I am female, 28 y.o. I have known being the carrier for about 10 years (probably since birth).
I first started treatment since Jan 08, due to very high load of DNA (almost 600m copies) and high AST, ALT (200, 600 respectively). Echographie abdominale shows Liver were functioning well (all following tests showed same result).
As prescribed by doctor, I have been using Baraclude since. After 6 months treatment (Jul 08), ALT, AST were back in normal range. Virus count dropped to less than 30K copies . Anti-Hbe tested Pos. I was told that the treatment objectives were achieved but advised to continue with the medicine to bring back DNA to lower level.
6 months later (1 year after treatment), my DNA test was done again and showed the undetectable level of the virus (<500copies/ml). I expected then the treatment might be able to stop. However I was advised to continue to taking the medicine being afraid that the resistance to the medicine might develop if I stop using. I have since continued the treatment and all follow-up check-up shows very good result.
Most recently, test in Dec 2009 shows AST 16.2, AKT 11.2. HbeAg Neg. Non-detectable virus count (<500copies/ml).
It looks like it is advisable for me to use Baraclude for life, which is although not too much a problem on the finance aspect, but is extremely inconvinient for other aspects of life. This is because I would like to use contraceptive pills for birth control but it is advisable that anyone taking treatment for Hep B shouldn't use pills.
My questions are therefore, in my case, when can I stop Baraclude? My second question followed, if I have to continue w the medicine, what are the options I can use for birth control (beside usage of condom everytime, which is not a prefered choice)?
Thank you very much for helping with my case.
Only advanced cirrhosis will show its signs in some of the common lab values, like Albumin and Bilirubin, possibly together with an increased spleen size ( a sign of elevated portal pressure) and also a decreased platelet count.
A fibroscan or biopsy is needed to clarify for you where you stand on the fibrosis extent.
The SGPT is not an indicator of fibrosis or cirrhosis, although long time increased values or strongly fluctuating values ( repeating flares) point to ongoing liver inflammatory damage that can add up to fibrosis over time.
The upper quadrant pain is also not of any value in the diagnosis of fibrosis or cirrhosis.
Why the hell it increases again? Does anybody have the same personal experiance? After 5 th month the doctor thought I bacame resistent for entecavir. After 7th month it decreased again and now reincreased. Ast is normal, ALT is 76 with decreasing tendention compare to the previous blood test. So, I dont understand. After 7th month I was so happy, looking forward for being undetectable soon.. All the blood parametres are ok, even I got a good cholesterol. I am sad and stressed again for my last blood check. :-( I just got my blood test today by e-mail so I asked my doctor what should I do now...so, waiting his answer. Last month I have lost about 7 likos during two seeks, I found the blood in my stoll, so my doctor checked everything. They found entamobea e.coli parasite in my stoll, so I took any chemoteraphy and antibiotics during one week and the parasite disappeared, then the blood in my stool didnt. So, I have passed the colonoscopy, nothing found, only a small hemoroid what was the reason of bleeding. They sclerotised with any injection, no more bleeding. They have checked all the organs with ultrasound - kidneys, gall.bladder - 3 mm polyp found, pancreas - ok, liver - no changes compared with the ultrasound of 2 years ago - mild fat. So, what the hell is going on with my DNA HBV? Is it because of my age - 48 - that my body doesnt react so well with entecavit, can it be caused with that chemotherapy and antibiotics?
it is absolutely clear entecavir is resistant or not working, 1500iu/ml is too high to keep it because at more than 1000iu/ml you will develop resistace anyway, add on tenofovir and after 6 months discontinue etv or keep it like i did
the first thing i said to one of my doctors saying lets wait some more months for my case...i immediately said i dont wanna live thinking i can become resistance or keep checking hbvdna every 3 months...it is just not tollerable even psycologically
Acctualy, I dont know, may be I am wrong. What is the diference of blood test of plasma compare to serum? The test of 7th month mention is is serum, all the other test mention is tested with plasma. Is it comparable plasma and serum results? Isn´t it a little strange? Still waiting the answer of my doctor, But if I dont count with 7th. month result my DNA is decreasing. If the plasma and serum tests are comparable, it was desecreasing and now it is increasing.. so I dont understand at all.
I have not been tested before starting etv for resistance. But if I were resistant it would not work even from the early begining, no? On the begining I have asked my doctor about posibility to become resistant, he told me that it is very rare and then there is always some new moleculas to treat it...he said
Acctualy the doctor wanted to test me after 6th month result for the mutants, so I went to the laboratory to test my blood, then after couple of the days the laboratory answered that the viremy is so low that it is impossible to test it. Is it possible?
Acctualy there was something wrong with me in 5th and 6th months of baraclude. My blood test were completely in chaos, the major parameters were wrong - WBC, RBC, hemotocryt, hemoglobin, neutrophiles, lymhocytes, monocythes, cholesterol, ALT, AST, everything was wrong. After I killed that parasite everything is ok again. So, could it be the reason, that parasite threatment? Is it possible if I wait still one month that it will decrease again?
it depends on the lab, good labs can test for resistance even detecting less than 20iu/ml, of course they need to waste more expensive pcr to increase sensibility
in any case tests for resistance have so poor sensibility they get only 25% virions population while even few cccdna mutants can generate a new population
lam mutants are present naturally even not using lam in 13-20% tested subjects
the mutants can take one year to years to develop there is no time and it can develop even if you get und with the weak old antivirals
a slow decline of hbvdna can be connected with the presence of more mutants and weak immune system
but again all this waste of time and talking just to use an antiviral which is:
- not the most potent on hbv
-it is the most expensive among all the antivirals
- and also has resistance from as little as 1,5% if no mutants to more than 50% if lam mutants present...
it makes more sense to add tdf just because etv is not working
see if you find by search my posts about the italian studies on full hbv genome and mutant populations check directly in cccdna by biopsies, that test is of course 100% reliable and see all the mutants even those that will never develop
that article is interesting to just see how the hbv genome is and that it is best to use most potent ntivirals and make hbvdna un fast since most mutants are already stored in cccdna, although they may and may not develop to breakthrugh
i posted those studies in 2010 or 2011 when i was checking tests for my etv non response after 2 years
so, my doctor answered that I should wait still one month more to see the next blood results then we will see. He said that sometimes it can increase but it doesnt meas yet that I became resistant for Baraclude. So, what can I do. I will wait one month more. If I became resistant it doesnt matter if I switch to another medicament now or in one month, does it? He said that even the quanitity 1500 IU/ml is so small that there is no reason to be afraid of waiting one month more.
