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alinia

did anybody try alinia with hbv?

it is strange nobody tried it yet since it is not expensive and available at pharmacy
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181575_tn?1250202386
Alinia has anti-HBV effects.  If (and it's a big IF) it become a legit treatment for HBV, it's still a far way off.    Most research for alinia is for HCV.
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Avatar_f_tn
I know a Chinese man are trying it, just got started, less than 10 days, so, just watch and see.

I keep in touch with him, and I want to try it in 10 days.
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Avatar_f_tn
One Chinese man is on it, one wants to try it in 2 days.
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Avatar_m_tn
very very good, i will also try it as soon as i get und and on combo tx to be supersafe anyway

please ask him to check his hbsag quantity since alinia acts lowering hbsag and achieving seroconversion this way, if he is also hbe positive he also must check hbe quantity of hbe and of course hbvdna quantity.
since asian people have very high virus quantity and much less immune response than caucasinas against hbv in general he needs to check all those parameters to see if it is working and i would suggest to combo with antiviral tenofovir if he doesn't see hbvdna und in 6 months

the best results are on hbe negative with 100% hbvund and with the highest seroconversion rates within 1 year, combo with an antiviral is needed to achieve the highest seroconversion rates especially with hbe pos
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Avatar_m_tn
this is very good because i think trials on hbv will take very long time for the following reasons:
- little money, romark is a little pharma company
- little cost of compound and without patent or with low durability of patent
- a big pharma is selling thier compund in japan for hcv and they probably want to avoid damaging each other markets
- probably replicor will have very good results for seroconversion becoming the main drug and leaving little market to other meds

alinia would be the best med for inactive carriers since they have no other tx available, and since they have low hbsag and alinia works lowering it it would be a very good try
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Avatar_m_tn
if we get to be 3-4 persons with different immune phases (hbe pos, hbe neg, inactive, low hbsag) trying it we can achieve significant data on its potency, i stress again the best candidates are inactive carriers because they have the lowest hbsag quantity and the strongest immune response among hbv cronic (chronic) carriers
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Avatar_f_tn
The guy's medical history:
1. HBe positive for a long time (don't know exact time)  HBV DNA E-8  alt as normal
2.alt ast>2ULN  used Adefovir  then DNA decreased to E-6 (within 2 months), then no decrease
3. then stopped Adefovir, began IFN (1 month), no effect (DNA  E-6)
4.then Lamivudine, effective, 3 months DNA und
5. then stop Lamivudine, then relapsed
6. then changed to enticavir, DNA und within 8 months
7. now, DNA und, but HBe still positive after taking enticavir for 2 years.

So he was really upset, cause his uncle died of liver cancer, so he added alinia to enticavir, just got started it, so, we'll wait and see. He knows all the knowledge about alinia and blood tests, so don't worry about it. He will take blood tests in three months.

The other guy who is going to begin alinia is resistant to all the tx (except tdf, which can't get from Mainland of China), and he can't use IFN either, those put him in a really dangerous situation, so he is on it (I guess he has already received it and began).
He is HBe positive, dna detected, that's all I know.

I am female, 30, HBe positive, DNA E-9, alt 130, ast 85, I want to try alinia first and see how it works after 3 months, if not effective, then add tdf, if effective, then continue until HBsAg negative.
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Avatar_f_tn
According to the first guy, there is very little side effect, he can't feel it after taking it 2 days, though in the beginning, he felt a little diarrhea.
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Avatar_f_tn
The second guy's alt and ast have been unnormal for 6 years, and they are between 1-2 ULN. He doesn't think his body can take IFN, so wants to try alinia first.

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Avatar_f_tn
I wrote a letter to a guy in romark lab, he said,

"We do not have definite plans at this juncture to embark on formal studies of nitazoxanide in the treatment of chronic hepatitis B. However, I am hopeful that sometime later this year we will have the resources to conduct a phase II study using nitazoxanide in the treatment of chronic hepatitis B."

But we can see there are some clinical trials on HCV, flu, so I think we can figure out.

We have to try it ourselves, otherwise, we have to wait at least 3 years
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Avatar_m_tn
of course consider that being hbe pos with such high hbvdna has very little chance on monotx with alinia so if you don't see any result within 3 month combo with tenofovir, especially to avoid hbv to adapt to it, even though resistance should not be possible.

the first guy is resistant to which antiviral?adefovir and lam?he must add tenofovir if resistant to lam because entecavir doesn't help a lot in this case and even if resistant to adefovir tenofovir still works although less effective.

for the guy who can't have tenofovir, he can order tenofovir generic on this website which is very safe, the name is tenvir, and i do suggest to do it:
http://www.aids-drugs-online.com/productindex.php

prescription is required and this is a real pharmacy with address and phone number, this is also good for those who can't afford tenofovir becuase of high cost.

the generic is produced by cipla and has been approved by FDA for selling outside US since there is a viread patent in US, also HR suggested cipla products some years ago for those who can't afford viread, now they are even FDA approved
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Avatar_m_tn
i also suggest if possible less stress working and in general and good diet and good sleeping since the immune system will do the job helped by alinia
also check that your vitamin D is at least 50ng/ml, also check zinc level and antiossidants, becuase they have all been found to be low on most hep B patients, so little sun or D supplements and fruits like nuts can help if they are low after checking by blood test.

soluble fiber has also been linked to strong boost of immune system by increasing il4 concentration (il4 is known to lower hbsag), soluble fiber is in fresh oranges, nuts, apples, strawberries and i don't know the name of this in english bread and pasta with the full wheat
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Avatar_m_tn
in the near future me and my sister will join so we will have also an idea from hbeab pos low hbsag

me: hbe ab positive with hbsag 300S/N, etv tx 4 moths

my sister inactive hbe ab positive carrier with hbsag 323 S/N
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Avatar_m_tn
i ve sent my email by PM
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Avatar_f_tn
the first guy isn't resistant to any antiviral. He switched to enticavir for avoding resistance, you can see that he responded to lam very well, but his doctor stupidly suggested him to stop it after DNA und. So for safety, he turned to enticavir.

I'll buy Vit D and take B-50, I would rather to take them directly than do blood tests, that will cost me much and I can feel that I absolutly lack Vit D.

I am not so cautious as you, I don't think resistance to alinia is a problem. So I'll give it a shot. Plus, I have a brother, he has HBV, HBe +, DNA  E-6, alt ast  normal. If I succeed, that will help him. My father had HBV (from his mother), and he recovered automatically at his 50's (we don't know the exact time, cause he never take annul physical test) .

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Avatar_m_tn
i have been asked where to buy alinia by PM

http://www.merlonipharma.ch/ita_frm_presentazione.htm

this is a real pharmacy to buy online or in the shop, it is in swiss, alinia from romark (not genreics) is about 109euro here
prescription is not required here for alinia since it is a very safe med even for baby 1 yo
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Avatar_m_tn
before starting alinia it is ery important to have quantification of hbsag in iu/ml, today i spoke with a researcher and he said that baseline quantity is the most important and after tx is started recheck at the 6th month, if there is a decline of at least 1 log and it is continuous the tx is working.
the link is easy, hbsag is produced by cccdna in the liver cells so a decline of hbsag is a decline of cccdna.
cccdna is the template of the virus that aloows persistent infection in the liver, getting rid of cccdna is getting rid of hbv.quantification by s/n is not usefull for this
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Avatar_f_tn
"before starting alinia it is ery important to have quantification of hbsag in iu/ml".
I knew that but my doctor refused to prescribe that test for me, he thinks DNA is enough. Given our different situations, I think DNA is enough for me until DNA und, after that, I should keep an eye on quatifications of hbsag and hbeag. I am in America now.

Thanks for your link. That website alinia is more expensive and reliable than generic. If I can find a generic alinia in America, that'll be great. Because I am still a student and pay by myself.

The two guys are keeping an eye on the quatification, so don't worry about it.
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Avatar_f_tn
what's your medical history and family history? Did you and your sister get hbv from your mother or father?

