Hello every one!
I'm from Albania! This is my history: In sepember 2010 I have the result: Alt 420 IU, Ast300 IU, Hbeag Negative, hbv-dna 2.6x10^5 IU/ml. Immediatily I was put on interferon (roferon A 3 times weekly) for one year till october 2011. After 6 month off treatment (march 2012) my Alt 42 IU, Ast 35 IU, hbv-dna 1.4x10^4 IU/ml, Hbsag 1080 IU/ml. On March 2012 Hbsag 960 IU/ml, Alt 40 IU Ast 30 IU. Today after 2 years and half after the end of treatment (march 2014) Alt 41 IU, Ast 30 IU Hbasg 747 IU/ml, Hbv-dna 4.0x10^4 IU/ml, Fibroscan (7.5 kpa) F2 (for the first time) . During this time I,m taking 5000 IU vit. D every day. Doctor told me to treat with tenofovir, because your fibroscan is F2. I ask him to treat me with interferon, because I thougth that my hbsag is declining and is <1500 IU/ml., and doctor said ok , but we have to wait 1 month for interferon, because it will be delivered to hospital.\
My question is : Is my decision good to go for second time for interferon or to treat this time with tenofovir? The first time of interferon was terrible, but I want to be cured, not to be on tenofovir for all life.
Any suggestion Steff Ti prego!
Hello mustthinkposite! Thanku You for your response.
When you said terrible while on IFN the first time, what do you mean? Inconvenience, tiredness?
Every part of my body hurt, my hair fall and did not grow back . I was very nervous with every body. I lost 15 kg and I gain only 5 kg after interferon. My live changed, I thing now I am an other person. I am very depressed, not happy guy anymore. About tiredness I was not, even never got flu for 2 years. Only my legs even now hurt, they burn. I was changed like a victim, people did not even regnozise me. I work in the office, but was very hard to do something, I was not concentrated. About interferon I am happy only about one thing: my hbsag is declining. I never did this test before treatment, only after and was 1080 IU/ml, and now after 2 years and half is 747 IU/ml.
Do think I have a chance to go again for Pegasus, or better to go for tenofovir? I,m afraid that maybe again my sacrifice will not be worth.
Hello there .i hope u doing well..please can u tell me were did u do the hbsag test..did u do it in Albania or u when out of country..I m from that part so I wanted to go for that test..thanks and I hope u cure ...
Hello Seka! The hbsag test (called Hbsag Quantity, cost around 33 euro) I did in Albania, in Tirana. The name of laboratory is Intermedica, is well known in Tirana. They used ellyses, not Architect Abort, but I think is the same thing.
Elis don't think that you have to take your antiviral for all your life. The cure is on way,for few years will be out. Cure for hep c is already out, now the interest will focus on hep b, and already there are discoveries. For now the best cure 60% is tenofovir for 2-3 years and later on peginteferon. You need to low your viral load, while your hbsag is a good number to get a chance to clear it.By the way,here in USA we don't have the possibility to know about the quantity of Hbsag, I am planning to come this summer in Balkan. Where in tirana is located Intermedica?
you have now the highest chances to clear hbsag and make hbsab, even if you will not clear by 48weeks hbsag will be so low to continue the clearance by your immune system
tenofovir cannot help in this, so i would not use it
be sure to have good levels of vitd like 60-80ng/ml before starting peg, i believe it can help a little in lowering inflammation, it also boost peg repsonse because it activates genes involved with intf pathways (a research a read recently).sides should be much less, many report less sides on peg with low hbsag, usual sides at start but less when hbsag start the decline towards very low levels like 100iu/ml
you have immune activity since you have low hbsag and declining, but also some hbvdna which suppresses your own intf pathways but at the same time these virions boost your immune activity.if you go for tdf now you may lose some of this immune activity and need to stay on tdf for a few years to be sure peg add on will work
it can also happen that hbsag increase at first with the decline of immune activity, i think it is best to retry peg
Thank You Steff2011. My doctor is well know here in Albania. During the the first treatment my doctor follow only HBV-DNA, which was negative during the treatment. One month after the end of treatment my HBV-DNA was 240 IU/ml. My doctor order me to test HBV-DNA, and HBSAG after 6 month off the treatment. 6 months later my HBV-DNA was 1.4x10^4 IU/ml and Hbsag 1080IU/ml. My doctor was happy about Hbsag and order me to test only Hbsag (not HBV-DNA, it is not necessary he told me) 1.5 years after the end of treatment. 1.5 years after the end of treatment my Hbsag was 960 IU/ml. My doctor was happy and told me that Hbasg is decling. I ask him about HBV-DNA, he told me that Hbsag is decling so and HBV-DNA is declining and order me to test Hbsag. HBV-DNA and fibroscan (he don't want biopsy) after 2.5 years after the end of treatment. 2.5 years after the end of treatment my result are:
Alt 41 IU, Ast 30 IU Hbasg 747 IU/ml, Hbv-dna 4.0x10^4 IU/ml, Fibroscan (7.5 kpa) F2.