I am a compensated cirrhotic; cleared HCV virus, sustained (SVR) for several years now - but left with damaged highly fibrotic liver. Made worse by alcohol abuse (I no longer drink alcohol, however) -
Do you have experience with Heptech products? I've seen you make references to them - and I plan to start them very soon.
If so, then how long did you take them?..or are you still taking them?
What improvements have you seen?...symptomatically, any blood test improvements, liver numbers improved, etc??
drug makers can even be owned by mafia organizations which can gain more profits from approved drugs than narcotics only....i dont think there is any way to prevent this to happen and probably it is real since where money is mafia is
I'm very confused with your HBV DNA, how come it goes down on 5th month then goes up on 6th month, then goes down again on 7th month, then goes up again on 8th month? If you are resistance to Baraclude then maybe your HBV DNA should continuously go up from 5th month onwards? This is very interesting.
I have no idea at all. That´s why I am waiting now my next blood test. Acctually there was something happening in my body in 6th and 7th months of Baraclude it was last summer. My red blood cells went down, my white blood cells went down, then On the begining of 8th month I got some diggestive problems then my doctor found out that I have a testinal parazit Entamoeba histolica, so I got some antibiotics and chemoterapeutics for one week, then the parazit disappeared and the RBC and WBC are ok again. But it the same time with the parazit I got a huge pain of the spine, I thought it is just a pain, so I tried not to care about it, the the pain si begger and bigger, exactly today I have been to the doctor then he sends me to magnetic resonance and x-ray to check my spine. We have a antigen HLA B-27 geneticaly in the family. But it can be whatever.. So, I dont know if I am resistant for Baraclude or if it was only the result of my body fighting with spine inflamation or parazit or something else. I will tell you Monday what the magnetic resonance will show. Maybe this parazit activated that antigen HLA B-27, then my immune system was confused or overworked... I dont know. I think if I got this HLA B 27 sickess activated...ugh...it will comlicate the HBV treatment because it is autoimmune disease... :-( My father had it, his father had it too..
Just keep on monitoring maybe the virus and the antiviral are fighting. If the virus multiply fast in one month maybe that's the time you have to switch for another antiviral. I still trust entecavir but hepa b is a case to case basis. What is effective for some may not be effective to others. Maybe you should also consider taking some supplements for liver protection. Avoid eating or drinking unsafe food and water as we are high risk to get superimposed infection.
I think I eat very healthy. So, today I have passed magnetic resonance... it found the degenerated discs, I am 49, it is not disease, it is the age..ugh. It makes a horrible pain of spine but I manage it with my osteopath already. Then there is a second problem, higher blood presure and fingers tremor... I was always very low, like 128/60, then last month I am something like 140/80, 150/100 then 130/90... strange. So, the doctor gave me today a device on the hand to monitor the blood presure for 24 hours.. The test should show if it is a stress or if it will be necessary to search more. I still have to wait 11 days for my next DNA test then the doctor said we will see if it decreases or increases, then he will test the resistence and switch the medicament if it is necessary. I am quite down, I dont give it up but I start to be little apatic for my HBV. Then my employer sends me to work to India, ugh. I cant say no, I dont wanna loose my job. I dont know how I am going to manage all this.
It is Baraclude that is running up the blood pressure. I have developed the same thing.The doctors all deny it.. but on HIV forums they have been complaining about it for the long time.. and finally have started to list it.. for HBV crowd it has not catched up yet..
here are the examples... Entecavir (Baraclude) was designed for HIV as a magic bullet. And HIV really blew Entecavir away.. that is why they have dumped it on us HBV folks. My hair has stopped growing too and I have developed high blood pressure like you 140/90 is now normal for me. And I am 36 years old.
Also fatty liver (steatosis) is also linked to NUCS.. this is what the doctors don't tell us...
Temporary headaches, high blood pressure, or a general sense of feeling ill
Rare cases of hair loss
Tenofovir DF (Viread)
An antiviral drug for people with HIV infection. When taken with other antiviral drugs, it can reduce one's viral load to extremely low levels, and increase one's T-cell counts. Tenofovir may also help control Hepatitis B. It also works against several strains of HIV that are already resistant to AZT, ddC, or ddI.
Possible Side Effects:
High blood pressure
A general sense of feeling ill
Loss of appetite
Increase of enzymes in the kidney and liver that may indicate damage to these organs
Reduction of bone mineral density
For more information, please visit Viread.
Emtricitabine (Emtriva, FTC)
An antiviral drug for people with HIV infection. When taken with other antiviral drugs, it can reduce one's viral load to extremely low levels, and increase one's T-cell counts. Emtricitabine was approved for use by people 18 years old or older,but has not yet been approved for use in younger people. Emtricitabine has not been approved for people with HIV who are also infected with hepatitis B. Some people with HIV had their hepatitis B get worse after they stopped taking emtricitabine. People who have HIV that is resistant to the drug 3TC (Epivir) will almost certainly be resistant to emtricitabine as well. People with kidney problems should lower the dose.