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Avatar_m_tn
your doctor is of course very ignorant on this matter, that is the most important test.......maurizia brunetto is the researcher who studied this (you can google it to find studies), she has also discovered the precore mutant hbeag minus among other discoveries.
again it is very important to do the test before starting so you can see what is lowering hsag and how and if you are gaining immune control, for example the researcher in pisa asked me to check if the labs have my blood samples from 4 months ago before starting etv so that they can check everything starting before tx, but if it is really expensive skip that

that really a pity in USA you don't have control over your health for free, hope obama will change this (i pay zero in my hometown and about 7usd in pisa research center for hbsag and all other tests, everyone should be allowed to make all blood tests dispite money)

please see links below and how hbv works and what is the meaning of cccdna linked to hbsag in a picture i got from a conference, from there you can see that if we have an hbsag decline we know that cccdna is declining and eradication is getting closer.

https://docs.google.com/fileview?id=0B_yFgxI8KNcRMjUwNjI3YjgtOTI0NC00ZmZhLTk1OGEtMGJlODcxMmU0YzEw&hl=en

https://docs.google.com/fileview?id=0B_yFgxI8KNcRM2E0NWE0YjEtOGNlNi00MmQxLWI0OTQtZjUxN2I0MGIzNTVh&hl=en

https://docs.google.com/fileview?id=0B_yFgxI8KNcRYjBkNzQ0ZjctZTAyOC00NjgzLWFiYzAtMmNlODFiNGFjNzFk&hl=en

https://docs.google.com/fileview?id=0B_yFgxI8KNcRYTRhNmJkMWEtN2M1Ni00Y2YxLWJkNDItNzcyNjY4MjUzNzYw&hl=en

hbvdna doesn't tell anything about immune control and eradication of hbv from liver cells, it just says replication of the virus is less but of course having hbvdna und doesn't mean there is no replication, and even worst cccdna replicating in the liver has almost no link with hbvdna.so hbsag, hbvdna, hbe, alt/ast, they all need to be quantified at a specialized lab.
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Avatar_m_tn

our history is hbv spread from birth.
i have a good immune response and had inactive disease most of my life with hbe conversion at 19yo (before 19yo it was hbe neg, hbeab neg, dna neg, normal alt) which leads to complications of cirrhosis/cancer about only 3%.

having a good immune response is linked to having very alt flares like acute hepatitis, 1000 to up for many months with very low hbvdna, this is the immune system attaking the virus.if hbvdna is high during flares it is not immune system but the contrary it is virus attaking the liver.these flares are followed by hbvdna und or very low and alt/ast normal or almost normal.this state is also linked to a low hbsag.

all this means the immune system can see cccdna inside liver cells and kill them, this should lead to eradication of hbv but it is believed that over production of hbsag blocks the immune response and keeps hbv cronic (chronic).

my sister made interferon at about 22yo and made hbeab, this has lead to an inactive hbv until now (she s about 35yo)
hbvdna 300000iu/ml,hbsag 320S/N (about like mine), normal alt according to old range

i started etv because of my age and because i felt it was time to start a tx, but all researchers did not agree with my doctor's choice to start antiviral, since my active immune response they all prefered interferon, but that was not a choice anyway because  have seen interferon on my sister and mother and it wasn't an easy thing on them.

the researcher in pisa said to keep etv anyway and see if my hbsag goes down and clears, they said we must check before tx and then after 6 months so they know if i am in the 5% who clears on etv or get immune control and can stop it and then try interferon.they don't agree on combo because mutation should not be an issue in my situation.i don't agree on interferon and prefer to try alinia but with thier control on hbsag, hbvdna by week and only after etv has safely lower hbsag and hbvdna more than und

anyway everything will be clear after i receive all hbs quantifications by the end of the month/early april
on april i will also know my liver damage because can retry fibroscan after 5 months away from the flares

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Avatar_m_tn
of course all my explanation is not linked to cronic (chronic) hbv with high hbvdna and low alt in the range of 200-300, in this case the immune system cannot see cccdna inside liver cells and eradication is not possible at the moment.

another good suggestion is start tx as i did with high alt flare with low hbvdna if it ever happens because this can lead to eradication or to good response to tx
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Avatar_f_tn
Thanks for your links about hbsag. My doctor didn't agree that test, and I thought it would be very high anyway, because my DNA was almost the upper bound of the test.
And I also read some articles about hbsag, hbeag monitoring the process of responce.

Now my big issue is that my alinia (from http://www.wisemeds.net/buy_online/Nitarid.shtml) seems disappeared, it's been 14 days, I haven't got it. I have to find a new pharmacy which doesn't require a prescription to order.

For me, cost is a big issue, every month, I pay 200$ for insurance, but if I take tenovofir, I have to pay another 200$ for it, and 20% for the tests.

What does "tx" stand for?  Sorry.
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Avatar_m_tn
first alinia results

https://docs.google.com/fileview?id=0B_yFgxI8KNcRYzE5MjkwOTUtMjcyMS00MTYyLTlmODMtYjk1OTcwMGE0ZDc4&hl=en

https://docs.google.com/fileview?id=0B_yFgxI8KNcRYTQwMzRmYjgtZThjYy00ODlhLTg3YjUtMmZmNjA4MWZhZjE0&hl=en
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Avatar_f_tn
Do you mean using hbsag to monitor my responce to alinia other than DNA?

If so, I have to persuade my doctor.

No matter useful or not, I am going to take alinia at least three months if I don't have severe GI side effects.
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Avatar_m_tn
well no you need both, if you have to choose between the two start with hbvdna which is the first to be affected altogether with alt

3 months is ok after this period you might choose if to keep it or combo with antiviral according to the potency of result

in the first studies i have posted on links it required 1 year for seroconversion so even if you see little result keep taking it, in your case hbe ag decline is the parameter that will tell you the time of seroconversion to hbab.

if you see etv and tdf studies they take 24-48weeks on most people just to have hbv und and for others take more than 1 year so alinia looks more potent anyway
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Avatar_m_tn
tx is for therapy

to spend very little you might check hbs/hbe before tx and then only hbvdna/alt, and then recheck them only if you want to start an antiviral

as to tenofovir take the generic and you still save money

my, your insurance is very expensive (damn bastards), if you were a foreign student in italy you would pay very little for health coverange and then all free blood tests....
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Avatar_m_tn
interesting study from 2008

http://www.natap.org/2008/EASL/EASL_85.htm

this is particularly interesting for those with lam or adv resistance who might have no rescue drugs if resistance to both is present
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Avatar_m_tn
is interferon and alinia a good combination?

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Avatar_m_tn
yes but it is on trial for hcv only at the moment, but alinia looks much stronger than interferon on hbv so i would not make this combo with all sides from interferon

combo with tenofovir is much better, alinia has already been tried on lam and adefovir combo leading to hbs seroconversion, since tenofovir and adefovir are similar i would combo with tenofovir

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Avatar_m_tn
so what you'd recommend is AFTER the interferon treatment is to maintain it with alinia?
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Avatar_m_tn
no just check hbsag possibly with iu/ml unit for 5-10 years

use alinia only if it starts to increase or if you see people clearing hbv from alinia from posts here, if hbsag keeps decreasing or steady at very low level you can just monitor and have nothing to worry about
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Avatar_m_tn

very very good news, i think cherrynancy will update you soon

one of the guy got hbvdna decrease in 1 week only, this is very much in the hbv state they have (hbe pos, hbvdna E8/E9), resistant strains
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Avatar_f_tn
His DNA did decrease 1log (from E-8 to E-7), but he isn't resistant to any antiviral drugs.

He used to respond to ADV very well, one month, DNA und and HBe became negative.

But I think we should be cautiously opposite. Although I believe it's safe and effective.

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Avatar_f_tn
Sorry, cautiously optimistic
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Avatar_m_tn

of course this is just a little sign it is effective, we will have to wait 4weeks, 12weeks, 24weeks and more cases.

actually preliminary results on hbe pos are less on monotherapy, on 4 patients, 2 had hbvdna und, 3 lost hbe, 1 loss hbs.
on the contrary on 8 hbe neg monotherapy, 8 got hbvdna und, 2 lost hbs.

there is also 2 comparative cases of hbe pos, one in monotherapy and one in combo with adefovir, both seroconverted to hbeab and hbsab

i have planned to start as well, probably at the end of month when i receive alinia (hope no delivery delays), my case hbe neg combo with etv
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1242578_tn?1268357589
: )
I am the first guy cherrynancy refer to who start to use alinia from 2010-03-01;
thx a lot about the alinia buying information sharing
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Avatar_m_tn

please share sides, me and cherry are trying to understand best high dosage

from hcv combo trial they used a maximum dasage of 2700mg/day and a minimum 500mg/day  (the high dosage is on a slow release tablet), on the 2700mg/day the result is 100% hcv und in a short time and in the 500mg it is about 63% it is a huge difference.

