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Stopping Viread after HBV Seroconverged
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Stopping Viread after HBV Seroconverged

I am 34/asian/female chronic HBV... Acquired via vertical transmission.  2 1/2 years ago my virus became active and viral load suddenly increased in the hundred millions.  I was sent to a specialist and immediately started treatment (Viread).  I have tolerated this drug extremely well, and now I am undetected.  Liver biopsy during surgery also revealed healthy liver with zero signs of HBV.  Earlier this week, my doctor says I seroconverged and can stop treatment.  I still have to be monitored every 6 months for the rest of my life to make sure the virus stays suppressed.  Has anyone stopped treatment in a similar situation?  If so, what are the results so far?  I am nervous that my virus will come back with a vengeance and that I will be worse than ever.  Any advice/info would be so appreciative!
6 Comments Post a Comment
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Avatar_m_tn
seroconverted what hbsag or hbeag?
most probably it would be hbeag seroconversion. there is no good rule for stopping but to continue for atleast six month after any seroconversion (hbeag/hbsag) with alt normalisation. standard golden rule is stop only after six month from hbsag seroconversion.
even if it is hbeag seroconversion better u go for hbsag quantative with dilution in iu/ml, if it is low(<1000 iu/ml) then you can stop viread without having a dna load flare after stopping.
one more thing check anti body level of whtever u seroconverted. for sustained seroconversion it must be high.

if seroconversion is hbeag (not hbsag) then u can consider steff's view, he may suggest u to add interferron to clear hbsag at this stage as you already have completed more than 2 years on viread and responded well. please ask him for his views, it will be helpful to u.

so do following tests:
hbsag quantative
anti body quantative whatever u seroconverted (anti hbeag/ anti hbsag)
dna load
alt
vit d level for sure, as we members are studying its effect here.
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Avatar_m_tn
it makes no sense to stop antivirals and being hbeag negative makes to difference to hbv infection....you have to follow hbsag quantity and add pegintf to clear hbv definitively when it reaches low levels like 1000-1500iu/ml

sorry but only ignorants can say zero hbv, the virus is inside liver cells integrated in human dna, the only test to show clearance of hbv is hbsag undetactable and hbsab antibody very high around 200-250miu/ml all the other tests are useless to define the infection, tests like hbvdna pcr or hbeag can only define if antiviral is working or not and absolutely not the infection

so to check the number of infected cells and infection in the liver you have to do hbsag quantitative in iu/ml which reflects cccdna inside liver cells and integrated hbvdna in human dna or cccdna quantification by biopsy but few research center check cccdna and hbsag in serum is a good and cheap surrogate
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Avatar_m_tn
so keep the antiviral and add pegintf if you don want to waste the response to the antiviral and keep the hvb infection, i also think you better look for more updated and expert liver specialists it looks you are treated to stay infected by current doctors and not cured of the infection
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Avatar_m_tn
Hi, have you seroconverted the surface antigen or the e-antigen? Big difference.

I stopped treatment with Entecavir after sero-converted the e-antigen. And yes, the viral DNA has come back 6 months later. Now I am on IFN.

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Avatar_m_tn
Hi! How's your viral load now? I am on ETV too for more than 6 mos and have seen dramatic changes since then. I'll just go on with antiviral even undetected?
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Avatar_m_tn
My viral load has increased to 30000ml hence, I was put back on treatment with IFN.

Before ETV, my viral load was 840mil. I was on ETV for nearly 2 years and then monitoring for 18 months thereafter.

No measurement on HBsAg at all during these time to my knowledge.

You should continue with ETV and measure your Surface Antigen until an add-on with IFN suits your needs. Like Stef said, if your goal is to get rid of the virus (which is like 100% of us), then surface antigen knockout is your goal. Viral DNA is not a factor but undetected level is good to maintain.

Good luck.



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