Possible Side Effects:
High blood pressure
A general sense of feeling ill-headache
Levels of lactic acid in the blood increase in some people taking nucleoside analog drugs.
Liver problems including "fatty liver" may also occur.
In rare cases, people had some limited changes in skin color.
When you start any ART, you may have temporary side effects such as headaches, high blood pressure, or a general sense of feeling ill. These side effects usually get better or disappear over time.
The most common side effects of Truvada are the same as with tenofovir (Viread) and emtricitabine (Emtriva). They include headache, nausea, vomiting, rash and loss of appetite. In some people, tenofovir can increase creatinine and transaminases. These are enzymes related to the kidneys and liver. High levels can indicate damage to these organs.
Tenofovir can reduce bone mineral density (see fact sheet 557). Calcium or vitamin D supplements may be helpful. This is especially true for people with osteopenia or osteoporosis.
Levels of lactic acid in the blood (lactic acidosis, see Fact Sheet 556) increase in some people taking nucleoside analog drugs. Liver problems including “fatty liver” may also occur.
In rare cases, people taking emtricitabine had some limited changes in skin color.
Acctually, today I came from cardiologist, the 24 hours monitoring of my blood presure shown that I have a high blood preasure even while sleeping. But, as I got that device on my hand yesterday, I knew that the night will be relevant to the resuls, so I wasnot able to sleep.. you know, when you really wanna sleep you cant :-) So, the doctor said I am a psycho (somatic) :-) and he gave me some sedatives, then I have to came back again to repeat the monitoring... ugh. I am really becomming psycho thanks to the HBV, I will not die for hepatitis but for heart attack probably :-) However, when you take any long term pills, tehre is always any side effect. I take already about 7 years the pills against the cholesterol. The side effect is that it destroyes the muscles. I was very sporty and muscled then after 7 years I am not what I was... the muscles have not the same tension and volume even when I make sport and work out regularly. My mom got her pills in her 55 for hypertension, so I think I would get it even without etv. It is simply the age plus stress plus HBV plus smoking.. It really *****! Because of the HBV I had to spot drinking then now I should have stop even smoking...:-( What a fun of life we are going to have more? The positive thing - during the interferon threatment I lost completely the erection... then it is comming back, so still one fun remains!
Here is what I can recommend. You take the deer placenta live stem cells capsules. You check if it's available in your country. As mentioned by veteranb there is no magic bullet that can cure everything but my mom take this capsules for only one month and her hbsag is suddenly down to 1.18 gray zone level. I don't know if this is coincidence but she already took several antiviral for the past 10 years. Started from lamividune (4 years), hepsera (3 years), baraclude (5 years) many relapses. Her bone and heart is weaken due to side effects of antiviral. That's why my naturaphat doctor told me if hbv dna is undetectable and hbeag is non reactive then stop taking antiviral.
That is why I exercise not to loose muscles from antivirals. We really don't need them. In the old days all they were doing for CHB is 6months of interferon during flares, and then just diet and right nutrition. And maybe that was sufficient..
As far as nerve damage or psychotic behavior on Baraclude I went through that in about a month when I started to take the drug. I mean I found myself at night trying to put my foot over my head. And I remember thinking why is it I am doing what I am doing. Аlso I was not able to sleep at all, for like 2 weeks maybe it caused this... and I had terrible migraines.
My entecavir salesman :) denied it of course by saying etv has no sides.. I remedied it by drinking more water. And listening to my body. Exercise always helped, because after more oxygen was in the blood.
Also it could be dose dependent I started with 1mg of ETV daily because I had 500,000,000 hbv DNA.. and that does had more sides then the 0.5mg.
But NUCs are dangerous drugs from all that is know. And it is irresponsible of doctors to prescribe these for people with healthy livers. These drugs should be the last resort of treatment not the first.
But because most of the research is only done using these drugs, doctors that go to these Hepatitis Conferences (that are also sponsored by the same mega drug companies) tend to five NUCS to patients thinking they are doing actually a good thing.
Now that it has been almost a decade of antiviral use on us, there is a realization that this is not the way to go with prolonged chemo-therapy that develop super viruses. They hit the same wall as with HIV. But HBV is not HIV,, not that complex it is very important to know. And for us immune rescuing therapies have always worked. And the newer drugs that they are working on goes that route..
Have you tried this replicor is this a drug? Honestly based on the experience my mom had for several years I don't think a single drug can cure HBV. And to think all drugs have it's own side effects especially antivirals which affects kidneys and bones. That's why my approach now is simple. We have to combine supplements or interferon with drugs. The logic is.
1. Drugs cures a specific disease and this is a fact. If you have cough you drink cough medicine and these drugs are tested do it's function unless it is still on trial or study stage. So if you have high HBV DNA then drink antiviral to make it undetectable.
2. HBV is the cause of elevated sgpt and sgot and this happens when hbeag is reactive meaning the virus destroys our liver. When HBV DNA is down then sgpt and sgot will become normal and liver will normally regenerate.
3. Supplements provide nutrients, vitamins and minerals to our body giving our internal organs such as the liver the added support to regenerate and perform it's function.
4. Interferon has antiviral effect and increase cell immune response against infection. If your lucky your cell response can eliminate the virus totally.
5. Stem cell therapy is inserting new undifferentiated cells to our system allowing dead cells to be replenished and old cells to regenerate as cells heals cells. If the source of Stem cell is from animal then there is the transfer factor effect.
I'm not a doctor either my friend but sometimes you have to raise questions to your doctor this way you will know how good your doctor is. Of course you may want to believe that doctor's in your country is the best but there will always be a good doctor and a bad doctor in every region. That's why I have 3 doctors in my country alone and I even find time to go to Singapore to attend a seminar from a Professor Scientist who specialize in stem cell. By the way my results came in today. I got undetectable HBV DNA but HBeag is still around 5. This is my 11th month under Entecavir Baraclude. Goodluck to us all I know we can eliminate this virus and live healthy in the future.
