hbeag pos tdf clears hbv in 16% by 3 years, not so rare, but it is rare in so little time, you were already clearing hbv yourself probably if you were tested hbsag quantity we would know

do not stop tenofovir unless you develop hbsab antibody at 250miu/ml or higher, being hbsag negative does not mean the virus is cleared, the virus will be there inside liver cells for many years as a template called cccdna.being hbsag negative and hbsab 250miu/ml or higher means your immune system can block the few infected cells that you still have so with time any cccdna will be cleared

so keep tdf, check that hbsab is developped and if not repeat hbv vaccine until you get hbsab, when hbsab is high tdf can be stopped
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Avatar_m_tn
Well done. Gives us hope. Although you still need HBV surface antibodies to create immunity. Like stef said, it could come back but it's a good start indeed to be HBsAg Negative. Congrats.
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Avatar_m_tn
Yes congratulations.
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Avatar_m_tn
you need another test to confirm.    There is such a thing as primary reagent failure.  I mean the test failed.  Diseases follow specific patterns.  Yours is a bit unusually but possible.  BEst to do HbsAG quantitative.
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Avatar_m_tn
good job, but why would cranberry juice help?
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Avatar_m_tn
Congrats Wantinfo. I think your immune system was already clearing anyway. The detox also helped
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Avatar_m_tn
The whole story is that they first tried pegasus, which just about put me in the hospital because my white blood cell count dropped critically low, plus my AST/ALT values + viral load were all very high - in spite of / because of the interferon.  I talked to an alternative medicine friend, who suggested milk thistle.  I am convinced it protected my liver + boosted my immune system...my pee seemed "too clear."  I started drinking cranberry juice and a liver/bladder tea from a local (Dutch) herbalist.  My pee became almost tan after about 2 weeks of drinking them + has stayed a good yellow color.  It may sound crazy, but I could see that the juices/tea kept me and my filters (liver + kidneys) work to clear me out.  I could stop by the herbalist to find out what was in the tea (in addition to milk thistle) if anyone is interested.
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Avatar_m_tn
Thanks, my doctor told me to keep up what I am doing + will retest for antibodies, liver values in January 2014.  He told me we will proceed very carefully before stopping Viread.  He is also in consultation with an university hospital in Amsterdam.
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Avatar_m_tn
Milk thistle links:
http://www.mayoclinic.com/health/silymarin/NS_patient-milkthistle
http://altmedicine.about.com/cs/herbsvitaminsad/a/Milk_Thistle.htm

Basically many German + Dutch doctors recommend it, along with any meds - it is traditional.  All I can say is that it DEFINITElY played a role in bringing AST/ALT levels back down.  I take 2 capsules every morning, Hell I even noticed that Walmart sells the stuff in the US.  In the UK people take milk thistle to protect the liver before a drinking binge.  
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Avatar_m_tn
...there are also studies (funded by who?) that found no positive results in HepC patients.  Whatever.  My attitude was that if didn't hurt me or my liver it was worth a try.  
My Routine:
2 milk thistle capsules in the morning
Viread at night with my meal (eating it with my big meal of the day reduced stomach uncomforted).
Plain old cranberry juice at breakfast + once in the evening
A few times a week, detox tea (no coffee)
(I also did the slightly whacky thymus thumb a few times a week - but that is really out there.)
1 week a month echinacea, 1 capsule a day
A good daily multi-vitamin, plus one of those lousy fish oil capsules
Eat well - lots of fruit and vegetables - + exercise

I treat it basically like a part-time job
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Avatar_m_tn
all your story is managed increadibly wrong how can they treat you without hbsag quantitative?it is like a blind man driving in a race......it was peginterferon to lower hbsag and tenofovir finished the job
low ast alt is very bad, increase of alt is needed because it means infected cells are being killed and cleared of hbv

the alternative you take we all take already, it makes nothing to hbv as already said

as posted already if you dont have hbsab you may relapse
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Avatar_m_tn
Relax please, stef2011 - they did manage hbsag quantative, which did not drop as much desired, whilst my ALT + AST shot through the roof.  All fine, but the drop in my white blood cells did not respond to an additional treatment, so they took me off of Pegasys after 4 months, when I started Viread about 1 year ago.  My quantative levels dropped significantly within 2 months, to where my viral load has been undetectable for over 3 months now.

I work with a doctor who get advice from a university hospital, and a nurse practitioner who specializes in inflammatory internal diseases + she is very open to everything that is supposed to reduce liver damage and clear your system.  It has worked for me so far.

Relapse would be a bummer, but I am meeting with the nurse monthly to make sure all of my numbers stay where they need to be.

Again:  got immunized but had no antibodies, first the Pegasys with not enough response, now Viread with all of stuff mentioned above.  

