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)
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
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
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
Thanks Stef for your view....very helpful
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%
Thanks for the good wishes....
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.
Very good result re: HBsAg. Hope it continues in this trend. Good luck to your son.