Start Viread? Please help Stef2011 and others

I would like your opinion/advice.  I am a 45 yo asian female living in the US, HBV positive probably from birth.  My lab tests come up with normal ALT/AST.  No Fibroscan or HBsAg quant information.  

AST 20
ALT 19

Viral DNA 2790 IU/ml
HBsAg - positive
HBeAg - negative
HBeAb - positive

AFP - 3.3
HBV Genotype C
Basal Core Promoter Mutation 1762, 1764
No PreCore Mutations
All liver enzymes within range.  No symptoms.

The ultrasound results were normal with 2cm cyst on liver.

My doctor recommends that I start on Viread as soon as possible.  What do you think?

Other questions from reading Stef2011 posts:

1.  Currently on 20mg of Simvastatin.  Do I have to increase to 40mg for it to be effective?  Do you have a link to the research that shows that Simvastatin can reduce risk of HCC by 50%?

2.  What does Vitamin D do?  My current level is low - 24 ng/ml.  I have started with Vit D2  (50,000 unit) once a week for 3 months.

3.  What does Alinia do?  Do you know if it is a prescribed medication in the US?  Do you have link to research material?

4.  Would I be a good candidate for Viread followed by Interferon at a later time?

Any advice/input is much appreciated.  Thank you all in advance.

[stef2011]

being geno c, 45yo, with core promoter choice to start tdf is very good to prevent hcc which is very high on geno c.
it is good to see a fibroscan too but not necessary to choose tdf therapy, it is indicated since geno c with core mut

1 we posted many studies and 40mg was the most effective on boosting antivirals in vitro but as regards hcc and fibrosis regression even 20mg is ok, i d stay with 20mg if tot chol is less than 150, ldl less than 100 and hdl superior 60

fish oil is even more potent on hcc prevention, i use this brand which has the highest content of dha and epa.there are so many products with just minimum fish oil content.this is 5ml dose  4.5g fish oil which contains 1.8g epa and 0.9g dha, filtered from pollutants
http://www.pho.it/schedaProdotto.asp?prodottoID=202

a study on japanese eating much fish found a 40-50% reduction of hcc, this is also good for fatty liver and general inflammation

2.  What does Vitamin D do?  My current level is low - 24 ng/ml.  I have started with Vit D2  (50,000 unit) once a week for 3 months.

very very bad why d2?d2 is nt natural and has much less power and effect on rising vit d.d2 is just a synthetic patented copy of natural vit d3 with less effect.you are too low and need to rise to 50ng/ml or higher but do use d3, 5000-10.000iu daily are ok as long as you check calcium and vitd25oh monthly at first

d3 prevents fibrosis, cirrhosis, increases hdl, increases glutathione, activates macrophages and prevents cancer, flu and infections at levels 60-90ng/ml.it also boosts hbv immune response on those who have some, the higher the vit d level the lower hbvdna a study found and some members experinced too

4.  Would I be a good candidate for Viread followed by Interferon at a later time?
only hbsag quant can tell

[sea17]

Thank you very much for your prompt response and advice.  Also thank you for taking the time to contribute to this forum. Your contribution is most valuable.

[ono8ono]

is this the first time you tested for HBVDNA? Or the number has been around 2790 iu/ml for how long?  
The reason why I asked is because my HBVDNA has been going up & down between 32 iu/ml to 3610 iu/ml over the past 6 years. My last count was 1960 iu/ml in April, 2012. My liver function is normal, ultrasound normal.and my doctor has not put me in any antiviral yet. I'm asian male, 55 years old and probably HBV +ve since birth.
Thank you

[sea17]

No, this is not the first time.  I have about 7 years of data.  The numbers were low (under 1000) until 2 years ago.  It has been consistently been over 2000  in the last 2 years except for one reading - June 2011. My readings range from 1280 to 13,000 iu/ml, but mostly between 2500 to 3500.  My doctor seem to be concern about anything above 2000.  Not sure if that is a good guideline.

My main concern is that I have HBV genotype C that is high risk for HCC.  I just found out about this 2 weeks ago.  I have been reluctant to start treatment, but I am now ready knowing that my risk for HCC is high.

Hope this helps.

[ono8ono]

You and I seem to have similiar situation. The only difference is I have genotype B. What is the difference between B & C ? Thank you.

[ono8ono]

I'm also :
HBsAg - positive
HBeAg - negative
HBeAb - positive

[sea17]

Sorry, I do not know that much about B, but it probably has a lower risk than C for HCC.  

Steff2011 probably knows a lot more.

[stef2011]

http://www.ncbi.nlm.nih.gov/pubmed/22333950

http://www.natap.org/2007/DDW/DDW_05.htm

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0035145

the higest risk for hcc is diabetes, it has the highest percentage of hcc, so trying to keep sugars, chol, fatty liver in check is also very important

as for the studies age, cirrhosis, fibrosis level, genotype, core mutants, hbsag level in hbeag neg all are correlated to higher hcc with C the highest, B less than C but more than A and D