on alinia trials they used 1g,2g and 4g without anysides but unfortunately they made this trial for short time

are you on the etv-alinia combo and hbeab pos?
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1242578_tn?1268357589
yes I am on the etv-alinia combo now;
0.5 mg etv and 500mg*2 alinia everyday;
I have used etv for 2 years, dna is und when on etv for 8 months
the hbe 2009-02 is 169 s/co and
2009-08 is 12 s/co 2010-02-15 is 4.37 s/co;
I start to alinia 500mg*2 from 2010-03-01
Hoping that ,the alinia will cut short my hbv curing lasting time

Chery give me a lot reports about drugs knowleage and alinia, I also think the
best dosage will higher than 500mg*2; but i am not change the dosage

before etv:
At first my alt ast is about 190 120; the hbvdna is 8 log;
then i used adv for 11 month ,the hbvdna is up and down between 5-6 log
then interferon for 5 months, in the middle 3 months ,I also used lam for 3
month; in the second month adding lam,the hbvdna change to und;
when stop the lam for 1 month,the dna increase to 6 log;
and then start to etv ; one month on etv ,the hbvdna change from 6 log to 3
log and this state last 8 month;and then und;
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Avatar_m_tn
you are clearly close to hbe negative, hope alinia will help on this in a couple of months

please let me know of your hbe count at 1 one month of alinia so that we know etv and alinia can work in synergy

i will be starting at the end of the month because after 4 month on etv hbv is not und yet, if i see ther eis synegy from you i will start directly on the 2g daily dose otherwise i will use the 1g daily dose

tdf+ftc should be the best combo because etv has very low rates of seroconversion but at this point we are on etv so we better keep it.
if we see an hbsag decline to 1-2log in the future we might add this combo since we are sure to go hbs neg.

i have also found reports on antivirals active against cccdna:
ftc is the only one with a decline of 50% of cccdna
tenofovir, i haven't found any study on cccdna
etv, they say it doesn't eradicate cccdna but they didn't say if it is active or not
all other antivirals have no strong influence on cccdna

at this point we should find something on tenofovir and etv related to cccdna, next week i will talk to one close to pisa researchers and i will try to ask him, when i asked about tdf+etv combo he said tdf+ftc is much better
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Avatar_m_tn
1-2 log i mean hbsag must be from 10 to 100iu/ml, when so low seroconversion is sure
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Avatar_m_tn

pls do not forget to check vit D level (it is an hormone actually not a vitamin,) 25 (oh) level to be at least 50ng/ml (best 50-80), if lower take little sun or supplments

by now it is widely accepted it boots immune system, and hcv and hiv are using supplements already, at this point it is no use to wait for trial results on hbv
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Avatar_m_tn

well it is different for anybody but it will be wihin one year for sure, on monotherapy it took from as little as 12 weeks to 1 year,
since their hbe was very high and yours is very low thanks to etv i would say within 6 months, it might took long only if synergy with etv fails
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Avatar_m_tn

found a study with high dosage, started at 1g/day and if needed moved at 2g/day or 4g/day.
they use is reported as indefinitely when people got relapse when stopping therapy.the study is on Cryptosporidial Diarrhea (alinia is active against many viruses and parasites, flu, hcv and hbv are among the many ones)
http://www.sfaf.org/treatment/beta/b36/b36nitazox.html

so if needed we can move to higher doses quite safely as they are doing on hcv trial (the most active dose was 2700mg/day) taking it with food which henance absorption.
So we can take 500mg every 12hr for the 1g a day, every 6hr for the 2g a day and so on.the maximum dose tried has been 4g/day but i would stop at the hcv trial maximum dose.
then we lower only if we get the mild sides of this med which are reported in very low percentage and very mild (abdominal pain and mild diarrhea).

hcv trial link page 28 results on 2700mg/day slow release tablet:
http://www.ihlpress.com/pdf%20files/hepdart09_presentations/symposium/6_Keeffe_NTZ.Update%20on%20Treatment%20of%20HCV.Hep%20Dart.20%20min.12-09.pdf
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Avatar_m_tn
another article about doses, doses up to 4g/day have been found safe but on these high doses there are more episodes of sides like abdominal pain or diarrea (diarrhea) but sides have not been so severe to lead to discontinuation of drug.
http://www.expert-reviews.com/doi/pdf/10.1586/14787210.2.1.43
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Avatar_m_tn

started alinia yesterday on 500mg twice per day with food, no sides until now, combo with entecavir and tenofovir has been suggested by manufacturer.

i am hbe neg, f4 liver damage on entecavir, hbvdna 200iu/ml, alt 40, hbsag 300s/n in february (hbsag test taken on march 26th will be ready soon).

i am also increasing my vitamin D level will update as soon as test is ready and taking selenium supplements as liver cancer prevention

i will update all my data at 4weeks, 8 weeks, 12 weeks
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751470_tn?1268502109
I was wondering about your selenium supplements: have you done tests that show that you have selenium deficiency? I ask because overdosing on selenium has a huge list of things that can go wrong.
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Avatar_m_tn

no i just take supplments and then check that blood level is in range, i know selenium is toxic if that is out of range

there is a research on selenium supplements made on a huge number of people for 4-5years at 0.2mg per day and it lowered liver cancer rates when they stopped liver cancer rate returned to normal.

0.2mg is very little so you don't get out of range but in anycase i check for everything by blood tests otherwise there is no points in these supplementation.
all the supplments i take are extracted from natural sources or diet (very expensive...) and this is very important because synthetic supplements are not proven to make any good, i do not suggest supplements from artificial sources.

vitamin D is now from the sun since in my area we have very strong sun from mid april to october (15min sun gets more than needed vitamin D)
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Avatar_m_tn

we are still on first weeks of therapy but we have had some little results already, although i would wait for 12-24weeks to say.
only one hbe pos have had a big result already, seroconverted to hbe neg and hbeab pos in 3 weeks

alinia works by pkr and eiF2 alpha phosphorylation which blocks cell viral antigens production hbsag and hbeag, of course we don't know the potency of this action, the best results are on time release tablets at 2700mg per day which avoid side at this high dosage but these are available only on hcv trial and not marketed yet.

i have tried 1500mg per day on normal alinia tablet for one week but lowered to normal dosage 1000mg per day since i felt some change on stools even if had no diarrhea or other sides.manufaturer told us that over 1000mg per day there is diarrhea possibility increased

alinia can also kill our intestinal bacteria like antibiotics and cause diarrhea so it is better to stay on normal dosage 1000mg/day and use probiotics
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Avatar_m_tn

i am using generic from lupin ltd (this producer has been expected by fda and safe).I have used same website as other members did from hcv community.

alinia from romark takes too long to order, it is the same thing at much lower price
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1191262_tn?1366766621
Hello Stefano

I just read one of your very interesting posts and I knew that there is a cheaper medication substitute to Tenofovir called Tenvir. Do you know if it is as efficient?

Thanks.
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1191262_tn?1366766621
does anyone know if Alinia is prohibited during pregnancy? Thanks.
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Avatar_m_tn

tenvir is made by cipla and is fda approved (also suggested by HR before FDA approval on 2006 or 2007), you can find it at this safe canadian pharmacies

http://www.aids-drugs-online.com/productindex.php

or also ask for it at the alinia pharmacy

http://www.progressiverx.com/store/

both pharmacies require prescription and both are verified by pharmacy checker.com and have canadian addresses and phone number
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Avatar_m_tn
i wouldn't use it during pregnancy even if this drug is so safe that it can be used on 1yo babies

Pregnancy: Teratogenic Effects

Pregnancy Category B: Reproduction studies have been performed at doses up to 3200 mg/kg/day in rats (approximately 26 times the clinical adult dose adjusted for body surface area) and 100 mg/kg/day in rabbits (approximately 2 times the clinical adult dose adjusted for surface area) and have revealed no evidence of impaired fertility or harm to the fetus due to nitazoxanide. There are, however, no adequate and well-controlled studies in pregnant women.
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Avatar_m_tn

forgot to mention tenvir and tenofovir have exactly the same ingredient but if you have to choose between alinia and tenofovir during pregnancy i would go for alinia.