Just came back to my doctor. I asked him about HBV DNA going up and down and he told me it doesn't matter. We just have to monitor hbeag if this reactive we have to take antiviral. So maybe your doctor will advise you to continue with Entecavir Baraclude. Just keep us posted.
Maybe we can now have a conclusion in this forum question. When can I stop Baraclude treatment? My answer is if the hbeag is non-reactive and HBV DNA is undetectable then we can stop taking Baraclude.
Hi, all, there is something strange..My results after 9 months of Baraclude:
1. month - 187980 IU/ml
2. month - 40000 IU/ml
3. month - 37900 IU/ml
4. month - 9000 IU/ml
5. month - 3980 IU/ml
6. month - 4060 IU/ml
7. month - 590 IU/ml
8. month - 1500 IU/ml
9. month - 680 IU/ml (after this result I have no more hypertension, so I am psychosomatic..)
So, my doctor adviced me to continue with Baraclude. They he said that we should probably check my blood only once in three months because every month checking make me stressed because it is normal that the quantity of the virus is never permanentaly stabile and decreasing. Then he checked my genotype (that´s what my previous doctor never did) and he found out that my genotype is not well responding to Pagasys and that the previous doctor should have never prescribed it to me. Then he said that my genotype is very well responding to Baraclude and I should not become resistant because I didnt take lamudivine before. Then all my ather somatic problems disappeared. So, the point is I cant come to this web anymore because there is always someone here who gives some bad info about Baraclude and it stressed me and then I panic and then it has a bad influence to my heatlh. So, guy, dont give up and dont read too much the internet. There is lot of people (as I said already swho are the employees of drud producers, competitors etc, who put here very bad information and if you thrust everything here it can have a fatal impact to your heatlh, because some people are as sensiteve for the info like these as me. Dont give up! Ciao
David you are doing good. This is typical of ETV. I suppressed 500 million copies in 5 months. Etv yes is vl crusher it is known. And Yes follow your doctors advice. Stress could and does raise blood pressure.
But this forum is one of the best out there in terms of info.
As for drug companies agents and clinical trial recruiters well they inject their info too and it can be informative. As well as usefull to many people. I just wish the companies that they represnt here were more flexible to deal with.
This forum is good you get to hear many opinions which are 90% of the time are spot on. It is just you have to understand there is no gold standard at treating hbv. And that there are an even more better combo treatment approaches for hbv then just etv monotherapy.
But you are doing great. I share your happiness with you. It does feel goodvto be approaching almost negative pcr.
I told you so several months ago do not get HBV DNA every month it will drive you nuts and it is basically useless and a waste of money. I think your doctor now is making it clearer and we start talking on the same page. You'll probably have undetectable HBV DNA in less than 6 months and then wait for your hbeag to become non-reactive. Then try to visit this site again and look for my post. Probably I'll can give a more precise technique to eliminate hbsag and totally kill the virus. I'll keep you posted guys.
We got my mom's result today.
HBsag w/ titer = 0.67 C.O.V. 1.00 Non Reactive
Anti-Hbs = 1.79 C.O.V. 10.00 Non Reactive
Finally hbsag eliminated after more than 10 years but Anti hbs still non- reactive. Can anybody here give me some advice if she can take vaccine for immunity. Thanks and God Bless us all.
Congrats or ur mum! I think she may benefit from a hep b vaccination, but better let the experts advice you. May I ask what was her HBs and DNA levels before she started taking the deer placenta stem cell?
In 2007 she clear HBV DNA to undetectable taking Baraclude for two years
In Apr 2009 HBsag = 4402 , HBeag = non reactive, no medication
Dec 2009 HBsag = 3211, HBeag = non reactive, no medication
Apr 2010 her sgpt went up to 120, hbeag become reactive this is another relapse her third relapse, HBV DNA around 12 million. Doesn't want to take antiviral anymore. We go to naturaphatic doctor, medication is selenium and zinc and copper.
Jul 2010 sgpt went down to 80, Hbsag =1157, HBeag = 0.114 becomes non reactive again.
Sep 2010 Hbsag = 581
Year 2011 hbeag = non reactive. we only monitor hbeag and sgpt as long as this two is good there's no need for medication
Apr 2012 hbeag = 0.61 Non reactive, no medication
July 2012 we try the live stem cell capsules
Sep 2012 HBsag = 1.18 , hbeag non reactive
Nov 2012 HBsag = 0.67 non reactive, hbeag non reactive
We are coordinating this with the doctors and soon I'll be using this if i become non reactive to hbeag. I'll keep you posted. If you have questions you can message me. God Bless everyone.
I started taking Baraclude 3 months ago due to high virus amount. I have not not seen the total. Also my ALT and AST levels are high. I felt off when starting my therapy and have gradually lost appetite, some aches and numbness in my legs. Has anyone else experienced these side effects?
After having read some very helpful stories, I need to ask my doctor about what genotype I belong to. I am chronic carrier of Hepatitis B.
I am taking baraclude for 13 months and I don't have that reaction. I'm a believer of baraclude as it has good effect on me. But I combine it with some supplements.From 640 million copies per ml now down to undetectable range of HBV DNA. Hbeag from 1500 iu/ml now down to 5.0 iu/ml, hbsag now also down to 29 iu/ml. I'm nearing seroconversion and my target is 1st quarter of 2013. We just need the proper medication, proper combination and self disciple eventually we can clear this virus. My mom is cleared she has it for 17 years and know she is hbeag and hbsag non reactive. If you can share you history, past and present laboratory results then we can have a better understanding of your health and how to remove the virus.