I was reading all the time your post Steff so I made a decision to go again for interferon.(in Albania we can not use tenofovir +interferon, beacuase is poor country, so I choose interferon)
Thank You Steff, god bless You.
I am Elis! Thank You Steff! Thanks to you I proposed my doctor retreatment with interferon. I know that Italian doctors are the best. I have been in Roma and the doctor told me that even you will not clear your hbv at least you will wash up your body with interferon. Gracie mile!
Hello Steff ! My cholesterol is high around 215 IU/ ml. Do you think I have to use Sim like otan did? I have a lot of pain in my right side near the liver, because of gas in colon(doctor told me after fibroscan that saw gas). To ringrazzio!
I have reada lot of your postes here helping successful clearing hbv. I wish and believe that you also will clear hbv, thanks to you rs doctors and Italian mediacal system that are so human with patients. My doctor has been specialize in milano for professor degree. I will post my whole treatment
I know Italian system is more human than even switrzeland. I have been in Italy a lot of time, even in viterbo there were a lot of pleasant doctors. I am happy that I live so close to italy. We in Albania can get a lot from Italian experience
PEG is once weekly, roferon is 3 times a week. A big difference in lifestyle.
The only bad thing about IFN treatment is the inconvenience of keeping the med in fridge and constant monitoring on blood count such as WBC and Neutrophils. I am sure you been through Roferon and know what's it's like.
Hopefully you don't get too depress because PEG IFN is not for people with already depressive mood as it can cause more problems. Good luck.
I never got vitd25oh test. It cost 400 euro here. I got used with interferon. Even I didn't clear I felt that my body got restart and I havemore energy now. I am not a doctor but ifeel that interferon is better than other antiviral.
Ask once and told me 400 euro. I will ship Steff. About vit d and fish oil my doctor said that in mediteranio area is not neccesary because we have a lot of sun and good food. What do you think. I bought vit d3 and fish oil from USA on internet. Do I have to continue taking them?
doctor is a little ignorant, vit d is suppressed by chronic viruses, especially hbv, hcv and cancer but also all auto immune diseases, even if you stay under the sun all day and vit d doses need to be very high, there is inverse correlation of vit d and hbvdna
Hello erjona...when I found out I have chv my vit d level were low in 20..thanks to steeff coments I start taking 10000 daily and after one year in half my vit d level is 90..I still take 5000 daily...hope u doing well..
Hello erjona...when I found out I have chv my vit d level were low in 20..thanks to steeff coments I start taking 10000 daily and after one year in half my vit d level is 90..I still take 5000 daily...hope u doing well..
Hello mustthinkpositive! It 's true than depress is almost sure while we are on interferon, but the hope that we will regain the life back is much stronger that depress. I hope You will beat the devil. I would like to thank my wife that supported me during the tough time.
there is no correlation with hbsag and hbvdna except when hbsag gets very low and of course with very low hbsag hbvdna gets almost und or very very low
hbsag will drive pegintf results, but if hbvdna is on the rise on high numbers that might reflect on hbsag too.if hbvdna is on the rise start peg as soon as possible and start vit d too with 5000iu daily you ll never overdose
Hello Steff! My platelet for the last 3 month are 313 000 /mm3, before they were always 260 000 /mm3. Is something wrong with platelet that are rising? I am not on treatment, after one month I think I will be on interferon.