they are both category B but tenofovir can have very heavy sides although rare, alinia's most heavy side is diarrhea which is nothing compared to tenofovir sides, plus tenofovir cannot be used on babie while alinia has been made especially as a cure for babies diarrhea and diarrhea on aids patients (they just noticed alinia wroks on hcv and hbv from hiv coinfected with hbv-hcv)
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Very interesting. My doctor said it is ok to use Tenofovir during pregnancy. Also, there is an AntiRetroviral Pregnancy international Registry to report any birth defects or anomalies.  There are no anomalies. Many HIV and HBV carriers reported pregnancy during tx with Tenof but no higher (than normal) birth defects have been recorded.Tenof is also classified Category B.
See this report:

http://www.apregistry.com/abstracts/olmscheid.pdf
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interesting report of a coinfected hcv-hbv who was on trial for hcv for 24 weeks, in this trial there were also patients with mildly decompensated cirrhosis that proved alinia to be safe even in this catergory.
the coinfected had hbvdna at about 1000copies/ml which got und at first visit at 4 weeks (so it could have been und even before), too bad the study was on hcv so there is no hbe and hbs antigen quantification.
alinia monotherapy is very weak on hcv and results were very little, on the contrary on hbv even monotherapy looks very potent and safe.

http://www.medscape.com/viewarticle/580934_3
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just to have an idea that guy made more than 3 logs to get und and it is possible he did it in less than 4 weeks because they didn't check before, he also had hcv which is not a plus......

entecavir and tenofovir which are the most potent drugs have about 2,5-2,8logs at 4 weeks and at best....
http://www.meds.com/hepatitis/casebased/images/slides/l_01.gif
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and forgot alinia has no resistance and is active against resistant strains, definitely this makes it the most potent drug for hbv, on the contrary:

etv is not safe with lam resistance because you get etv resistance very fast and anyway etv has 1,2% resistance even naive
tdf is not active or only partialy active with adefovir resistance
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You are the fourth guy to take alinia, I am the third guy, and there is going to be 5th guy soon. Wish us luck
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we also have the sixth person, my sister will start alinia monotherapy today.
this way we have all types of examples since aisan and caucasians have different immune system response, different hbvdna values and in general different genotypes (asians respond less to therapies and caucasians easier):

me and my sister caucasians, genotypes A or D which usually have lower hbsag, lower hbvdna and hbe negative/hbeab positive.i am combo with etv and my sister monotherapy.

the other patients are asians with very high hbvdna and hbsag and hbe positive, in this case the response will be probably slower and will need combo with antivirals to lower hbvdna faster.
some are already combo with etv and other monotherapy, the main step of asians is to  seroconvert to hbe neg and hbeab pos, this way hbsag and hbvdna will get very low and hbsag seroconversion can be theorically achieved
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Hi Stefano

I want to stop tenof for cost reasons and because my dr never mentioned it was a contract for life! what is the best strategy considering Alinia?
How easily did you get Alinia prescribed off-label? What if I use it in Combo with tenof for 1 year and then stop?
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you can start combo with tenofovir or tenvir and then after you are hbvdna und and alt normal you must get hbsag quantification, if you have a decline of hbsag until values lower than 200 s/n or lower than 1000iu/ml it means that you have immune control, if you see a continuous decline stop only after hbsab are formed and keep alinia for another 5-6months

if you see that hbsag is steady and doesn't decrease you can combo for one year and then use only alinia.alinia works on immune system so theoretically after you reach a low hbsag you should be able to safely stop it but we are waiting for an answer from manufacturer about this

chances of hbsag seroconversion on combo with antiviral should be high especially if you are hbe neg and hbsag quantity low


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what is your hbsag quantity and hbe status?
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- HbeAg Negative, HbeAB positive
- I asked dr about calculating hbsag quantity, he said we do not do this in Canada!!
- Virus is undetectable after 3 months of Tenof (initially 59000UI/ml.
- ALT has been around 30 since many years, never more than that but according to Dr, it is still high as the new upper limit is 19 for women. Labs display wrong normal ranges (up to 40), I have been ALT around19 when I was maybe 25 or 26 but I am 37 now.
- Fibrosis stage F1.  Thanks.
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hbsag quantity is very important, without it there is no way to see results after you are und, you need to find a good lab to make it, it is impossible you don't have it in canada

in italy is everywhere, at the moment it is essential to see if interferon works so even in canada they must have it where they do interferon therapy.
the kits for hbsag quantification are made by abbott in US, i have seen people from third world countries with this test so you doctor is probably not aware of specialized labs in canada
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the second guy's DNA has decreased 1 log again, very good, i don't remember if that's second or third week

as to me i have checked only alt at second week and they are the same as before, still at 45, they get normal when hbvdna gets und, my hbvdna was about 200iu/ml ( 1160copies/ml) early march i hope to find it und in 4 weeks alinia therapy

etv has had an homogeneous hbvdna decrease at 0,5log per month from 15 dec 2009 so it will be easy to see if alinia will boost response (if i kept etv monotherapy hbvdna und was for july or august).
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The second guy has been on alinia for more than one month. It seems the 5th week.
He is very sensitive to any drug, really a good tester.
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On behalf of the second guy, thanks for your kind donation.

Hope all our participants have a good end.
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cherrynancy found the data about 2 cases, one monotherapy and one combo with adv failure (patient also had lam failure).

one hbeag pos with 5log iu/ml hbvdna and one with very high viral load 6log iu/ml who had no results on lam or adv (the article doesn't say about resistance to lam or adv), both seroconverted to hbsab antibody in 2 years.
i hope we can also find all data about the 8 hbeag negative monotherapy cases which gave better results compared to the hbe positive cases
also data about the 4 hbe pos cases on monotherpy.


(case#2):
60yo, lam and adv no response, HBeAg-positive
NTZ 1g/day+adv, when ntz was added to adv hbvdna 8,380,000 IU/mL and ALT was 82 IU/L.adv+ntz for 2 years
results:
after 1 year HBV DNA 71000iu/ml, ALT 61iu/l
after 2 years HBV DNA  undetectable, ALT was 19 IU/L, and HBeAg and HBsAg were negative.

Case #1
17yo, HbeAg-positive, HBV DNA 310,000 copies/mL, ALT 25 IU/mL, grade
3/18 inflammation and stage 1/6 fibrosis on biopsy.
NTZ 1g/day through month 5, was off treatment for 3 months secondary to
elevated ALT levels, and then was treated with 500 mg/d through month
24.
Results:
undetectable HBV DNA at month 13, negative HBeAg at month 12, and negative HBsAg at month 21.


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i have found another case report on lam resistant strain and high viral load 6log copies.only 4 weeks to get hbeab positive and 8 weeks for hbvdna und and normal alt, discontinuation after only 24 weeks and follow up for other 24 weeks:

T1852. Nitazoxanide in Treating Chronic Hepatitis B: In vitro Activity and a Clinical Case Report

J. Rossignol; B. E. Korba; S. M. Kabil

Nitazoxanide is an anti-infective drug from a new class called the thiazolides. It is marketed in the United States for treating gastroenteritis caused by Cryptosporidium parvum and Giardia lamblia and is in late stages of development for treating Clostridium difficile-associated disease. Based on earlier screening suggesting antiviral properties of the thiazolides, we tested nitazoxanide and its active circulating metabolite, tizoxanide, against hepatitis B virus in cell cultures. We also report the results of a patient with chronic hepatitis B treated with nitazoxanide after previously failing a long course of lamivudine.



Methods.

Nitazoxanide, tizoxanide and lamivudine were evaluated for activity against hepatitis B virus in 2.2.15 cell cultures. A 48 year-old Egyptian male with chronic hepatitis B refractory to lamivudine was treated with nitazoxanide. He was HBeAg-positive before treatment with a viral load of 5,250,000 copies per mm3 and ALT of 53. Nitazoxanide was administered by oral route, 500 mg twice daily with food for 24 weeks, and the patient was evaluated every 4 weeks during treatment. Evaluations included physical examination, laboratory safety tests and RT PCR for quantitation of HBV DNA.

Results.

Further in vitro experiments showed that nitazoxanide suppressed HBeAg and HBsAg suggesting a mechanism of action that differs from other antiviral drugs. The patient treated with nitazoxanide was HBeAb-positive after 4 weeks of treatment with a 2 log10 reduction of viral load (51,000 copies per mm3 down from 5,250,000 at baseline) and a slight increase in ALT (60 up from 53 at baseline). At weeks 8, 12, 16, 20 and 24, he was HBeAg-negative with undetectable serum HBV DNA and normal ALT. No significant adverse events have been reported. The patient discontinued treatment after 24 weeks and is being followed up for 24 weeks to evaluate the duration of response.

Conclusions.

