adnvhb / fibroscan test results, i need guidance

Question

Fibroscan 7,6 kp (f2) 
Adnvhb : 17.000.000.0   UI/ml
Fibromax normal ( just alt 79)
Hbsag positiv
Hbsab negative
Hbeag positive
Hbeab positive
Alt (79-110)
Ast 30

Hbs ag quant did not came yet.

My doctor said to wait a few months because he believes i will seroconvert and hbeag will become negative and this is the reason my adnvhb is so high. Also said that he recomands interferon if treatment necesary. I will see another doctor

stef2011 · Accepted Answer

it is a good suggestion to monitor, also having 2 tests of hbsag quant and hbvdna few months apart may help to see kinetics.if hbsag and hbvdna are going down hbeag serconversion is probable

if hbsag low and hbcab igm quantitative >0.2s/co (few labs do this quantitative) pegintf is highly recommended

melcul · Answer

also i forgot the dates 

ADNVHB -23.07.2014
HbsAG q - 08.08.2014

this two should i recheck ?

melcul · Answer

my situation so far :
Hbv discovered 6 months ago(was chronic) also i had 206 cholesterol.
since then i checked my alt monthly to se kinetics : 
03.06.2014 :ALT -86.7
13.06.2014 :ALT -111.14
09.07.2014 :ALT -79.4 (Fibromax result)
14.07.2014 :ALT -92.5
13.08.2014 :ALT -63.6
01.09.2014 :ALT -50.9
26.09.2014 :ALT -81.8(somewhere here got a flu)
13.10.2014 :ALT -72.9

Fibromax (09.07.2014 ) showed no fibrosis and fatty liver S0-S1(0.33) FibroTest F0(0.17) ActiTest A1-A2(0.42) NashTest N0(0.25)

-Fibroscan 08.08.2014 (F2 -  7.6kp)- 10impulses, 83% success rate

-ARFI test (13.08.2014) (some kind of an echography) the doctor said that i am for sure  F2 on metavir scale 

next day i went at other clinic at a good gastroenterologist doctor and i rechecked 
-Fibroscan 14.08.2014 (F0 -  5,3kp)-20 impulses, 87% success rate 

HBVDNA : 170 mil
HbsAG : 350 k

Today after i rechecked HDV and HCV for the 3'rd time and came negative my is not satisfied by the alt that wont stop flaring.
i sugested him to recheck in 3 months ,and in this time i will have a vgetable diet to see if Alt flaring is from fatty liver or not .. after 3 months i will do a fibromax. then if fatty liver is solved and alt still high, he told me that ,at that point i have to start treatment. if alt comes down, then i wait being imunotolerant. 
Last month i did not hold on to diet ,being far from home, but now i started again .
Any sugestions guys ?

melcul · Answer

Thanks a lot . I will start with black rice, lots of vegetables, grapefruit, tea from leaves  i will try blueberrys but if i can find i will start to 0.5/ 1h exercises or running, i will eat black bread with weeds and I will check again my fibroscan in 3,4 months ? I think that sounds resonable?

stef2011 · Answer

check out how i did it several years ago.i used all supplements and diet backed up by scientific research and it did work in few months

http://www.medhelp.org/posts/Hepatitis-B/update-on-my-fatty-liver/show/1500346

melcul · Answer

Thank you very much stef, can you give me some advice about how to solve fatty liver ? Should i eat only vegetables ? Also i drink a lot of tea .my cholesterol got from 206 to 150 in 1 month

stef2011 · Answer

no biopsy is useless for this, this is the path to recover:
resolve fatty liver which is probably the source of damage, not hbv.with fatty liver there is almost no possibility to lower inflammation or fibrosis

once fatty liver is solved regressing inflammation and fibrosis from hbv, if there is any in you, is a joke and antiviral will take little time to do it

melcul · Answer

my fibromax grafic came along. It says F0(0.17). A1-A2 -(0,42) , S0-S1(0,33) N0(0,25) H0(0.0) .it sais i have inflamation in my liver and a bit of fatty liver .so i guess it is directly conected with fibroscan which said F2(7,6kp) .if you have inflammation in the liver, fibroscan is high..not just for fibrosis. Should i do i biopsy just to be sure from where i start ?

stef2011 · Answer

my fibroscan is almost normal since may 26 2011 (it is the period i started gcmaf and resolved my fatty liver).it jumped from 9.2 kpa in january 2011 (rising) to 6.3kpa in may

dec 6 2011  6.1kpa
oct 16 2012 4.5kpa
july     2014 4.0kpa

melcul · Answer

my mistake with the reference units : 
urinary creatinine : 0.77   g/24h   (1.040  -  2.350)   volum urine 24h/ 1.9 l 

I ask because the doctor didn't said anything about the kidney , and still there is a some abnormal values

melcul · Answer

it's logic what you say , but I don't understand . I have HbeAg positive and HbeAb positive too, they say to wait a few months because it will seroconvert and the adnvhd will come down , it is a smart choice to do this?


Also, if anyone can help me with this other results :

urinary creatinine : 0.77 g/24h (1.40-2.350)   volum urine 24h/ 1.9 l

eRGF(Glomerular filtration rate ) - 95 ml/min/1.73mp ( the lab says 100-170 ) 

serical creatinine : 1.09 mg/dl (  0.70-1.20 )

Microbiologie- complet urine test came ok (just urinal density was 1008  [1010 - 1030]  

do I have to concern  ? I want my kidney to work perfect cause I will need them ...

SafiSifa · Answer

High level HBVDNA is not important if you are under treatment. Because, the numbers come down to zero very fast with anti-virals (see my results). 

However, if you are not under the treatment with high level HBV DNA, this is problem. Because, your immune system start to fight with the virus by attacking to your liver, which makes and progress your fibrosis. And final stage of fibrosis is cirrhosis.

melcul · Answer

probably I will need treatment, I don't think this high adnvhb will go down in few months . so stef recomanded peginth (interferon I guess), isn't good a combo antivirals ? , or If I go on tenefovir + entecavir ? you said that one alone cant fight the virus and need a combo treatment .why is inter alone the best solution in my case ? thank you, you are very helpful to a lot of people

SafiSifa · Answer

My biopsy result was F3 before treatment.

melcul · Answer

You are lucky ..and also you had low fibroscan score .hope to not get worse or i will freak out. On the internet they say that normal range for fibroscan is 5.8 +- 1.5. Or something like that . That means normal range can be 7,3 too ? I dont understand this measurments .and i have f2 with 7,6. Wierd. I want to start something, vit d + antioxidants, what else it is recomanded, help guys

flyinsky · Answer

yes and this is what my doc do with me in 2 or 3 monthes i repeat all tests if no good result treatment,stef can i ask you about you fibroscan now;last time i think was 9 then 6 and now!

stef2011 · Answer

it is not high and 6 months won t make any trouble at all.i d monitor that keeping in mind that if next reading in 6months is the same treatment is recommended

SafiSifa · Answer

I think you need treatment. Your results are very similar to mine (before treatment).

See the development: http://www.medhelp.org/posts/Hepatitis-B/My-all-new-results-after-9-months-Entecavir-treatment/show/2246276#post_10790560

melcul · Answer

This is so high...it wont damage my liver in 6 months  ?!

stef2011 · Answer

just recheck it in 6 months

melcul · Answer

Doctor said also that the 7,6 kp result is because i have high alt and he doesnt belive i have f2. How can i reverse it stef, you have a lot of experience in this .thank you

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