So far it has worked for me.
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Avatar_m_tn
Hello Magda123,

Sorry I saw your email just now, it was buried in my inbox.

were you hbeag positive or negative?  sorry I am not sure - may seem strange but I only focus on the present
brand of milk thistle?  have had a few, including Spring Valley and a Dutch brand - capsules are easily found in Google search, ebay, etc.
cranberry juice? plain old Ocean Spray which is pretty widely available, in any form that tastes good to you
detox tea?  the mix I used had milk thistle + nettles in it.  I also used a German brand (Bad Hielbrunner Blasen u. Nierentee (for bladder + kidneys) and also Marks & Spencer detox infusion.

I PERSONALLY think that using the herbs every day has a good effect.  This is probably a more traditional European approach.  If you read the comments from some of these very frequent posters they are SO focussed on running after the next hot med or trend, it sounds a bit crazy to me.  I also meditate (think about calm, healing, liver improving....every day).

My doctor and nurse said try using everything you put into your body to help you heal:
http://www.globalhealingcenter.com/natural-health/liver-cleanse-foods/
http://www.bodyandsoul.com.au/nutrition/nutrition+tips/10+tips+for+liver+detox,11285
http://www.liverfact.com/liver-facts-3.php
http://www.care2.com/greenliving/15-ways-to-boost-your-liver-for-great-health.html?page=1

If you look at these links you will see that you need to change you eating habits.  Find what you like + works for you and focus on the positive.

One more whacky thing is the thymus thump.
http://www.youtube.com/watch?v=UIR7dWwqKIw

Reading many of the comments in the forum makes me think of a desperate, slightly evil girl's school full of gossipy twitter.  Calm down, focus on turning you body into a healing machine and stay positive.

Hope this helps you. Really
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Avatar_m_tn
hi.. may I ask you how old are you? were you CHB carrier since birth?
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Avatar_m_tn
..just turned 50.  I was not infected at birth.  Based on the liver stage of liver damage that I had (but don't know for sure) the doctors/nurse thought approx. 5 years - but again who knows.

My doctor + nurse were VERY stern about "you need to make choices to promote healing".  Really a more "macro' approach to improving my overall general health (I chose to cut meat consumption by 1/3, more of the foods mentioned above, losing that 5 kg, exercising regularly (I do Pilates)).  So look at what is going to promote healing in a reasonable way + what is going out - my nurse taught me to see the signs here (yea the pee + poop).  

The other approach is probably more "micro":  what are your latest numbers, etc.  When I focussed on these it made me crazy.  My family, doctor + nurse would ask "have you been on the internet again" when I seem worried/too focussed - and most of the time they were right.  

Find out what works for YOU to support healing to give the meds a strong foundation (your body) to work in.

...well that is my philosophy.  We will see what happens.  

BTW I was just going in to talk about the results of an ultrasound of my mid-section + was absolutely not expecting any good news for another year or so.  I was so disappointed by things in the past, I just learned not to expect "too much."  That helps me too....and hey if I have a relapse as some seem to think; hey, I will just deal with that if it comes.
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Avatar_m_tn
If you were not infected at birth, then you  have most probably had acute HBV that resolves by itself in 95 % of the cases whatever you think about or what kind of herbs you take.
But you are right absolutely stress does not help to regenerate the liver.
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3156104_tn?1357284795
@ Dear Stef2011 plz flag the reference of 250miu/ml titre should be the mark for cessation of therapy if possible

rgds
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Avatar_m_tn

yes 250miu/ml should be safe, at least you have some range to monitor and in case it lowers dangerously too much you can go back to therapy while if it stays stable it means you can safely stay out of therapy and always keep immune system in good shape (good nutrition, no corticosteroids, no steroids, no immune suppressing drugs)
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Avatar_m_tn
...nope was definitely NOT acute but chronic.  Why would anybody allow spending the money on expensive pegasus + viread for acute, that is just preposterous - that would have resolved itself within 6 months.  

-->had the hbv vaccine cycle over 6 months, was not in a high risk group so they did not pre-test me
-->was tested + had no measurable antibodies, determined to be chronic + there was a waiting period in there to make sure that I was really chronic.
-->liver biopsy, was candidate for pegasus with all of those implications
-->4.5 months pegasys; had to stop early because white blood cell count way too low in spite of additional treatment
-->started Viread with very good response within 3 months
-->on Viread + additional stuff since March 2012
-->viral load not measurable 3.5 months ago
-->had ultrasound + blood test 2 weeks ago, ultrasound was great + seroconversion

My new goal is to go for the 250mui/ml.  My doctor and nurse are working with me now on that.

It could be the sequence of the treatment, who knows:  vaccine, pegasus, viread + herbs.

Good luck with whatever you are trying.
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Avatar_m_tn
thanks, that is my new goal and I am going for it.  Will gladly keep you posted.
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