Our results suggest that nitazoxanide is effective in treating chronic hepatitis B with a mechanism of action that differs from traditional antiviral drugs. A double-blind placebo-controlled study is being conducted to evaluate the role of nitazoxanide in treating patients with chronic hepatitis B.
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Wow, That`s very encouraging. Thanks Stefano for the information. I wish they can do more formal research on Alinia for HBV so that we can benefit from it easily.
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Thanks  for the information.
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i bought article with nitazoxanide (alinia) hbv cases and i found some more data than article found free online

on the 4 hbe pos, it took 3 month only for seroconvertion to hbe neg although only 2 got hbvdna negative by 1 year and only 1 hbsag negative

https://docs.google.com/fileview?id=0B_yFgxI8KNcRNzhhYjcwZTctMGJmOC00MjQ4LWI4ODAtOTlkM2EzNjdlMGVh&hl=en

next week i will pubblish the 5th weeks etv+ntz hbsag results

as to hbvdna it felt to 51iu/ml from 200iu/ml on 11 march (started ntz 28 march), i hope it gets und within 8 weeks combo
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Stefano, Thank you very much for the article!
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Tnx stefano. Keep the helpful infos going.
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Tnx stefano. Keep the helpful infos going.
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http://www.thefreelibrary.com/Romark+Announces+Final+Data+From+Clinical+Trial+of+Nitazoxanide+in...-a0225529080
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update on alinia results but keep in mind there are many things that can affect how results are fast as genotype, mutations, resistance,ethnicity:

genotype D caucasian, hbe negative, hbeab positive
about 3 weeks from hbvdna 173000iu/ml to less than 300iu/ml

we will make another test this week in a good lab with sensitivity to 0-5iu/ml because this one has hbvdna test useless they count till 300iu/ml only

as to hbsag quantity t is available at research centers so we will make it when she can move to other areas of the country, she started from hbsag 335 s/n
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i only wish i had started with alinia instead of etv.

this is very good for a etv/alinia comparison since me and my sister have same baseline values:
same genotype D and same hbe negative hbeab postive, same hbvdna load at 5 logs iu/ml, same hbsag quantity at 2 log s/n
we can have only different muations since she made hbeab positive by interferon so she can have wild type, i have precore e-minus hbv

me: etv took me 4 months to get to less than 300iu/ml
my sister: alinia took about 3 weeks to get to less than 300iu/ml
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Wow, that's great news. Can't wait to see seroconversion results!
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Thanks  for the information,  that's very good news.
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I am curious about something...What would happen if you stop Alinia right now, would you never (theoratically) have a flare up in your viral load?

Just a theoratical question as I believe Alinia is known for not causing any flare ups when you stop using it...Do you have to keep it for at least 6 to 12 months?

Thanks and all the best.
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i cannot stop i have cirrohosis, i'd keep it even if i make hbsab for at least one year, just for mega security
i am just happy i started ntz as i received it because today i recevied hbv genome and i have a natural mutation with reduced response to lam and adv (it is not lam/adv resistance mutation), ntz puts me in a safer condition anyway since is active against hbv mutants

the only way to know what happens and how slow is the relapse is hbsag or cccdna quantity, if you reach a level of 500iu/ml there is immune control so relapse should be very slow

in 1-2 weeks we should have data from another guy on hbe negative hbv, if he is already negative we can say that ntz is very active and fast on hbe negative and viral loads lower than 5logs iu/ml (this also reflects first clinical data)
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i am sooooooooooooo happy, the doctor just emailed me hbsag quantity and that's incredible:

90 feb  hbsag = 301s/n, this should have been equal to 301iu/ml or etv made an increse or this value is not reliable as quantitative.hbvdna 464iu/ml

26 march hbsag = *4873,8* IU/ml (abbott quantitative test), hbvdna 135iu/ml

30 april hbsag = 2292,29 iu/ml  hbvdna 51 iu/ml

that's a huge drop for hbsag in one month only, doctor said to chek again at end of may because probably hbsag is going down. i sterted ntz on 28th of march
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Stefano, that's really incredible! Let's hope to success!
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That is really a huge drop in a short period of time. Congrat and do keep the fight going until Hbsag-ve
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Great! Good for you! Really impressive results.
I know you can not stop I was just wondering about the risk of flare ups with Alinia.

Thanks again Stefano. All the best.
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How do u mean flare up with Alinia ?
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she means if she can stop alinia without hbsab seroconversion and if alt or hbvdna relapse with high flare

it all depends on immune response and the more cccdna and hbsag the more immune response is suppressed.Since alinia is active lowering hbsag and cccdna the relapse should be very low or no relapse

in your case you have nothing to worry since you have started with inactive hbv with very low hbvdna so if you stop before hbs seroconversion the worst you can get is go back to pretreatment situation
too bad you cannot check hbsag, you are the one with the lowest value baseline since you were inactive so you should have the fastest results in decline in theory
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Hi Stefano

The stupid labs here do only a qualitative verification, they just tell you if it is HBsAg is positive or negative. I just met yesterday with the other doctor. She is basically saying that guidelines changes since few years and that many people in the mediterranean area have HbeAg Neg because the Virus has mutate and doesn'T express Hbe replication properly...So she concluded, the decision of starting the treatment was good and I asked her if I could stop if because I may not be able to afford the cost for TNF, she said you can, the worst case scenario would be that you would be back to the initial state which is still good (F1 and not so high viral load and ALT) and she was very reassuring regarding there would be new medications, etc. I really like her, she seems very human compared to my 1st dr.
I also asked her about Alinia, she said this may cause tolerance issues, she was googling it and she got medhelp forums hehehe. She added that she can not prescribe something not yet approved by Canada and FDA for HepB and they seem to be in phase 2 studies for Alinia Hep B.
Yeah, I don't know what to do to have an idea on my HBsAg. I may try to ask a dr in another province and see what he says.
I am very happy for you Stefano. I wish the drop will continue until zero. I will pray for you.
Enolia.
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thank you, in your case i'd start combo instead of stopping complitely if your hbe is negative, but if you are still hbe positive results are not so fast

alinia has no tollerance issues and no mutations so it is safer than nucs, i wouldn't have been so mad to check carefully what is known about the drug and start something dangerous on cirrhosis but your doc is abolutely right prescribing off label can be legally dangerous for a doctor.if you are not in a rush just follow our trial and see results

hbe negative is good wehter wild type or precore.the mutation is due to immune system pressure the virus stops hbe production so it can keep replicating although at low level.
precore is found everywhere but in genotype D and mediterranean area is the predominant form of hbv (maybe the genotype or maybe immune strength)

precore is not the only mutation, if you have seen my other posts i have about 5 mutations, these mutations can make hbv much weaker since it did mutations in order to keep replication but they can also be dangerous in the case the mutation makes resistance to nucs so it is very very important to check the mutations before starting nucs
for example i have a secondary natural mutation which makes lam and adv less potent andlead easily to resistance, if i had started those without a genome check in previous years now i would have no therapy since lam and adv resistance mutations make all drug useless

i bet you didn't have hbv genome check before starting tdf, although rare these resistance mutations are found in as high as 10% naive patients
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as to hbsag i would check carefully at research center university or hospitals, where they make research they must have it, anyway don't expect to see big drops in short time tenofovir and entecavir have about 1 log decline per year on 17% patients only and on hbe positive only

actually hbsag is essential on interferon which can have 1-3 logs drops hbsag and alinia, less usefull on nucs, probably us and canada use nucs so they don't use hbsag quantity
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anyway on tdf you are safe since there are no resistance muattions detected until now only reduced response on some mutations that you cannot have since hbv und already

i do suggest hbv genome test to everyone before starting nucs therapy where available:
in my case the rtQ215S mutation present as >20% hbv population, happened naive and not very rare on genotype D, have lowered response on lam and adv although not resistance, theoretically lowered response <10 folds on tdf but this lowered response have never been confirmed in vivo, so etv was the best nuc choice since rtQ215S doesn,'t reduce or lead to any resistance on etv  
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let's hope for hbsag drop to keep like this, doctor said to check every month and if it reaches 1 log decline it will probably keep going down to seroconversion although there is no 100% prediction until hbsag reaches 10iu/ml and no time prediction to seroconversion

theoretically the big drop should keep going on until and after hbvdna negative so that's good drop started before hbvdna und, on the other hand flares less than 1 log can happen so let's hope for the best, i will recheck at 12 weeks therapy since i already made 8 week test for hbvdna, alt, genome mutations
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Hi Stefano,

