Seroconversion

[Airwind]

hello. how would you know that it's safe to stop taking lamivudine once HBV DNA becomes undetectable? once HBeAG and HBsAG seroconverted? thanks.

[stevenNYer]

Not it does, it just replicating, just not as much because you immune system had established some control over the virus.  As long as the surface antigen is positive, it's replicating.

That's why I tell people to monitor, labels are deceptive.  They used to use the term "healthy carrier", then "inactive carrier" but these people has HepB and the virus could escape immuno-control and re-activate.

It's great to have an "inactive" disease.  It's the next best thing of being cured.  Heck, I hope I will get there soon, but you still have to monitor it.

[Airwind]

so if it says inactive, it means not replicating right? and that i am not infectious, correct?

[stevenNYer]

The seroconversion you are likely talking about is the eAntigen.  Seroconverting to eAntigen - and eAntibody + is usually the mark of an inactive carrier.  It's a very good thing.  Most HepB individual reach this point by themselves. But antivirals could help them get there quicker.  

There is currently no treatment that could turn the surface antigen negative.  Maybe you would become that lucky 1% but don't expect it to happen.

[Airwind]

hi steve! i am chronically infected. i did some researches and i found some conclusions based on some case studies that being undetectable for HBV DNA, HBsEg and HBsAG gone negative could be the end point (wherein it was advised to IMMEDIATELY stop lamivudine). however, the patient should be closely monitored during the 1st 6 months after the negative state of the 3 was achieved. and probably if the state persists to be negative after 6 months, then the patient could have been cleared or "cured" - which happens rarely. my HBsEg is 1,200+, and my doctor/friend says it's highly infectious, but i saw some cases having theirs as high as 20,000! personally, i dont feel i am as infectious as he was telling me but i still take precautions.

if you are saying that lamivudine will not cure HepB, then which one could possibly do? as my doctor/friend said, he had some cases where they use lamivudine alone, becomes seroconverted; lamivudine + HB immunoglobulin once a month becomes seroconverted; or peginterferon alone becomes seroconverted.

i guess it would really depend on how the body will react huh?

[stevenNYer]

See your other post.  i need additional infomation in order to comment further.  

But in short, seroconversion from HBeAg to HBeAb   COULD be an endpoint of lamivudine treatment.  But no guarantee.  Lamivudine treatment will not cure HepB (HBsAG serconverted)

[zellyf]

Someone else can answer this in more detail but a surface antigen seroconversion is very unlikely and is not considered the endpoint of any treatment in chronically infected persons. Is your infection acute?