As written in my first reply to another member I have yet to receive the first results.
What I do know is that no scarring on my liver has been shown from two screenings made.
I hope I can provide more detailed information beginning of next year.
Here are my results after 24 months on entecavir monotherapy:
At the beginning of the treatments fibrosis level F3, nowadays 7.9Kpa
After 12 months of entecavir therapy:
After 24 months of entecavir therapy:
I am waiting for the apparition of antiHBe. On the other hand my doctor impressions are quite possitive in the sense that he has told me that it is very probable a complete negativization of VHB. Any suggestions? is there any way to help to the aparition of antiHBe? He told me that a combo with pegasys, in my case, is not recomendable, since it is very sure I will not need it...
on the contrary peginterferon add on it is needed in your case exactly because you are sure to clear hbv by etv+pegintf (not so sure on etv monotherapy) while higher hbsag cases have nothing to predict response.if hbsag continue to decline to less than 500iu/ml pegintf will be much faster to finish and clear
what was your baseline liver damage?f3 is not precise at all if you have the kpa value it is much better to see the recovery, 7.9kpa is still high value try to have a perfect healthy life style it will decrease slowly anyway
Before starting with entecavir, I ve been with inf for one year and no response at all. For that reason I ve started with ETV 2 years ago. Fingers crossed and I will wait for the clearance of HBV... I hope i get it asap... thanks.
I am taking baraclude for 3 years. My wife and I are thinking to have a baby. One doctor says it's not safe to do this while still on medication. Another one states the oposite. I looked for studies but all I could find was refferring to situations in which women are undrer treatment. Nothing on men under treatment. So I am quite confuse now. Is it or is it not a problem to have a baby while the man is under treatment?
Based on my two doctors there's no problem taking baraclude and having a baby if your a male so you can go and multiply.
I've been out of this forum for 5 months just for info my hbsag and hbeag are now on grayzone area meaning very close to 1. I'm just on my 17 month of baraclude plus supplement. Hoping that I will develop both anti-hbe and anti-hbs in the next few months.
for hbsag you need architect and not obsolete elisa tests, only results in iu/ml are quantitative
the obsolete test you are using doesn t count hbsag but just the regents used in the test so even if you get close to 1 your hbsag may have got higher instead lower, there is no correlation between the number in your test and hbsag quantity
There are only two tests for hbsag here in the Philippines. The titer (CMIA) which has no units but has a cut off value of 1 and the hbsag quantification II which has a unit in iu/ml but doesn't have a cut-off value. So what do you think is more advisable to take? If ever i become hbsag non-reactive in the obsolete elisa test, will I have a zero value on the quantitative test? thanks for the info.
Hi. Just reviewed the Architect Hbsag that you told me and found out that it is the same with the Hbsag w/ titer (CMIA) which I'm currently using for monitoring. Kindly advise if my understanding is correct. Thanks!
Guys..u need ur advise. I stopped entecavir mar 2012 and after stopping I did monitor and DNA was fluctuating up and down between 2-4log. But my latest bld test showed DNA 7log, and this makes me very worried. Also, my ALT has always been very low ard 10-12, but in feb it went up to 54 and apr it went even higher to 84. What is happening now? I did u/s which was normal and fibroscan 4.0kpa. My dr advised me 2 options - either start TNF or wait it out and monitor. What should I do and what is happening to my immune system?? This is making me so so worried.
I just emailed my diagnostics center regarding the hbsag w/ titer for their results are confusing as it indicates CMIA method but has no unit in iu/ml. I'm hoping to get a response from them. Thanks for the info.
I think your immune system are now responding and destroying the virus. This causes the elevation of sgpt. The main question is can the immune system eliminate the virus or does the virus multiply so fast that it still rises even with immune response. If the latter is true, then you need antiviral therapy to control viral multiplication but if the immune can eliminate the virus, the you will be an active case and your body can eliminate the virus by itself. This is based from my own experience, it's always better to get advice from health professionals.
I do hope I will win this fight but however it doesnt seem like im winning because if so my dna would have dropped right? Thinking abt this is just depressing and making me anxious all day. Anyway, dr says since my liver is considered healthy, he says I can wait it out. But im just worried what if something happens all of a sudden like a bad flare. Really hope God will pave a way for me soon.
Anyway how have you been engr? Have you seroconverted to e neg? Are u still on etv?
I do hope I will win this fight but however it doesnt seem like im winning because if so my dna would have dropped right?
no it is hbsag to drop when you clear hbv infection and not hbvdna, hbvdna can be und but infection the same as before
Anyway, dr says since my liver is considered healthy, he says I can wait it out.
he is correct and you just need fibroscan monitoring, hbvdna, ast and alt are useless to see how your liver is only fibroscan can say if you are having damage, remember it is not the virus to make damage so if you look at the virus to see damage you are totally wrong it is your own immune system to make the damage to your liver
I'm still under baraclude i'm on my 17th month under this antiviral theraphy plus concentrated selenium. My lab results is very good, HBV DNA is already undetectable on the 10th month, sgpt is normal, ultrasound normal, fibroscan normal, still hbeag reactive but values are so low around 3 and cutoff is 1, the good thing is my hbsag is also going down around 6 cutoff is 1. I believe I'm a very good candidate for seroconversion because hbsag goes down yet hbeag is still there. Usually the immune response stops when hbeag becomes non-reactive and we will enter the dormant or healthy carrier stage but in my case immune is still responding because hbeag is reactive but hbsag is going down fast. Very much hopeful that i'll seroconvert this year. If I were you I would take supplements to help protect your liver as your immune system inflicts damage on your liver and based from your high viral load I think your doctor will recommend antiviral in the next 3 months. I would like to ask if you are under entecavir before why do you stop taking it?
