Worried, pretty high viral load... antiviral treatment?

[cheng302]

Hi guys, just got my viral load results tested last month. They have to send my blood to Toronto, which takes a long time to wait... They didn't test my HBSAG (quantitive). They said they don't care that. Nonetheless, The viral load is pretty high! I am quite worried now. Do I need antiviral treatment right now? Since last October, I began to feel tiredness, especially when I walk upstairs. Also, I lost almost 10 pounds in the last few months. They still want me to see a doctor of internal medicine to make sure these symptoms are not related to other diseases.

2015/01/16
Male, 27
HBV surface Ag:  Reactive
HBV Surface Ab: 0.5 mIU/ml
HBV DNA: 1.1*10^8
ALT U/L [0-54]  197 H
AST U/L [5-45]   94 H
ultrasound: A small amount of free fluid around the liver. The liver parenchyma appears within normal limits otherwise.

I was first diagnosed with hep B in June 2013. The viral load was undetectable that time. HBEAG positive. My parents all have HBV Surface Ab >200 mIU.ml.

[stef2011]

of course once you make hbvdna und you will be healthy as anyone.just avoid processed foods and eat healthy organic foods and you will not have the diseases most people get from food today...it is there the real enemy of health, not stupid viruses we can suppress today

[stnana123]

thanks for quick response....
I'll get other test very soon..
iam 22 years now and graduated in civil engineering
no company is ready to offer me a job after my health exammination...it is too hard to live with disease..
is there normal life after hbv positive???

[stef2011]

no you need at least fibroscan, hbsag in iu/ml, hbvdna, hbeag baseline to see how you improve

ultrasound is just to detect liver cancer, not useful to see how liver damage is

[stnana123]

Thank you for quick response...
I did ultrasound test is normal....due to unavailable of lab in my place other yet to come....can I start medication ?? what medicine will you recommend ???
iam new here and hbv positive when I was 15 years..tnx a lot your suggestions give me a ray of hope..

[SafiSifa]

See my results: http://www.medhelp.org/posts/Hepatitis-B/My-All-Test-Result-After-12-Months-Treatment-of-Entecavir-I-am-cured/show/2355051

See my story: http://www.medhelp.org/posts/Hepatitis-B/Urgent-Advise-for-Entecavir-Usage/show/2044528

[stef2011]

sorry we cannot say how liver function is from these tests only

fibroscan= tells you about liver health, all degrees of damage or healthy
liver function needs also: albumin, platlets, pt

ultrasound: to check for liver cancer or fatty liver

hbsag quantity in iu/ml, to tell about infected cells, balance with immune system, possibility to clear on pegintf
hbvdna: level of replication of the virus
hbeag/hbeab
hbv genotype

[stnana123]

Had liver function test....result given below
billirubin total= 0.9 mg,/DL
billirubin direct =0.18 mg/DL
billirubin indirect= 0.75mg/DL
SGPT= 040.2 iu/L
SGOT= 031.9iu/L
Alkaline phosphate=0149.2 iu/L

is this normal?? kindly suggest

[stef2011]

of course is i took 16.2kpa to 4.5kpa (3.5kpa is only babies liver or some women, any below 5kpa is ok)

[varsa]

Stef is it possible to bring down 7.5 kpa value to 3.5?thanks

[stef2011]

can you get a supplement with lower dose so you can take 10.000iu daily?

so you can go with daily dosing untill you can check vitd25oh and intact pth again next month and see if you can go with 50.000iu daily or every 3 days.

unfortunately this study showed that even weekly dose is not ok, if i find it i will post here on medhelp too because they checked tissues for vit d after 1 dose of 50.000iu weekly and after few days there were none in tissues although you see levels high in blood

[cheng302]

Thanks, stef.

I've been on this dose for nearly two months, one capsule per week for the first month, and then increasing to one per 5 days (Amount
Per Capsule is 50,000 IU). I might check the vitd25oh level again next month (they only do it every three months for free).

I agree, I also think my fatigue is mainly from hbv. But both my family doctor and the internist don't think so...

[stef2011]

bit higher than normal (<7 kpa).

normal is less than 5kpa, some consider even 6kpa ok but 7.5-8 starts to be considerable fibrosis and also hcc risk is increased on hbeag negative

offer me antiviral treatment. Any suggestions?

go for tenofovir if any antiviral is needed, its the most potent


Now I am taking vitD 50,000 IU /5 days (Biotech). But sometimes I still feel extremely fatigue.

there is new study showing only daily dose is good because the vitd25oh we see in the blood is transformed to other type to get in to tissues and this other type has about 24-48hrs halflife and then goes down.
i use this biotech type too but my doses are very high so it is ok to take daily, what is your last vitd25oh level?so we see if you can take every 3 days at least

if you go on no diaries diet (even those present in processed food), water with calcium less than 10mg/l and drinking 2.5L per day, you are relatively safe for a short time even taking every 3 days but check calcium and intact pth every month if you go so high dose

fatigue is mainly from hbv, how long are you on this vit d dose?

