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Avatar universal

Starting IFN next month.

Hi all,

I will be starting a mono IFN therapy in 5 weeks time. After deliberating about it for the last 6 months, I think I need to at least give it a try. I just missed the trial for IFN/TDF in FEB this year because my viral load was too low for this trial (one of the criteria).

Lastest blood test today confirm HBV DNA has increased from 200iu/ml (2 logs) to 20000iu/ml (4 logs) in 3 months. These are approx. numbers and I didn't ask for a print on the result. We don't measure HBsAg in this hospital, which is not good. HBV DNA fluctuating between these number for the last 12 months.

Latest ALT steady at 40, AST at 34, GGT 16, ALP 52 and Bilirubin at 7.

My history:
Last ETV pill was on Dec 2011. During this treatment (somewhere in between stopping), I convert from HbeAg-Positive to HBeAg-Negative, e-antibody negative to e-antibody positive. Doctor ask me to stop after approx. 18 months. It was not my choice. I think it's because my HBV DNA was UND for a few months and my ALT value was below 40.








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Avatar universal
while nagalase is more interesting, nagalase is produced by infected cells, tumors cells and some bacteria too and it is used to suppress immune response

in nature we have two situations when it is used for good:
healthy bacteria in the stomach produces low amounts to hide from our immune system

during pregnancy to avoid fetus being attack by the mother immune system

so i think it is important you check it my guess is we still have hcc risk due to low amount of cccdna left which continues to produce nagalase (just a guess and who knows)....but one thing is certain it is not good to have abnormlly elevated nagalase for our immune system
Helpful - 0
Avatar universal
skip fibrosis check, if youlike you can recheck in 2 to 3 years but if you eat healthy you ll be ok

plus most population has fibrosis and fibroscan 6kpa due to processed foods they eat...so you liver is already better than everage population
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Avatar universal
Not sure whether fibrosis was reversed, the F2 was as a result of biopsy. The latest 4.9 was as a result of fibroscan. Two different method.

I will monitor it on a 6 to 12 monthly basis but now its on my own expense and I don't have a regular GP.

I don't know much about nagalase.











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Avatar universal
but it would be curious to see if in your case nagalase is normal after losing hbsag
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Avatar universal
sorry i am too tired in this period and posting from ipad is messy, i meant:

In his case it can't reactivate, hbsab around 1000 is absolutely protective

how fast afer cleaning nagalase should went to normal ?

these are just guesses, nagalase has been checked by me and few other members.but it was curious on aberdeen577 experience

aberdeen577
about 10 years ago, pegintf mono for 6 months stopped because no response
on tdf for 5 years, hbsag baseline not known but low hbsag for 3 years at about 16iu/ml if i remember correctly
nagalase before starting add on of gcmaf-goleic sublingual and vit d3 (not very high dose to make low pth). nagalase 2.2

after about one year of this combo hbsag und (sometimes found borderline), hbsab<10miu/ml, nagalase 1.8

my question is: who is making all that nagalase, 1.8 is still very elevated.possible answers low cccdna left or some hidden small tumor or another virus infection

to compare my nagalase:
13 04 2011  6.7 added gcmaf injections which are by far more potent than sublingual forms.hbsag 6255iu/ml
27 07 2011  3.3  hbsag 4995iu/ml
09 11 2011  2.1  hbsag 4572iu/ml
02 08 2013  1.3  hbsag 2853iu/ml

gcmaf was cont from 2011 to 2013, then i stopped and just restarted it in 2014 for few months

so i dont know it looks like there is no great correaltion, these are just thoughts of course nothing scientifically valid
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Avatar universal
how fast afer cleaning nagalase should went to normal ?
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Avatar universal
yep, it would be interesting to see nagalase results.
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Avatar universal
In his case it can reactivate, hbsab around 1000 is absolutely protective, he just needs ultrasound monitoring for liver cancer

if available i would just check nagalase, another member who reached hbsag almost und and no antibodies, had nagalase still abnormal.maybe this test reflects the cccdna and the liver  cancer risk not zero on those with hbsag loss
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Avatar universal
Congratulations :) great HBsAb count, like after vaccacine :)
But I think you should monitor it anyway, I know you want to forget about the disease but even people who lost HBsAg should be under monitoring especially older ones. It happends veeeery rarely that it reactivates.
So your fibrosis reversed just by diet, from F2 to 4.9 which is F0 or low F1 I suppose ?
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Avatar universal
Drinking alcohol is fine in moderation Safisifa. You got to live a little.

Just got back from my 6 monthly check up. Dr said I don't need to come in anymore. HBsAg and HBV DNA undetectable. No measurement for HBsAB but 6 months ago, it was 953. For some reason, no LFT result as I think it was not on the blood form. Last IFN injection was 25th June 2014.

Did a fibroscan that day as well. It only took like 2 minutes. Result was given on the spot as 4.9.

I will check the website from time to time to help fellow patient seeking help and advice. A big thank you to Stef2011 and StephenCastlecrag for all the education given regarding this disease and wish everyone all the best in the future.





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Avatar universal
Could you please delete the comment that you said you drink alcohol? Because there are many people that can misunderstand your saying and start drinking alcohol.
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Avatar universal
Sometimes during the treatment, I had quite a few drinks on the weekend. I don't drink wine. I quit smoking in year 2011 or so. Changed diet in 2013.

My nurse say it's fine as we must indulge in our lives. Once my GGT went up to the high 80's and I suspect alcohol to be the cause plus also IFN does cause GGT to spike.

I am not an avid drinker, just every now and then. Wine once a week should be fine. :)

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Avatar universal
do you cosume alcohol once in awhile? What does your doc say about it? glass of wine once a week?
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Avatar universal
I was F2, from what I been told. Eating healthy is very important. I guess it's not our nature to eat healthy. It's a habit that must be applied day in and day out.

A little splurge on junk food and alcohol is fine every now and then.
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Avatar universal
Safi did you done an other fibroscan?
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Avatar universal
I was telling my self that I will be cured probably in 2-3 years, but I am cured in 1 year :) (my HBSAG quantity was over 52000 at that time)

Eating healthy (immune booster and anti-infamatory) and believing that you will be cured is very very important.
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Avatar universal
What was and is you fibroscan results
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Happy for you and best wishes for all HBVers.
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Avatar universal
Totally agree with you.
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10915849 tn?1415112928
Congratss
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Avatar universal
happy for you
you and safi used deferent treatement and deferent diet(safi get married,you want to be cure and think positive when you use peginterf both of you get ride of virus ,i think the will for cure is the best booster of immune system
Helpful - 0
Avatar universal
Thank you all.

We actually do not know if diet alone (ridiculously changing diet and lifestyle) can reduce HBsAG to non-detected and create antibodies. The 2% annually cured from HBV could be the one with these healthy mindset and healthy habits that reversed the disease. This is only a speculation.

However, if you are on meds for HBV, it is more imperative that you live healthy and help boost your immune more as the meds (whether IFN or anti-virals) are kick starting your body and need more boost (exercise and healthy eating, along with supplements), let alone you suppressing it further by smoking, drink alcohol and eating unhealthy junk food.

I must admit andrey19 that I was more than suprised to see HBsAB of 943. It starts with 55 (week 36 IFN), then 255 (week 45), then 353 (week 48) and 953 (week 64).

Also please note I was on a reduced dosed of IFN - 2 weeks on 180mcg, 26 weeks on 135mcg and 20 weeks on 90mcg.

Good luck to all.


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Avatar universal
Another member cured! Fantastic, I hope one by one we will get out from here
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Avatar universal
your anti-hbsag level is amazing! Congratulations.
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