Hello Steff! I would like to ask You a question, because I don't understand.
Does it mean that I have to get F0 fibrosis during treatment to clear HBV, or (if I can clear) can I clear HBV without getting F0 fibrosis during treatment?
I mean my liver must be ok to clear HBV??
Thank You Steff!!!
I would like to ask You Steff that during fibroscan the doctor said that I have angioma in my liver. He said that nothing to worry about, because that are something like benign cancer. Is that true?
I have HBV and I'm going to retreat again with interferon.
Hello All! Ciao Stef!
I just started last Friday my second treatment on Pegasus.
Before my first injection:
Trigliceride 180 (high <150)
In april I had Hbasg 747 IU/ml, Hbv-dna 4.0x10^4 IU/ml, Fibroscan (7.5 kpa) F2. Genotyp probably D (not checked but I am from mediterranean area)
I did not have high temperature, I have only back pain all the time, but compare to my first treatment I don't have heavy symptom. Maybe is only first injection :)
I am taking 10.000 iu D3 and Vit.B Complex every day since 6 month
I hope this time maybe god will be with me.
Good elis keep all of us posted as I'm also starting peginterfron by the end of the month and my results similar to yours. I think many members will benefit from our experience especially when we update on peginterfron and good luck to you and don't forget to update
To check the level of vitd25oh and parathormone is very expensive here in Albania. I am taking the vit D3 10.000 iu without knowing the level of vitd25oh, because I thinking is not dangerous ( or am I wrong?).
Of course I am going to update all my experience. I think after 3 months I am going to check the Hbsag and hbvdna level.(what I remember from my first treatment)
Do you think Stef is better to take also simvastatin 20mg?
Be sure to have good levels of vitd like 60-80ng/ml before starting peg, i believe it can help a little in lowering inflammation, it also boost peg repsonse because it activates genes involved with intf pathways (a research a read recently).sides should be much less, many report less sides on peg with low hbsag, usual sides at start but less when hbsag start the decline towards very low levels like 100iu/ml
THIS IS WHAT YOU WROTE TO ME IN APRIL 11, 2014.
I think you are right, because I feel is not like the first treatment.
I am thinking now (maybe I am wrong) that is not the interferon, but the HBV makes so much damage to our defence system
Thank You very much Steff
you are right hbv tries to push our immune response on too much inflammation and th17 and this helps virus persist while vit d suppresses both too much inflammation and th17
this means less sides and less inflammation than with low vit d and it looks like you are confirming that
if you can get sim then try 20mg first, if no sides go to 40mg and then 80mg.it makes more low fever and back/leg pains but if you can stand that it is ok to keep 40 or 80mg.
keep an eye on creatinine and cpk, these may become abnormal due to sim or peg but its rare
Hello Stef! I got sim 20 mg yesterday. I have to get every evening after dinner. Also I am taking 10.000 IU D3. fish oil, Vit B complex.
What I am worry about is that I have not side effect from Pegasus like I had from Intron A (first treatment). I am afraid that maybe my immune system is not working, or is to early, i just had 2 injections.
In my first treatment I was terrify from side effect, but now I am worry that I have not. I do not what to expect, but I am going to fight even without successful, because interferon is good for a lot of diseases.
Thank You Stef!
I am not going to take any more fish oil (I just restarted yesterday after 4 months break). First treatment was Roferon-A 3 times weekly (my mistake no intron).
I am hoping that low hbsag (747Iu/ml) is the reason that I am not having heavy sides effect
Hi Mike! First of all I would like to thank everybody here in this forum especially Stef. I am going to post every think during my treatment and if I clear it's thanks to You guys.
I am hoping to regain my life back.
Thanks elis. I'm in same boat my professor is well known in hepatitis b and she didn't want to start me on treatment but I think she will change her mind as I got my ALT test back and it is 55 and ast is 35 now waiting on hbeag viral load to conclude
I don't know what to say. My Alt also fluctuate between 41-55 (and doctor also let me without medicine for 3 years from my first treatment) and I know (so I feel) that some damages are in the liver and is better to try to take some medicine. Maybe I will relapse again (because I am Hbeag negative) but I have to try with nowadays medicine.Let's pray to cure our disease.
