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Treatment using TDF - six months results
Dear all,

Want to share treatment results. My son has been on TDF since 6 months ago with the following results:

Baseline (before taking Tdf):
SGOT 47 (range for normal: 5 - 34)
SGPT 102 (range for normal: 4-36)
HBV DNA 2.43 X 10^8
HBSag Quantitative: 43,205.18 IU/ML

Result after 3 months:
SGOT 89
SGPT 244
HBV DNA 3.19 X 10^5
HBSag Quantitative: 11,570.50 IU/ML
HBeAG  reactive
Anti HBe  non reactive

Result after 4 months
SGOT 60
SGPT 127
HBsAG Quantitative: 6,029.41 IU/ML

Result after 6 months
SGOT 52
SGPT 90
HBsAG Quantitative: 3,482 IU/ML
HBV DNA 5.7 X 10^3
HBeAG reactive

I notice that in the beginning of the treatment HBsAG drop very fast from about 43,000 to around 11,000 in 3 months but in the following 3 months  it reduces slowly from 11,000 to 3,482. I do hope it will continue declining.

What a bit worry me is that his monocyte count, eosinophil and basophil are a bit elevated.  Other blood counts are within normal range, including leucocyte and creatinine.

Will appreciate your views on the slowing decline on HBsAG (whether it will continue to decline) and on the elevated monocyte, eosinophil and basophil.

Thanks in advance for your views.

Afif
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9 Answers
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Avatar universal
Very good result re: HBsAg. Hope it continues in this trend. Good luck to your son.



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very encouraging hbsag trend. Most will not experience such decline even with interferon. As for slowing decrease trend - as hbsag gets to lower numbers the decline rates lowers as well. You can clear thousands of hbsag iu/ml in a month or even a week but when it gets very low it can take months to clear some remaining units. Good Luck !!! I hope your son clears hbs with TNF.
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Thanks for the good wishes....
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it is normal that you have slower decline as it gets to low numbers because hbsag is presnt in many parts:

hbv virions which is reflected by hbvdna
cccdna parts in hbv liver infected cells
integrated hbv in our own dna

the first decline is mainly due to hbvdna decline, the second slow decline is from the killing of infected cells by immune system or purging of cccdna from infected cells, this is a very slow process

the good thing is that immune cells like monocities are incresing and this means your son immune system is activating.the chances are hbsag undetectable by about 3 years of tdf are about 16%
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Thanks Stef for your view....very helpful
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little mistake but overall meaning about the same, hbsag is not present but produced by:

cccdna parts in hbv liver infected cells
integrated hbv in our own dna

so getting rid of these...hbsag source is cut.

if hbsag is not cleared by 3 years peginterferon add on will finished the job in 48-172weeks of combo therapy
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little mistake but overall meaning about the same, hbsag is not present but produced by:

cccdna parts in hbv liver infected cells
integrated hbv in our own dna

so getting rid of these...hbsag source is cut.

if hbsag is not cleared by 3 years peginterferon add on will finished the job in 48-172weeks of combo therapy
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I do hope that HBsAG will be cleared by TDF only but already discuss with his doctor on possible peg add on if TDF only can not clear it....thanks again Stef
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i was checking response to tdf and hbsag decline, the decline experienced by your son is quite a lot by 6 months only so it is not reflected by the hbvdna decline but by some immune activation thanks to hbvdna decline.

hopfully it will continue, keep checking hbsag and if available ip10 too (ip-10 over 350pg/ml reflects activation of endogenous interferon).
according to hbsag response and hbeag seroconversion and ip-10 levels peginterferon add on might be considered before 3 years to fasten the hbsag decline/loss
IP-10 test is available at synlabs in europe

also check vit d levels and if low supplement (at least 40-50ng/ml of vitd25oh in serum)
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