in this case i'd try nitazoxanide right away, hbvdna gets und in a cople of weeks and then see if hbsag lowers until negative by 1-2 years
if you don't feel safe with off label nitazoxanide you might wait for our results in 6months/1year and just monitor your hbvdna and hbsag quantity, if they get higher than 3 logs i d consider treatment
other choice check for hbv e-minus mutations and monitor liver damage and alt/ast and when one of these abnormal start interferon.
i'd leave viread as the last choice because it doesn't eradicate the virus but only stop liver damage and virus replication
first thing you have to consider all drugs at the moment, except nitazoxanide, do not change hbsag.
they can only stop liver damage not the virus, and you have probably no liver damage if alt/ast lower than 30 or so, so approved therapies are not very usefull in your case, again i think you might try off label nitazoxanide
ask your doc why he wants to start viread since normal alt and low hbvdna and very little benefit from viread
The liver tissue parenchyma preservation of the lobular architecture. In the Masson trichrome-stained section, there is no increase in intrahepatic fibrous tissue. Most portal tracts are small and free of inflammation, alothough one portal tract contains a heavy infiltrate of lymphocytes. There is no interface hepatitis.Interlobular bile ducts are unremakable. The hepatocytes are free of streatosis, ballooning, or ground glass change. No iron pigment accumulation is noted with the Prussian blue stain.
Stef, you are probably the one to ask...have you read any literature on whether taking Viread every other day, or taking half dose (150mg) per day is as effective as taking the entire dose every day? This may reduce the toxic effects and risk for kidney damage.
The 150mg dose will work well in most patients. But if partial resistance mutations are present like in LAM res patients, the full dosage is well advised. A paper by a Spanish group has published 100mg tenofovir with excellent reductions in viral load. But Dr. van Boemmel, the German doctor who originally pursued Viread for HBV - against the resistance of Gilead, shamely- warned in an editorial against this dose reduction, with the argument that the excellent resistance profile of tenofovir might be compromised by this practice.
It can be speculated that once UND is achieved and resistance forming power is consequently reduced, the half dose might well be sufficient to hold this status with reduced toxicity as a benefit. But which doctor will risk to recommend this to you, since it is a deviation from the common practice and violates the FDA approved dosage?
I don't know if I a high risk (hcc risk?geno C, precore bcp?). I'm going back to a Dr. in Sep-10-2012, have alots of question to ask him about viread trentemt since my liver have no damge. Beside in US viread cost about $25 per pill, if I taking this for life that alot of money I don't have. I have more blood work data for you to look at. see what you think and thank you againg for you help.
HEPATITIS BE AG Positive 5/14/2012
HEPATITIS D AB Negative
HEPATITIS BE AB Negative
HEPATITIS A AB Reactive
FERRITIN 546 22 - 322 ng/mL 5/14/2012
HEPATITIS B DNA ULTRAQUANT 528267 12/7/2011
AST 35 11/22/2011
HEPATITIS C RNA PCR, QUAL Not Detected
HEPATITIS B SURFACE AG Reactive 10/21/2011
HEPATITIS B CORE IGM Non-Reactive
HEPATITIS C AB INDEX LT 0.02 0.0 - 0.79
HEPATITIS C AB INTERP Non-Reactive
I need your advice please! I am a member for few days now, recently visited doctor and my test came back with these result:
AST: 54, ALT: 66
Viral HEP B DNA QT: 67700 20IU/mL and 394000 116 copies/mL
HEP B Antigen: Non-Reactive
HEP B Antibody: Reactive
HEP B Surface Ag: Reactive
HEP B Surface Antibody QUAL: Non-Reactive
my ultrasound is normal, does that mean my liver is not damaged? how do I find out? my doctor told me to start Viread and this is my 3rd day on this pill, but I am still wondering if I need to take it? Should I ask doctor for othe tests? and should I stop the pill?
You should continue on the pill because you are over the recommended guideline for HBeAg - patients. The current guideline is HBV DNA over 2,000 IU and elevated ALT/AST (2x). You are over the minimum for DNA, and you're ALT/AST is slightly elevated.
I've read about combo peg-interferon+tenofovir, when am I supposed to use both of this combination? or Viread would just do it for now? do you know where can I go for a fibro scan in US? how about fibromax testing? is it effective? Also, should I ask doctor to test for GENOTYPE? what does it mean?
Fibroscan is not done in the US. Fibromax is just taking a blood sample and then putting the lab numbers (like ALT and Triglycerides) into a formula to predict estimated fibrosis. It is not the real thing.
Genotype really only helps with determining course of tx. If you are Asian and got it through vertical transmission you are probably Geno C or D.
you should know yoour liver damage by fibroscan, viread itself is useless on a healthy liver with no HCC increased risk by c genotype or precore/bcp
the only thing that makes sense is using viread to add on intf after 3 years or more and clear hbv definitively, not taking viread pills for life.these antvirals damage mitocondria over many years so the plan must be clear hbv sooner or later
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