Yeah what is so depress to me is when I did my hbsag quantity came back 223 iu/ml but my doctor wasn't so excited about that as she still thing my chances are low to clear on peginterfron because I'm hbeag neg
There is a very good answer for doctors like that "think" is not enough!what if your think takes away from cured...do you have a 100% security it won t work even not trying?
since we have hbsag quant we can go 12 to 24weeks and stop if it doesn t work...things of the past like i dont think have no space now, 12 to 24weeks of peg must be given to all patients because it is not possible to know what patients will be not cured and uk guidelines and european guidelines indicates exactly this..peg the first to have the small percentages of cured patients and the other to nucs
I agree Stef and I'm pushing her to give me interferon especially now my alt is elevated for the first time to 55 and ast to 35. She is waiting on the viral load to decide. I was thinking if my 10000 iu of daily vitamin d3 had anything to do with my alt going up?
I Stef! I would like to ask you that I have spider vein around the liver in my skin. I showed this to my doctor 6 month ago and he said nothing to worry about. Now I have even more spider vein. My fibroscan is only 7.5 kpa . Is that a sign that my liver is not ok? I am worry about this spider vein
Hello Steff! I just did US: my liver is a little bit large (right lobe 128mm) and I have the same gas in colon (the same result was seen in fibroscan 6 months ago, all the time the pain is there).
I am in second month of interferon, and taking 20.000 iu d3 and 40 mg simvastatin.
I feel more tired and fill something like gas in my shoulder (back)
I lost 300gr of my weight
Compare to first treatment is not heavy.
very good reports, i hope hbsag will get a big declien by 24 weeks.check pth so you ll be sure the vit d does is getting to the cellular receptors and not blocked by vdr resistance (made who knows by genetic or hbv itself)
Hi Steff! I just finished my 3 month of treatment with interferon. Alt 28 iu, Ast 29 iu, GGT 57 iu, bilurubin 0.7 iu, cholesterol 155 iu. I am taking 20000 iu vit.d3 and 20 mg sivastatin daily. Why my GGT is still high? I have to take for my gas in colon ( I have a lot of pain because of this) 1 time in the morning esomeprazol and 3 times kreon before foods daily for one month. Is that dangerous for my liver? Thank You
Hello Steff! thank You very much! don't have the 12 weeks hbsag result. These test it will be in 24 weeks and also hbvdna. I don't have also parathormone test in Albania.
What do you think Steff do I have to continuing taking 20000 iu vit.d3 and sim 20 mg daily? I am drinking 2.5 l water daily, but I smoke. I know is not good, but is difficult for me to quit:)
And what about the medication for the gas, do I have to take these? Maybe will be no problem for the liver.
Thank a lot.\
An other think Platet 135, Wbc, 4
if you avoid all dairies, all milk in food and all cheese in food and keep drinking, you can go for vit d3 50.000iu daily but you must check urine calcium every 4 weeks and serum calcium every 4 weeks.in italy these are 1-2euro cost tests so i guess also in albania
i dont know if sim really works, if you feel that gas is due to sim you can stop it
Hello Stef! I did blood test for:
Sodium 132 mmol/L(Low) range136-146
Potassium 3.9 mmol/L range3.4-4.5
Chloride 98 mmol/L range 98-106
Always my Sodium is low.
Is that something that I have to worry about?
I just keep taking 20000 iu vit.d3 and 20 mg sim. Also I started the medication for the gas.
High Steff! I have a lot of abdominal pain in liver or in colon area(maybe because of gas in my colon). My skin is turned a little bit yellow. I go to toilet 3 times per day, but my pain is still there. I am worry about this pain, Maybe is side effect of interferon? I would like to be the side effect of interferon not a cancer.
Thak You all
I just finished my 4 months of Pegasus.
After 1 month of treatment:
After 2 months of treatment:
After 3 months of treatment:
After 4 months of treatment:
I am taking 20000 iu vit.d3 and 20 mg simvastatin daily.
I am also taking for my gas in colon esomeprazole 1 time in the morning and Creon 2 times before foods daily for 2 months.