No I never did a genome checkup before starting on TDF and although I am Hbe Neg since a long time I don't know which genotype I am. I am also from the mediterranean area so big chances are that I would be genotype D as it is predominating in all the mediterranean.
I would definitely go with a combo tdf + alinia after baby will be born. Right now, I just do 3 months checkups on dna and ALT. I guess you are right, in north America, they seem to prefer using Nucs so they don't prescribe any genome checkups or HBsAg quantitative checkups. That is really bad.
Thanks for all the info. I will spend sometime reading your posts and trying to understand all of them and do my research :)
Thanks.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1698511/

very good explanaton of pkr and eIF-2α Phosphorylation

ntz induces pkr and eIF-2α Phosphorylation
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alinia grup update:

me, caucasian:
8 weeks alinia (ntz) combo with entecavir, hbvdna und (it is the 8th week of ntz and the 6th month of etv), about one week later alt are getting to high normal range 37 and decreasing
hbsag update on the 12th week (10-14th june)

2nd guy in the gruop, asian:
13th week ntz mono, hbsag drop from 16000iu/ml to 14000iu/ml, hbsab antibody from o to 0.4iu/ml
hbe seroconversion at 3rd week - hbe negative and hbeab positive
hbvdna from 2.70E7 copies/ml to 1.9E6 copies/ml
alt from 52 to 77
i strongly suggested to start tnf combo because ntz is not potent enough on high hbvdna loads, still on mono ntz

5th guy in the group, asian:
LAM, TNF, NTZ - adv resistance-hbe positive (ntz will work on lam and adv resistance)
7th week
hbvdna from 1.4E3 to <1000copies/ml
unfortunately tests are old so we don't know hbvdna quantity less than 1000
also hbsag and hbeag are made with s/n and s/co unit so are not reliable for quantification, hope this guy will be able to make tests in iu/ml for hbvdna-hbsag-hbeag

the guy is not very happy but with adv resistance getting hbvdna to und is very very important



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Many thanks for the update and for being the pioneers.
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Stefano...thanks for posting update of the Alinia group. However the result is not looking that bad and congrats you now got to UND with ur DNA result and for the second guy with mono, was he hbeag positive and hbeab negative before ntz ? Didnt really get that and its like ntz works faster or better on low DNA and hbeab positive, am right ? ALT going up while on ntz guess is a concern or not ? when should it be expected to normalized ?
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was he hbeag positive and hbeab negative before ntz? yes

ntz works faster or better on low DNA and hbeab positive, am right ?
absolutely yes.it has different cellular pathways to low antigens and to low hbvdna, but it works similar to normal immune system which lowers hbvdna by lowering antigens.hbvdna is low positive often even after acute hbv recovery and hbsab positive

ALT going up while on ntz guess is a concern or not ?
no it is a goos sign but hbvdna must be lowering
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This is my blood test after three month alinia combo etv:
I start alinia from 2010-03-01 ,the dosage is 500mg * 2
The blood sample date is today,2010-06-07,

Hbsag 4482 iu/ml two month ago is 4642 iu/ml
Hbeag 3.29 s/co  1.0 is und , tow months ago is 1.53 s/co ,three months ago is 1.68 s/co

others like DNA and alt/ast ,I have not test this time
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Something wrong in pre post, update it

*******************************
Hbsag 4482 iu/ml two month ago is 4642 iu/ml
Hbeag 3.29 s/co  1.0 is und , tow months ago is 1.53 s/co ,three months ago is 1.68 s/co
********************************

change to this:

Hbsag 4482 iu/ml two months ago is 4642 iu/ml
Hbeag 3.29 s/co  1.0 is und two months ago is 1.53 s/co ,three months ago is 1.68 s/co
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My post was changed automately ,  because of the Chrome brower?
so curious. This time I used IE8 instead of Chrome to post it,If this time faild ,I don't konw how to post the right data

*******************************
Hbsag 4482 iu/ml two month ago is 4642 iu/ml
Hbeag 3.29 s/co  1.0 is und , tow months ago is 1.53 s/co ,three months ago is 1.68 s/co
********************************

change to this:

Hbsag 4482 iu/ml two months ago is 4642 iu/ml
Hbeag 3.29 s/co  1.0 is und two months ago is 1.53 s/co ,three months ago is 1.68 s/co

My post was changed automately ,  because of the Chrome brower?
so curious
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*******************************
Hbsag 4482 iu/ml two month ago is 4642 iu/ml
Hbeag 3.29 s/co  1.0 is und , tow months ago is 1.53 s/co ,three months ago is 1.68 s/co
********************************

change to this:

Hbsag 4482 iu/ml two months ago is 4642 iu/ml
Hbeag 3.29 s/co less than 1.0 is und  two months ago is 3.84 s/co ,three months ago is 4.73 s/co
Hbeab  1.68 s/co greater than 1.0 is und two months ago is 1.53 s/co ,three months ago is 1.68 s/co

I
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so we all know its working with ntz even at a good rate since we have such result of 12 wks. 48weeks and above should look even much better..good work guys
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yes, also consider than i have staggered 500mg X 3 X day april (one week 1g the other 1,5g)
may 500mg X 2 X day since 23rd when i recevied the hbsag drop so i switched back to 1,5g (3pills)

now i am continuously on 500mg X 3X day (3 pills per day), so i suggest to everybody who is having response to use 3 pills per day not two

alinia affects bacteria in the stomach like antibiotic so it is better to take antibiotic resistant bacteria (i use 6caps of enterogermina from sanofi aventis, maybe different name in other countries, http://www.galenotech.org/erborist/Enterogermina.pdf), this prevents diarrea (diarrhea) sides and i feel i might even switch to 4 pills per day but being on cirrhosis i prefer to keep the lower dosage.

normal dosage 1000mg per day with food, best results dosage without diarrea (diarrhea) 1500mg per day, best results dosage but with diarrea (diarrhea) 2700mg
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i am happy about your results, we have seen that ntz is very slow on hbe positive but still decreasing hbsag, i guess when you get hbe negative you should go very fast on hbsag drop

on the hbe positive trials the seroconversion hbe negative happened after 3 months for all patients so i do hope you are close to it, if you can take probiotics and had no diarrea (diarrhea) till now, try the 3 pills per day

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yes,the Hbsag slowly decreasing rate make me  itched to try 3pills per day now
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today i emailed to the second guy in the group and he updated me about his situation:

his hbsab antibody has become positive at 4.03 so it is definitely positive and hbsag droped from 16000 to 14000iu/ml but he used ntz 3pills per day for two weeks and 4 pills per day for two weeks, on the two pills per day he had no effect on hbsag on previous month but had hbe seroconversion and 2 log drop of hbvdna

since i had a big drop of hbsag on the 3 pills per day dose too i think that this is the best dose for a big drop of hbsag not the two pills per day

i will try to increase to 4 pills per day too since i am perfectly ok on the 3 pills per day dose and will see hbsag in 2 weeks and hbsab antibody which is always been 0.00mUI/ml for me
i will also check if alt gets lower than 20 by ntz 4 pills per day which is 2000mg per day

by the way i was also reading yesterday the trials of ntz on hiv patients with a parassite which made diarrea (diarrhea) (a trial held in a new york hospital for fda approval of ntz many years ago) and the doctor said that he prefered the 2000mg dose instead of the 1000mg because results were better and there were no sides

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i have asked the guy his lab report to check clearly the sensitivity of the test and if it is low level antibody 100% or just low sensibility test and interference
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Really encouraging news!
Wish you a good result in the coming test!

