about hep b treatment

[ohngyi]

It was found out my husband has hep b one year ago and we consult with the doctor (Liver specialist).  From the very first time, his ALT level is over range and viral load also high.  Doc instructed him to take zeffix and livolin.  He's  been taking zeffix and livolin for about eight months.  During treatment we checked his ALT every three month and the ALT level is normal (within reference range) but it still positive. Doc told us he should take zeffix about one or two year based on his lab result. Now my hub wants to stop his zeffix treatment because it couldn't guarantee us whether it can cure to become negative result. Besides, we worried about other side effects.  We need some advice whether we should continue the treatment or stop it because we've learnth that some people who has hep b can live to the normal life spam without taking any drugs.  But we afraid to get his liver funtion worse if we stop it.  Kindly advice us what should we do? If we continue to take zeffix, can it be reduced his viral load? can it be cured to negative result.

Thanks in advance
Ohngyi

[doglover28]

Hi,  I just found out that I have Hep C in April, and I am learning about it.  I know nothing about Hep B., so I am sorry I can't answer your question.  Hopefully someone will come along soon and be able to help you or direct you to a site.

[leeac]

hi,

several things to think about:

1. similar to hep c, there is no actual 'cure' for hep b.  very rarely (1.5% per year) a person with hep b will seroconvert to HBsAG negative (cured).  this is rare, but not impossible.

2. your goal with hep b treatment is to normalize your liver function tests (ALT/AST, etc...) and to achieve a sustained virological response (SVR) where your viral load will remain at undetectable levels.  that is why it is recommended that you continue taking the medication for a year or two.  the medication is not like aspirin where you take it when you feel sick, it must be taken daily so your body can respond well to it.

3. if you stop treatment early, hep b can sometimes bounce back even stronger in some patients.  that is why my recommendation is to consult with your doctor closely if you are thinking of stopping medication.

4. zeffix (lamivudine) is notorious as hbv tends to form immunity to lamivudine usually within 1 year for most patients, after which they must move on to the next medication.  i think your husband would be fortunate to be able to remain on lamivudine for another year or two.

5. if you continue lamivudine and become immune to it, or do not achieve the sustained virological response, fortunately there are several other newer and stronger drugs out now that you can switch to.  one of the stronger ones is called entecavir (barraclude).  talk to your doctor about it.

6. as for side effects, i think the tradeoff is rather simple... one or two more years of treatment in exchange for a normal life after treatment...

whatever your decision, please consult with your doctor before stopping medication.

hope this helps,
leeac

[tulsatime]

Here is what I found out on a site. Sounds like you Dr is on top of things and if one don't work try another. But please remember by not doing anything you run a risk of developing liver cirrhosis. That is what I have from Hep C And I am only 42. I say, don't stop trying to rid the virus!! God Bless

The good news is that there are promising new treatment for people living with chronic hepatitis B. Today, there are several approved drugs in the United States that can slow down liver damage caused by the virus.

The new drugs can help slow the progression of liver disease in chronically infected people by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus. With all of the new exciting research, there is great hope that a complete cure will be found for chronic hepatitis B in the near future.

Are there any approved drugs to treat chronic hepatitis B?

Interferon-alpha (Intron A) is given by injection several times a week for six months to a year, or sometimes longer. The drug can cause side effects such as flu-like symptoms, depression, and headaches. Approved in 1991 and available for both children and adults.

Pegylated Interferon (Pegasys) is given by injection once a week usually for six months to a year. The drug can cause side effects such as flu-like symptoms, depression and other mental health problems. Approved May 2005 and available only for adults.

Lamivudine Epivir-HBV, Zeffix, or Heptodin) is a pill that is taken once a day, with almost no side effects, for at least one year or longer. A primary concern is the possible development of hepatitis B virus mutants during and after treatment. Approved in 1998 and available for both children and adults.

Adefovir dipivoxil (Hepsera) is a pill taken once a day, with few side effects, for at least one year or longer. The primary concern is that kidney problems can occur while taking the drug. Approved September 2002 and available only for adults. Pediatric clinical trials are being planned.

Entecavir (Baraclude) is a pill taken once a day, with almost no side effects for up to one year. It is considered to be the most potent oral antiviral drug for chronic hepatitis B to date. Approved April 2005 and available only for adults. Pediatric clinical trials may be planned for the future.
It is important to know, not every chronic hepatitis B patient needs to be on medication. Some patients only need to be monitored by their doctor on a regular basis (at least once a year, or more). Other patients with active signs of liver disease may benefit the most from treatment. Be sure to talk to your doctor about whether you could benefit from treatment and discuss the treatment options.

It is very important that all people who have chronic hepatitis B see their doctor at least once year (or more, if needed), whether they decide to start treatment or not.

There are additional promising new drugs being tested and developed for chronic hepatitis B. Please visit the Hepatitis B Foundation's Drug Watch chart to find out more about new potential treatments.

[nirrti]

I don't really know much about the treatments for hep b, however I had similar results on my testing. My ALT was 2000+ and AST 800+ with a viral load of over 200,000. They have yet to give me any treatment.

I do agree with the others. I would not stop any treatment until you have discussed it with the doctor. If you feel that doctor isn't doing enough then see someone else.

Sorry this probably didn't help much, God Bless and best wishes to you and your hubby!

[shawn_sph]

I'll suggest your husband not to stop the treatment, because it's extremely dangerous...

Though the drug does not have any side effects while you are taking it, but the withdraw symptom will be quite devestating, I know because I stopped taking the medication for about 2 months early this year since It became quite costly, so I want to do a liver biopsy to cut down the cost. (Should consult with your doctor if you want to do a liver biopsy, I consulted my family doctor, my liver specialist, and my aunt who's an examiner at a hospital about the risks involed)

About 2 months after I stopped taking the drug, the withdraw symptom kicked in for me, I get tired even if I don't do anything, nausea and yawning often, and the worst of all, my blood test came back disasterous, all reading were quite high.

I've actually taken the drug for 3 years already, so i'm checking in with my liver specialist next month to see if the virus has mutated or not. If it's mutated, then I'll need to move onto a much stronger drug. (Not sure if there are side effects or not, wasnt able to check it because I forgot the name of the drug)

[fivecities]

Strange.  The first blood test I had in 1996 showed elevated enzymes. My un-informed doctor told be I had Hep A, B and C.  I went to a specialist who told me that I really only had Hep C. He said I had a "marker" for Hep B because, as a teenager, I contracted Hep B.  In 1963, at the age of 17 (I'll be 60 this year) I was diagnosed with Hep B.  I was hospitalized for three weeks and given heavy doses of gamma goblin and was sedated the whole time.  I was then house bound for 2-3 months and my liver normalized.  I was told I was cured.  I never thought about Hep B again, until the 1996 testing.  No DR has told me that I should be concerned about Hep B, only Hep C.  From the comments made here, maybe I still should have a Hep B concern?