My dr said if high dna and high alt for too long will inevitably cause damage to liver. Is this true? Or can high dna and high alt still result in healthy liver?
Problem w me is that I have taken lamivudine 1.5yrs before and stopped for 3yrs. And now entecavir 3.3yrs and stopped again, for so far 1yr 1mth. So it seems my dna is the type that always rebound...not easy to treat. If want to treat means it will be lifetime antivitals am I right to say this?
That's good news for u then! Hope ur e antigen becomes neg very soon. I heard there are 2 schools of thought for e antigen positive. It could mean a better responder or it could mean a very strong virus.
I stopped entecavir because my dna was undetected for over 2yrs, plus I also seroconverted to e antigen neg and e antib pos while on etv. I dont like to be on antivirals for too long. I think my body needs a break too.
Thank you for your previous response which you had posted in a thread started by me.One thing I want to ask you is that if hbv dna becomes negative but hbsag remains +ve even after taking a medicine then should that medicine be continued or discontinued?My doctor(a hematologist who is treating my mom also) says that my medicine(Hepitec 100) will be stopped whenever my hbv dna becomes negative(falls below detection limit of 20 iu/ml) but that doesn't rule out possibility of the infection in the future,isn't it?
Yup. After lamivudine 6mths my dna was alrdy undetectable. I continued for another yr then stopped for baby plans. But then my e antigen still +. It was only on etv that my e antigen became - and antib +. I probably didnt take lamivudine long enough to e seroconvert. But anyway now that I have e seroconverted, I honestly do not see any benefits too.
So your a classic case of what is called a "relapse". You took antiviral then become HBV DNA undetectable and hbeag negative, stop the antiviral then after sometime everything goes up again. This is the normal cycle of antiviral therapy and my mom was in this cycle for 17 long years but now she is both hbsag and hbeag negative. What is wrong in this picture? First antiviral is used to suppress viral multiplication which is indicated by the e antigen. Second immune system is the the one responsible for the destruction of hbsag eliminating the virus. So I'll ask you some simple questions:
Q: Why do antiviral therapy not recommended for healthy carriers? Healthy carriers are those who are hbeag negative.
A: Because antiviral therapy is used to suppress viral multiplication or hbeag.
Am I correct here? Anyone may comment and then I'll proceed.
Yeah I probably am. But I thought "healthy carriers" term is no longer used as dna does not determine the "health". And that the only way to tell the "health" is by fibroscan and probably a low ALT is preferred too. Antiviral therapy is just to suppress dna (long term high levels may cause damage to liver) but doesnt mean it suppresses hbsag levels am I right?
My story - My treatment with Baraclude ends in about 20 months. HBV DNA UND for more than 6 months and I seroconverted from HBe-Positive to Negative. I think that's the reason my Dr got me off it. That was Dec 2011.
Fast forward now, HBV DNA has come back. I think when I was diagnosed with Hep B, I was ignorant about the disease. I still drink casually. Sometimes binge drink in a night out. Only since the start of this year, about early FEB 2013 I have changed drastically. No alcohol whatsoever, diet like a rabbit, no fast food, no junk food. Will add some Vit D supplement soon and will start an exercise program.
After I stopped Baraclude, HBV DNA came back at 1 log 3 months later, then 3 logs, then drops to 2 logs, then to 4 logs and now back to 2 logs in March 26th this year. 4 to 2 logs in 2 months, the biggest drop so far. All this in 15 months after Baraclude - no meds. Only start this health freak combo in early Feb this year. Along with this latest drop in HBV DNA, my ALT drop to 38. First time without treatment. Before it was in the range of 40 to 67.
In hindsight, while I was on Baraclude or at anytime, I should have start a good diet with Fruits and Vegetables. Your body is an engine and needs good oil to run. Along with no alcohol and no junk food to hurt your liver, should give your immune system a big boost.
don t be fooled by hbvdna it goes up and down and means almost nothing to hbv infection or immune pressure on hbv, you have to follow hbsag quantity to know how many infected cells you have in the liver and if your immune system has got hold of it
big mistake stopping entecavir while you are hbeag pos you have chances to clear hbv definitively by peginterferon add on, y stopping entecavir on hbeag change you can become bcp/precore mutant and reduce chances to clear hbv very very much even add ing pegintf
I understand stef. This disease is very frustrating. However, is it possible to get the virus to UND level and then maybe for HBsAg to respond and your immune system to create antibodies?
no because the disease kinetics is not made of virions in the blood but of a template called cccdna integrated in human dna
just a funny example, have you seen the movie "alien", you could kill all the aliens but one egg could make all the population back in a bit......the egg is cccdna and is integrated in our human dna.
so you dont have to look at hbvdna but hbsag quantity when hbsag quantity gets low it means there is less cccdna integrated in our human dna and when hbsg gets to und some antibodies hbsab can be created
I guess the combo of anti-viral and Interferon will be the new treatment.
it is already but most countries just care to make money selling antivirals only so this s not applied.after a decade of antivirals most reach lower hbsag levels and can be easily cured by peginterferon.
the new treatment is personalized hbv treatment according to hbsag levels by combination
Their goal is to lower HBV DNA and a normal ALT. Nothing was said about curing it. I think they know the percentage of success and do not want their patient to have too much hope.
no they are incompetent and dont even bother to cure, cure rates can reach from 30 to 50% from pegintf mono 5-10years to sequential treatment from nucs to combo with peg 5-10 years.they simply care to make money and not cure or just incompetent...
cure rates are well known just long term cures by expert liver specialists, they are low on peg mono but 50% in the combo is not bad even if it requires 5-10years.hbsag goes down on a good percentage of patients on simple nucs in 3-6 years and then peg add on finishes the infection on 50% patients, of course if there is no hbsag quant test there is the intention "not to cure any patient" from the start and just treat blindly all patients
I stared reading about HBV only rescently.
please explain what you mean:
"they are low on peg mono but 50% in the combo is not bad even if it requires 5-10years."
what is "peg mono" and "combo"?