[cheng302]

Hi everyone. I finally managed to get a fibroscan done today. The number is 7.5 kpa, a little bit higher than normal (<7 kpa). But it does indicate there are some kind of scarring of my liver. I am still waiting for the viral load result and will have another appointment with my doctor in the middle of the month. He will probably offer me antiviral treatment. Any suggestions?

2015/01/16
HBV DNA: 1.1*10^8
ALT U/L [0-54]  197 H
AST U/L [5-45]   94 H

2015/04/20
HBV DNA: waiting
ALT U/L [0-54]  94 H
AST U/L [5-45]   43  

2015/05/06
ALT U/L [0-54]  98 H
AST U/L [5-45]   48 H
Albumin and INR are normal

Now I am taking vitD 50,000 IU /5 days (Biotech). But sometimes I still feel extremely fatigue. My recent two blood works show both the red and white blood cells are low, don't know why...

[stef2011]

it goes down in few days

instructions are available online and say to cover blood sample bottle with tinfoil.
it is best not to test in small labs, i guess big networks have temp controlled, no light equipement

[stef2011]

this said if liver is in advanced cirrhosis it cannot make vit d conversion any more so if values are like 6-8ng/ml it is easy to reduce it to zero


Can body accumulate some vit D and how long it stays ? I've been for a while in tropical countries and returned 3 months ago to dark and almost no sun weather.

no for us, in all chronic conditions vit d is consumed by the body in incredible amounts, it goes down in few.it is also not possible for us to increse it by the sun i wasted more than 1 year trying

[sorte]

Problem is that they send it to the other place, but I will ask her to cover my sample, I suppose they have some special equipement for this.

[stef2011]

any light, these are the instructions of vit d testing machines.i found it because a small lab close to my home gave a totally wrong low vit d result impossible on me.
i saw this lab has no machines for these test and sample was moved many km away and probably exposed to light

now if i go to the small labs if i see the nurse not covering one of the samples i explain to them that they are making a mistake

[sorte]

"when taking blood samples they must be covered from light because it reduces vit d in sample.i think they made mistakes"

Any light or just a sunlight ? I'm pretty sure in my lab they don't know it. I saw blood samples being keeped near the window. Not Vit D but probably they treat all the same.

"sun makes 10.000iu of d3 in the skin and you are so low...you need mega doses to correct"

Can body accumulate some vit D and how long it stays ? I've been for a while in tropical countries and returned 3 months ago to dark and almost no sun weather.

[cheng302]

Thanks a lot, stef2011. I think by saying 'undetectable', they mean extreme low level. I will double check it.

Actually, I am very very thin now... and I have been strictly restricting my fat intake in the last few months. Since Vitamin D is fat soluble, I am probably in Vitamin D deficiency. And most of the time I need to stay in my office and don't have the opportunity to get it from the sunshine.

[stef2011]

you also need to check your liver damage, if liver is dmaged you may not be able to turn vit d from supplements in vit d in your body, have the fibroscan as soon as possible

retest vit d and retest in 4weeks of supplements like i indicated.take at least 2liters of water daily

[stef2011]

i think the test is wrong i dont think life is possible on 0ng/ml of vit d....aids patients dies when vit d reaches zero
when taking blood samples they must be covered from light because it reduces vit d in sample.i think they made mistakes

He suggests me to take 5000 ui a day.

totally useless.if vitd25oh is less than 10ng/ml guidelines indicate a dose of 1.000.000iu of vit d3 and then 5000iu as maintenance
if liver is damaged or you are overweight there is no production of vit d in the body and even these doses might not work

i suggest a single dose of 300.000iu and then 10.000iu daily

1000iu is nothing and it will take some days to convert what you take to vitd in the body placebo effect....sun makes 10.000iu of d3 in the skin and you are so low...you need mega doses to correct

[cheng302]

Hi stef2011,
I just got a call from my doctor and he told me that my blood test this Monday shows that I don't have any detectable Vitamin D... You have a lot of knowledge regarding Vitamin D. Could this be the reason for my tiredness and high viral load? He suggests me to take 5000 ui a day.

I just began to take Vitamin D 1000 ui three days ago. And I feel a little bit better now. I don't know if this is a placebo effect...

[varsa]

I had few ammount of free fluid in my abdomen. It was taken from needle and
Srnd to lab for detecing. But now after 2 and half year gone.my ultrasound normal and hbv dna undetectable and doc put me entehep 0.5 mgdaily.
U meet with good gastro doc as soon as possible. May be doc will start medicine.do fibroscan and post your result. In this forum there r so many
Expert they will guide u.

[cheng302]

All right, seems like fibroscan is the key. Hope it's not cirrhosis.