BTW, there are probably 2~3 guys starting to use NTZ in China. We are looking forward to the latest news.
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these are his tests, considering he is asian, started hbe positive high and hbvdna still 6log i think this result suggests to try this dose on hbe negative and hbvdna und: HBsAb    4.03    mIU/mL    0-10
this is not a protective antibody because less than 10 is useless but still a low positive according to me

about his situation i think he must get und by tenofovir otherwise the process will be very slow or steady on hbe and hbeab and especially hbvdna

2010-3-27:

HBsAg    16000  IU/mL      0-0.05
HBsAb    0         mIU/mL    0-10
HBeAg   0.58     s/co         0-1
HBeAb   0.03     s/co         1-999    
HBcAb   7.17     s/co          0-1

2010-6-5:

HBsAg    14000  IU/mL      0-0.05
HBsAb    4.03    mIU/mL    0-10
HBeAg    0.73     s/co        0-1
HBeAb    0.05     s/co        1-999    
HBcAb    8.49     s/co         0-1
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Interesting, at least his HBsAb went up very quickly! I am discouraged to see my HBsAb at 0.00 everytime........Alinia seems to trigger HBsAb which is very very good.
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http://journals.lww.com/eurojgh/Abstract/2007/10000/Sustained_HCV_RNA_response_and_hepatitis_Bs.13.aspx

i found this article on the meaning of hbsab very low and of course the situation is very different, hbvdna und, hbe negative and hcv coinfection but i think this shows that a very low hbsab titer can have a meaning in some cases and can go up (at least much better 4 than 0.00mIU/ml)
anyway let's wait to see if anything happens on the hbe complitely negative and high hbeab, hbvdna und on this 2g daily dose
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please tell them to report or you report their improvements especially if hbe negative so we can all have benefit and more data
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The new guy is now hbeab positive (seroconventioned with ENT, and continuing with Adf), DNA und, alt normal.
Cherrynancy and dddpppbox know him probably in that they are publishing news in the same chinese hbv forum.
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it just came up to my mind that replicor compond have a similar way of action, it first makes hbsab appear and then makes reduction of hbsag

all drugs and natural recovery work different, they all make the antigens negative first and after you see the antibodies to appear.
i do hope that 2g dose makes hbsab>10mIU/ml to the second guy and other people so that we can assume that ntz and replicor rep9 AC have similar way of action complitely different from other drugs and natural recovery.

http://www.replicor.com/debut_anglais2.htm

Interim data on the efficacy of the amphipathic DNA polymer REP 9AC in the treatment of chronic hepatitis B in 6 patients will be presented. Interim results will show that REP 9AC treatment rapidly leads to the detection of anti-HBsAg antibodies and the reduction and or clearance of serum HBsAg within the first 12 weeks of treatment in human patients. These findings are associated with substantial and sustained reductions in serum HBV titers which may be due to an improved immune response to the infection. This is exemplified by the first patient who had 2,000,000 copies of the virus / ml in his blood, was then treated for a total of 23 weeks and who has so far maintained a sustained virologic response (<70 copies of the virus / ml in his blood) for a period of 6 months off treatment.
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for those who have no idea of importance of hbsag reductions during therapy i have posted 2 graphics from locarnini presentation that shows hbsag/cccdna correlation and hbsag/intraepatic hbvdna and serum hbvdna

https://docs.google.com/leaf?id=0B_yFgxI8KNcRZjQyMWViNzctOTk5MC00YWY3LTlmYWQtYzg0YTU2N2I3NjFj&hl=en

https://docs.google.com/leaf?id=0B_yFgxI8KNcRNWE1YWY1MGMtOWJiMS00MDQ5LTk1MDctNTg2NGY4MmMyYTc0&hl=en&authkey=undefined

hbsag is also rappresentative of immune system suppression and main tool for hbv persistance

i've also found a wonderful scientific search engine
http://search.vadlo.com/b/q?&sn=158621799&k=Cccdna+Precore+PPT&rel=2&srt=0&rll=0

tons of very interesting stuff on hbv
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The NTZ seems not very sensitive to me...
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not only you all hbe positive are less sensitive and since you are already und you see result only on antigens but when hbe become negative you will go faster

hbe positive means having much higer cccdna and mcuh immune system suppression from both hbe and hbsag

anyway cherrynancy contacted ntz producers and those who are making the hcv trials and ntz is very safe at 2g, there is only some people who has diarrea (diarrhea) on this dosage but for those without any diarrea (diarrhea) this dosage is much better

try one month of 2g daily and then check results, use also probiotics to prevent diaarea although who tried the 2g had no diarrea (diarrhea) even without probiotics
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aldo consider my hbsag drop was on 1,5g so maybe 1g is not enough
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http://archive.mail-list.com/hbv_research/message/20100612.112708.d73f8fa0.en.html

this might be the reason you are less responsive, it is much better to start ntz before hbvdna complitely und

i already though this in your case since they have seen less response of interferon with hbvdna und in lam combo and probably happens the same with ntz, let's see what happens with the higher dose
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thanks for your info and reply
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i have also found info about hbc-ab Igm quantity which is a better tool than hbvdna to monitor therapy when hbvdna is und in hbe negative, this is data from research center where they follow me so i guess most doctors and labs are not aware of it

it looks like cut-off value is 0.2s/co and the lower the better, my hbcab Igm is end of march 0.17 and 0.15 end of may.it probably increases when there is a reactivation of hbv
of course these are low negative values for the test and only quantification matters, when the values are higher than 0.2s/co there might be a reactivation of virus replication

http://www.medical.siemens.com/siemens/en_GLOBAL/gg_diag_FBAs/files/tech-reports/id/ZB233-C.pdf

https://docs.google.com/fileview?id=0B_yFgxI8KNcRNzY3NGJhZGItN2Y2Ny00MTljLTg5OWItYmFlMWQ4ZWY4ZjNk&hl=en


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as to hbe positive the best time to start a therapy is when anti-hbc Igm is hiher than 0.2s/co if possible, this is when there is a alt flare with low hbvdna.seroconversion rates are higher in this case
so it looks like antihbc is a signal of immune system activation and lower than 0.2s/co signal of immune control of replication
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I have bought Alinia.if I take 1.5g per day,should I take 500mg during breakfast,lunch and supper? Any suggestion?
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My HBVDNA 3.14e+03 ,hbeag negative, hbsag 8110COI,alt normal.hope Alinia is effective to me.
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yes i think this is the best becasue food improve absorption by 50%, alinia stays in the blood about 7hours with pick at 4-5hrs

if you can tollerate the 2g dose you might take another one before going to bed or join 2 pills at breakfast and 2 at dinner, i'd go for the 2g dose only when i see good hbsag decline

is it alinia brand or generic?if brand where did you get it and how much for 1 month at 3 pills per day?

please also send me a private message so we can record all your blood test results together with other members and monitor improvments, this will be very helpful since all this data will help improve therapy
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HBVDNA 3.14e+03 = 3140iu/ml or copies/ml?

hbsag 8110COI, if unit is not iu/ml all other tests are useless, only when very close to cutoff they can give an idea of decline or increase.
for example i had 300,01s/n and the quantity was about 5000iu/ml, my sister 335s/n and quantity was 17000iu/ml.s/n s/co and others have diluitions so the scale is not homogeneous and can be used only as qualitative test.check for abbott hbsag quantification test in iu/ml with 1:1000 dilution which is the best test.
or you might ask the lab for s/n unit with 1:1000 diluition that might be close to iu/ml or at least if they use same dilution we know if increase or decrease

hbeag negative, well this is the best condition for alinia, once you see it works by hbsag decline (hbvdna is not enough to monitor), i'd combo with interferon, this will fasten and increase results very much although there may be sides from interferon

alt, these might get elevated at first but if hbsag and hbvdna get low it is working if not it is not working for you

since you just registered with the community it would be better to register in the group so we can make sure it is not a false posts
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My hbvdna is 3140copies/ml. How to register in a group?I bought Alinia from India.$0.79 per tablet.www.***-******.com.I got this info from a chinese forum
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click on my name, stefano170669 and send me your email or just check your private messages for my email
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another person in the group has made hbsab antibodies in very high titer in 3 weeks, also this one was hbe negative/hbeab positive with 3log hbsag when started ntz

my results will be ready in about 3-4 days, i hope for a continuous decrease of hbsag that's more than enough for me
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I need help in getting Alinia with out prescription, is it possible? can any one help.
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contact with lupin distributors
http://www.lupinpharmaceuticals.com/adrsub.htm#product_t

but i suggest to wait a couple of weeks that we see if hbsag decreases and how fast so we can also discuss the drug combos they had and baseline values
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All we read about Alinia is good news here so l cant wait...5 more weeks to go b4 test
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I called the distributer here in florida, and they informed me that, in order to obtain Alinia I need to have my prescription ready from a Doctor, if you have other sorce let me know.

Thank you anyway.
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May I know for your recommended 3 pills per day, how much is it converted to liquid suspension alinia? I just purchased it online and am waiting to start it. But my doc here doesnt know of the  quantity to presc me.
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is Alinia available in the Philippines?
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how much is it converted to liquid suspension alinia?
liquid suspension is for babies you ll never reach an adult dose with that, minimum dose 2 pills 500mg total per day 1000mg, max 4 pills per day 2000mg per day

plus suspension has a lower absorption in the blood so it can be used only for diarrea (diarrhea) treatment
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as the results shows alina is making HBV DNA to UND and in some cases HBsAg negative .