"hbsag goes down on a good percentage of patients on simple nucs in 3-6 years and then peg add on finishes the infection on 50% patients"
what are "simple nucs"?
I am 42, know of having HBV for 11 years. was listening to the ignorent doctors up to now.
fatty liver, HBV DNA went up over 4000 for the last months. liver biopsy supported these results.
never did hbsag quantity!!
the doctor recommended starting varead or baraclude "for life" as he said.
What do you think?
check all forum posts to understand peginterferon (peg) therapies and antiviral therapies (nuc)
it is wise to start with correct baseline tests and changing liver specialist for a more updated one, to understand the updated expert ones when you book appointment ask for "expert liver specialist on personalized hbv cure according to hbsag quantity response" all the ignorants will be erased immediately, but be aware you may find one or two so expert in your country, so tests:
hbsag quantity in iu/ml by abbott architect
then you can start tenofovir if hbsag is elevated and keep monitoring hbsag quantity and hbvdna, when hbsag quantity reaches about 1500iu/ml you add peginterferon in combination until hbsag is undetectable and hbsab detectable
ggtm: Yeah I probably am. But I thought "healthy carriers" term is no longer used as dna does not determine the "health". And that the only way to tell the "health" is by fibroscan and probably a low ALT is preferred too. Antiviral therapy is just to suppress dna (long term high levels may cause damage to liver) but doesnt mean it suppresses hbsag levels am I right?
Engr_j: Your partly right and partly wrong. Antiviral therapy is used to eliminate hbeag or viral multiplication. When hbeag is high our HBV DNA goes up because the virus is multiplying fast. When virus multiplies, our immune system responds killing the viruses and therefore causing liver damage. We can see this in our lab results. Hbeag becomes high, HBV DNA becomes high then our sgpt will go high also. So we take antiviral, our HBV DNA goes up and down if we check it monthly because immune system kills the virus. The antiviral does not kill the virus. What we have to check when we take antiviral is the hbeag. If it goes down it's good. HBV DNA is just a waste of money. I only check it once a year.
What about for people with hbeag-, and antihbe+? How to monitor if we dont check dna? I dont have hbsag quan test here and am really interested to know how do we monitor our hbv such that we know when to restart antiviral?
Concentrated selenium is a concentrated mineral in liquid form. It is used for medicinal purposes although by definition it cannot cure a specific disease that's why it is labeled as supplement. I combined this with etv and the results are great. My mom before used also the concentrated zinc & copper combine with selenium and she got hbeag negative in less than two months. It is considered as a natural antiviral. You can check if the product is available in your place. If this works on you then you won't need another round of antiviral you can just try it in 2 months and take a lab test. As I said in my past forums the zinc and copper does not work with me probably because my hbeag is too high and my hbv dna was at maximum (greater than 640 million copies/ml). So it has it's limitations that's why this disease is so complicated. My mom is cured from the approach selenium plus zinc & copper, then after hbeag negative stop zinc & copper and continue with selenium for a year then took stem cell capsules for 4 months and she become hbsag negative. Now I'm trying to decipher my case I'm under etv since Nov 2011 plus selenium. My current status hbsag and hbeag both very low, normal hbv dna and sgpt. Ultrasound and fibroscan both normal.
If you are hbeag negative you should check hbsag w/ quantity as suggested by stef. Although I monitor this in my case I'm still asking my diagnostics center if it has units or not because they claim they use CMIA method same as abott but there is no iu/ml in the results so it's conflicting. This is the next line of monitoring if you become hbeag negative and hbv dna undetectable. Now it is not good just to monitor because you are just waiting for your immune system to respond and we know that when we reach hbeag negative, usually our immune response also stop and then the virus slowly multiplies again, then they rapidly multiply, then we get hbeag positive and high level HBV DNA and we go back to relapse were in the virus is stronger and they develop protection from antiviral. So what we need to do when hbeag becomes negative is to focus on supplements or alternative approach to stregthen our immune system and eventually eradicate hbsag. There must be no stopping until we eliminate hbsag and develop anti-hbs. This is the time we are considered cured. This must be our only goal.
Yeah I think im in the relapse phase. Suddenly my alt increases which it has never before. I just started on chanca piedra tea. Read it has antiviral properties and will lower dna. Will update on my next lab work in 2 mths. If dna still high then I will start tnf. Tnf has no resistance right? So I shld think if I do need to start tnf, it will work to bring dna to und levels. Its going to be a long journey. Hope the final cure comes out soon.
Now you can see the full cycle my mom was in this cycle for 17 years that's why I can clearly see it. Actually the cure is available but it is a comprehensive approach, it does not come with a single medicine so don't count on a new found antiviral drug or supplement or whatever that can eliminate virus anytime soon. Let's set some goals for you. First goal is to become hbeag negative. You are now taking chance piedra check again after a month if its working continue, if not stop it. If zinc and copper is available in your country you can try it. Ask your doctor if you can take etv again, etv has very low resistance so probably this can still work if not proceed to tnf.
To stef, yes selenium protects the liver from liver damage. It does not cure hbv. It's good to have a protected liver because the hbv cycle destroys our liver. The liver regenerates but like wounds the process creates scars that can lead to cirrhocis or hcc and nobody knows how long will the hbv stay on our system. It's better to be safe. Defense plus offense is always better.
Actually I am already hbeag- and e antib+ for a few years. I stopped etv after und for 2yrs..so I thought its the end point of treatment, which was why I wanted to stop treatment and see how my body reacts..at the same time let my body rest fr the prolonged use of drugs. But after 1 yr of stopping, dna shot up this mth. I do not know if its because I was rather sick at the time I took my bld test which might have an effect in this high level too. Or is it just that my immune system cannot handle the virus anymore. But the fortunate thing is that my fibroscan is only 4.0kpa which dr said my liver is pretty good to be able to withstand so many yrs of attack.
