Today i’m starting tenofovir

[melcul]

I had my appointment today.
Short introduction:
27, european male
Hbvdna : hundreds of millions
Alt 90
E antigen positive
Fibroscan around 4,6 kp


I am afraid of taking viread from such a young age, and i asked my doctor if it’s possible to swith to peginterferon alpha after 1 or 2 months, being concerned of my kidneys being affected on long term, which he agreed, if my hbvdna will go down as he hopes.

Anybody taking tenofovir, has any advices on this matter ?

[melcul]

Yes, my fibroscan reading is good enough at this moment, although one year ago ws 7.6kp (F2), seems to have improved for some reason, even if my status was the same. Glad to hear that you are doing ok.
Thank you for your input .

[melcul]

Thank you for your answers. It is so hard to make a decision, knowing that you will have to take pills for years to come. I was hoping that i will be able to try peginterferon and maybe be in the 35% which become HbeAg negative, but i will just go with my doctor's choice i guess. He was willing enough to take a second look at my case and made another appointment, so at least he had an interest in my case more than some doctors would do.
I will keep you updated with my final treatment.

[Constantin90]

Monitoring during therapy will tell you if the treatment decisions is good. No need to worry too much at this moment.

Monitoring the liver (fibroscan, viral load, HbsAg quantitative is very important) and the kidneys to see if they suffer during therapy.

Considering that the fibroscan value is very good, your liver is not affected, therefore is highly unlikely to get any side effects from the antiviral.

Please keep in my, I'm telling you from my experience to check your vitamin b12 level to see if is normal. I was having very bad side effects during the antiviral treatment (some sort of nerve damage) and I was thinking that the culprit was the medicine. Doing some test it has revealed that I was b12 defieicient. I took b12 shots and the side effects totally disappeared and continued the antiviral without any side effects.

The doctor couldn't tell me if low B12 was caused by the antiviral or not. What is important that suplimenting has eliminated the side effect and all is ok.

[varsa]

I am on treatment with entecavir from five years feeling no side effects just use of one medicine in morning and monitoring every year once.

[melcul]

i know that you have to take it for many years once you've started taking nucs. Anyway, doctor just called me before taking the first pill and asked me to come back again after reviewing some studies which found that this strategy is not that successful, to re'think the treatment. Probably either nucs or directly Peginterferon.
Did any of you guys took peginterferon at such a high viral load? i know it's only 35% chance of going hbe negative, but it may be worth it to have some time until starting nucs.
The only question taking peginterferon when having hbvdna in millions is, Can ALT flare get so high that will put my liver in serious condition and irreversible ? Are there any studies on this matter ?
I appreciate any response.

[Constantin90]

I have taken Viread plus interferon for 1 year. And after 1 year of combination just Viread alone. I was put on combination with interferon after 6 weeks of Viread and then added the interferon, because if the viral load is very big, interferon will not work without a prior kick from Viread. Regarding kidneys the creatinine levels were better for me under Viread then under Entecavir.

As a safety rules all antivarls and interferon as well have the ability to deplete your B12 Vitamin levels. Therefore you should check your level before treatment to know if you a good level and to know the baseline level before treatment.

[Bm2016]

I started viread around 30 when my hbv dna spike exponentially, there is a newer replacement pill, TAF or vemlidy, suppose to be kidney friendly.  anti-viral suppression pill viread/vemlidy,  once started, suppose to be taken lifelong until hbsag seroconverted, otherwise, hbv virus will cause strong flare