Hsag and hbv -dna tests will be after 6 months of treatment.
Thank You !
It looks your AST and ALT are not elevated much but don't get discouraged we still waiting on your 6 month mark with hbsag quantity. Best of luck as i'm watching your results as your situation is closer to mine.
elevated trygl, cholesterol and so on, all useless to check we only have to check hbsg quant and dont mess on what we dont know if needed to immune system or not.
fats are extremely important to immune system so better not touch that and increase healthy fats during treatment
if hbsag decline is more/equal 10% you are a responder, keep in mind that pegintf activates immune system so it will keep working even after peg is finished on responders and hbsag loss goes from 7% at 48weeks to 30% at 5 or 10 years, dont remember exaclt which one
Thanks Elis i was waiting for your result to ask for treatment for ny meeting with my professor on march 18. Im also genotype D and it looks the harder to respond to treatment :( looks like i have to wait until we get a better drugs on market.
at this point keep pegintf without sim, so we are sure about no interference from it, and lets see how hbsag and hbvdna are at 24 and 36 weeks
in the end you have nothing to lose if sides are tolerable, an hbsag decline of 10% indicate response, response is possible even later than 24 weeks (a member who cleared had 24 weeks no response and hbsag baseline 5000) he kept pegintf for 60weeks or more and cleared hbsag
tenofovir can be always used after you finish peg
did you have a chance to check vitd25oh and intact pth?
it would be best to see intact parathormone levels, i lost response with lower vitd25oh and higher pth than 20-30pg/ml.it would be best to test intact pth at least so we can suggest higher vit d3 if needed
You are definitely a responder, pegintf is not able to make hbvdna undetectable or very low like nucs, so being less than 6iu ml makes you a responder
hbsag is also going down although very slow, so probably more than 48weeks treatment for hbsag loss but keep in mind max potency from peg is after 48weeks and that most of the decline happens from 48 to 96weeks
Yeah i know what you mean and hope you clear from all my heart as i'm in same situation but waiting witout therapy. Tomorrow im scheduled for anothe reading of fibroscan so it will be interested to see how i progressed from my last reading six months ago i was 7.6 kpa
Thank You Steff! After my first treatment with interferon I saw 200iu/ml decline of hbsg per year (three years off treatment). During the second treatment the decline is minimal. Maybe You are right I have to see hbsag decline after 48 weeks.
In bocca lupo amico
I think what stef is trying to say peg will not make hbv undetectable but in elis case was able to make it so low almost undetectable at 6ui which means she is responding but will leave it to stef to explain
I was just reading that the responder (hbeag negative) during interferon is if hbsag decline >0.5log at 24 weeks or 10 %. I am not clear about my case because my Hbsag baseline 747iu (2.87log), 24 weeks of interferon is 676iu(2.83log),
the difference is around 70 iu. It's mean 10 %, or 0.05log.
AM I A RESPONDER?
For the first time march.2012 my hsag was 1080iu (3.03log),
march 2015 hsag is 676iu (2.83log). Difference around 400iu or 0.2log during 3 years.
I see that hbsag is declining all the time, but very very slow.
it is not high and not of concern, it can be so much higher during chronic flares and not so important
it is correlated to immune response and liver damage but one thing is having slightly higher ggt like yours for a limited period of time, another thing is having that most of the life....if your liver was not cirrhotic you have nothing to worry from that
I had today (after 1 year) the second fibroscan. The result is 7.4 Kpa. The doktor said is a little improvement because is predominant f1. Last year was also 7.5 kpa , but predominant was f2. Any comment guys
Ohh that's sad bro. I can understand how it feels when a big step of peg fails. Any way hope is the thing which keeps man alive so better hope for off treatment response and do take tdf. Wait until herbernasvac comes for giving us a new push next year.
I showed my result of hbsag to my doctor. He said just repeat LFT blood only after 3 months. i told him my hbsag value did not change during treatment. He said just wait 3 months and we will decide. What do you think guys is better to insist to treat me with tenofovir immediatly? I feel like during treatment , the same side effect. My doctor said interferon rest in the body only 3 weeks, because i want to became a father. I thought i have to wait one year after treatment.