Now I just want to protect my liver from damage and hcc. I shld be genotye b or c as I am asian. Dr also said inteferon doesnt work well on b and c types.
being hbeag negative means nothing the infection is just like before and hbv just mutated to escape immune system to bcp/precore, the only goal is lower hbsag but this is not done by selenium or zin at all, i say again most of us are on it but it has no effect to clear any hbv and becoming hbeag negative is "NOT IMPROVING", hbeag view is something a decade old.the only thing to look at is hbsag quantity in iu/ml to know if infection is clearing or not
there is also no such concentrated, they are all the same and over a dose of 300-400mcg selenium is extremely toxic
it is not hbvdna levels to make the damage but our immune response to it, if you have no immune response you have no damage, so the only thing to make sense is monitoring by firboscan and start antivirals when there is damage
sorry but i am not a doctor it is best you are folllowed by a liver specialist and then check the research posted in this forum so you can choose what your doctor suggests
selenium had a big human study in china with thousands of people from a acouple of areas which showed less liver cancer rates on those taking selenium but no clearance of hbv on those with chronic hbv
How come being hbeag negative means nothing? High Hbeag has high viral multiplication. We can see it in HBV DNA increasing. If the virus multiply on a very fast rate and then our immune system responds and kill some virus we would have liver damage. If the rate of virus multiplication is fast and our immune system only kill small amounts then this will lead to liver cirrhosis, liver damage or worst hcc. That's why we take antiviral to lessen the rate of multiplication while our immune system kills the virus. I think this is also the reason why hbeag negative are not advised to take antivirals because they do not need it because their virus is not multiplicating on a fast rate. That's why I strongly suggest to take antiviral when hbeag is positive and then take immune booster when hbeag is low or negative. The selenium is just for protection so the treatment process will not do much damage to the liver. Toxicity is not a problem as long as we follow dosage, the liquid form does not stay on our body from more than a day so it is verified that no traces can be found one day after intake.
Ok sorry if you think I waste your time. This is a forum, we are not doctors and I just want to share to others some researches and personal history which is all backed up by the numbers and lab test and a succesfully cured chronic hbv infected person and then learn some from you and others research and personal experience also. Every approach differs from the other even doctors contraindicated each other based from their chosen field of study. You probably focus on the antivirals, interferon, the virus itself and stats from clinical trials while I focus more on immunology, molecular and naturaphatic medicine. Our approach may be different but I pray we both get to the same goal which is total cure from hbv.
Actually we need both of such approaches - scientific and hollistic ones. I believe hollistic treatments help, while have not been proven to cure hbv, but thats because of the difficulty to conduct trials and patents as they come fr plants. But every plant also contains chemical compounds (not modified) which may work on our body in a positive way too. Its just that no one knows what is the correct dosage to apply, therefore its best we take natural medicines in moderation and not reply solely on it. So stef and engr_JD, keep up your contributions on this forum! You guys have been a treasure.
For info: Just recieved a call from my diagnostics center (Hi-Precision Diagnostics Philippines). The hbsag w/ titer with a cut of value of 1 which I monitor is a quantitative measure. The machine used is Abott Architect same as the one mentioned by stef and it uses CMIA method. This answers the question that hbsag wich are unitless (iu/ml) is irrelevant. The screening type of hbsag test with no units is only referred as "hbsag test" and it's result will only reflect either "reactive" or "non-reactive" but they do not indicate any values at all. God Bless everyone!
At the beginning of the treatment fibrosis level F3, november 2012 , 7.9Kpa
After 12 months of entecavir therapy:
After 24 months of entecavir therapy:
After 30 months of entecavir monotherapy:
HBsAg 593 UI/mL
Doctor is still very positive about my evolution. I have asked him about add-on pegasys and he told me that ETV is working so fast with me and he does not recommend add-on INF. He gave told me congratulations. He is sure I will get HBsAg negative some day no so far...(fingers crossed)
Any recommendation? I ve been taking vit D pills for one month during august... I will buy milk thistle too... anything else?
At the beginning of the treatment fibrosis level F3, november 2012 , 7.9Kpa
After 12 months of entecavir therapy:
After 24 months of entecavir therapy:
After 30 months of entecavir monotherapy:
HBsAg 593 UI/mL
After 30 months of entecavir monotherapy:
HBsAg 146 UI/mL
Still waiting for seroconversion. The doctor very happy he asked me for research studies since my response to entecavir is being so fast. appy to hera that. I will have my new analysis by september and I wll post as well. He told me that probably I will finish with ETV and with my HBV in 1-2 years.
Yeah my friend. I ve been for one year on IFN and it does not work at all... my fingers still crossed. It is nice to share these resutls with you all, and I hope you are also going well. I did not checj my Vit D3, but of course, I wll take some pills as i did a year ago ;-)
i m having hbv for 5 years.i was diagnosed hbeag-ve.my dna viral load was 870.on march next was 180.now after five years on jun 2015 my dna is 4056.hbsag 1696,sgpt 27.sgot 45.my doctor has recently added me on entecavir .5mg.what would you say?after how much time the complete cure will be available.i was expelled from job because of the same.it is more psycologically now than phsically.
be sure hbsag is reported with unit iu/ml otherwise the number is useless and not hbsag quantity
keep using etv and take vit d3 10.000iu daily too, test vitd25oh and intact pth after you are on d3 for at least 6 months.keeping optimum vit d levels helps keep liver healthy and it may boost some immune response too, not saying you ll clear hbsag by vit d but it wont harm for sure and may slowly decline hbsag over many many years