But if someone use alinia and HBV DNA become UND and HBsAg is still positive
then how many chances are there  that HBV DNA will increase again?
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and in some cases HBsAg negative, this is from 1-2 years in romark human trials,in our group we are still at about 12 weeks and 2 persons showed hbsab antibodies but we have to wait 4-8weeks to see if hbsag gets negative.
the theory is it will get negative but we have to wait, ususally seroconversion works by hbsag negative and then hbsab appears, only replicor drug made the same thing happening to us that's to say antibodies appear before hbsag gets negative

But if someone use alinia and HBV DNA become UND and HBsAg is still positive
then how many chances are there  that HBV DNA will increase again?
hbsag and hbvdna are two different things but if hbsag gets negative and hbsab positive you are definitely cured of hbv (except some rare cases of hbsag mutants but these are made only by lamivuidne or adefovir therapy)
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there are also very very rare cases of occult hbv with hbsag negative, hbsab positive, normal alt/ast and very low hbvdna but there is no liver damage or hepatitis, you can only have very low risk of HCC

but in any case occult hbv is better than inactive carrier and much better than cronic (chronic) hbv and only very sensitive hbvdna pcr or biopsy can see it
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Oh dear, I see...silly me! I'll cancel the order then, since I just made the purchase online.
How about the alinia by Glenmark manufacturer? Strength 500mg right? http://www.noprescriptiondrugs.com/product.php?product_id=133&category_id=30
Is that suitable? I find this most affordable.
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of course generics are the most affordable but i don t trust online pharmacies at all, they might relabel expired drugs or do things like that, i would go with official lupin distributors only

also alinia from romark is a good choice but the price must be not more than 500usd per month while i only found it online at 2000usd per month using 4 pills per day which is too much.
if anybody find a good price for alinia from romark please let us know, maybe purchasing directly from them...they re in tampa florida
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Do you mean alinia you get from lupin is not a generic? How much did you pay for a bottle? Ok, I shall email them to enquire abt this and check if they ship to my country without a prescription. Tks!
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sorry...jus read above that the alinia u got fr lupin is also a generic. How much does a bottle of 60 tabs cost? Do they ship internationally without a prescription? Problem is I had a hard time finding alinia without a prescription. When I click on lupin's product list, I can;t find alinia under their generics too.
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Do you mean alinia you get from lupin is not a generic?
it is a generic but i try to get it fro official distributors or verified real pharmacies not the first lace i find online

How much did you pay for a bottle?
it is in blisters, i buy bulk blisters, 360 per order, i have ordered a big quantity since we are getting to summer in my country and tem higher than 25-30 might danage the drug, so i made orders in spring

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i spend about 204 usd per 180pills

the drug is nizonide500 and has been produced recently by lupin in joint with ind-swift, the other producer from long time is cipla with nitarid500

inquire lupin, of course they do ship int'l
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anything new? how is your latest test?
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i will have it monday.

i got hbsab antibody which is as usual hbsab 0.00miu/ml, hbvdna is <20iu/ml now, alt got elevated from 37 to 44 switching to 2g dose
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now i lowered again to 1g daily dose to see if alt go down and hbvdna stays <20iu/ml, i will switch back to a higher dose 1,5g if i see a good hbsag decline if it is a slow decline i will keep the dose to 1g
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2g is maybe too much for your liver to handle. Maybe you should stisk to 1.5g max.
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i called the doctor today but he is very busy and i have to call him back on thursday.

i have done the test in the local hospital this time because close where i live and very fast (1-2 days for hbsag and hbvdna )  but the test is not available for people outside the hospital so it is the MD to call the lab for the result......anyway i dont complain since it is all free and i just have to call the MD on mobile when i need

we'll have to fry for 2 days more
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2g is maybe too much for your liver to handle. Maybe you should stisk to 1.5g max.

very difficult to understand if effect of more active immune system or little drug toxicity, in anycase several interesting effects happened:

1-1.5g daily, very good and tollerable both for stomach and liver but i never kept this dose continuously alwasy staggered between 1 and 1,5g.no alt difference at this dosage and 1,5g probably more active

2g daily but every 4-5hours with food, my stomach cannot tollerate this dose unless i use probiotics, i never get diarrea (diarrhea) but very frequent stools and bloating stomach.no difference on alt level

2g daily but 1g all at once at breakfast and one all at once at dinner, alt from 37 to 45, my stomach cannot tollerate this dose unless i use probiotics

to understand if it is drug toxicity or more active immune system we might check the following, theoretically not 100% sure:

higher alt but hbsag or hbvdna decrease faster, more active immune system and drug

higher alt but hbsag or hbvdna decrease slow decrease, probably drug toxicity

higher alt but hbsag or hbvdna steady, drug toxicity

since i am on cirrhosis i should stop as you suggested at the 1.5g dose

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That's interesting to know. So ALT going does not always mean drug toxicity.I hope the ALT flare indicates a better immune system reaction rather than toxicity in your case.
Yes, with your Cirrhosis, you should be more careful.
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still no news about hbsag quantity, MD always busy....damn i will never ask for fvors and have tests done in pisa in the future

since the 3rd of july i lowered ntz and alt got back from 45 to 36, hbvdna und

on the 26th of july i should have monthly blood tests in pisa and there should be also hbsag
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Guys kindly share ur experience on the side effects of ntz since you started,thanks
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on the alinia group nobody reported sides
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I started Nizonide500 (Alinia) this Monday, took 1 pill after lunch only. Do you think I should increase the dosage? After which meals are the best? Cos Im still on etv every morning, and we not supposed to mix any other food/medication till 2hrs after taking etv.
I will check and update my results in Sept again. Hopefully it's good news.
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as to nitazoxanide you must take at list 2 pills per day, 1 breakfast and 1 at dinner

etv, must be taken with 2 hrs from last meal and 2 hours from next meal, in total 4 hrs empty stomach, the most important at least two hrs without food prior

as long as you follow these rules everything is ok, make also sure you have still hbvdna detectable and hbe negative for nitazoxanide to work at best

take also vit d suplements, vit levels at 50-60ng/ml boost iimune system and ntz response probably
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almost all group and also my sister are taking 2 pills breakfast and 2 dinner since they have no sides, i am staggering from 2 to 3 pills per day since i am on cirrhosis.nobody reported sides

make sure you have hbsag in iu/ml and hbvdna baseline so you can see results clearly

thank you for sharing
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Ok, tmr I will start 1 pill lunch, 1 pill dinner. Was trying out for 2 days with just 1 pill to see if I have sides...so far ok! Doctors here in my country told me to take etv in the morning on an empty stomach and only consume food 1 hr after. Or 2 hrs after food and 1hr thereafter. No one mentioned about the 4 hr rule though. So far, etv managed to convert me fr HBe pos to neg, and DNA und in abt a yr or less. So i think will keep etv for the mornings, and NTZ for afternoons and nights.

Regarding the quantiative tests on HBs, unfortunately, my doc says we do not have such tests here in my country. However, I will be going to the States for 2yrs soon and will look for a lab that does such quantitative lab works.
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the 4 hr rule though.....
even in my country they just menthion that for lamivudine resistance patients and by the way etv doesn t work on them.....for naive they say it is not needed, but that's all ********, i guess they lose a lot of people because this rule of the 4 hours is very very annoying, but when i wrote research it is needed to get max E50 (E50 maximum drug absorbed in the blood per drug dose)

so the 4 hours rule is very important

as to ntz sides most experience a mild diarrea (diarrhea) at the start but it just goes away by itself, if you like you can add lactobacillus reuteri to prevent diarrea (diarrhea).
i found reuteri+ntz on a human trial to lessen toxic substances from stomach bacteria on cirrhosis
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i think the best time for etv is before going to bed but at the moment i am taking it at 4pm so it is in the middle of ntz
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Oh really? The best time for etv is just before bed? Where did u get that info from? That timing sounds really good...at least much better than mornings, when after you wake up you are hungry but yet cannot eat!

Oh these few days I did not experience any diarrhea but I thought I did see some changes in urine colour...became yellowish. Not sure if that's a symptom of ntz. How's ur course of ntz so far? seeing consistent results?
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The best time for etv is just before bed?
it s just the best time because you don t have to worry about food, as to synergy maybe the best time is like i am doing now thats to say between ntz dose

it is not a side it is the drug, it is eliminated through urine, feces so the yellow color of ntz is found on them.
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I am so happy I started Alinia last Monday and taking twice a day but my urine is yellowish, is this supposed to happen?

let it be this as a starting point
6/12/2010 blood work

Hbsag=Pos, Hbab=Neg   Hbeag=Neg   Hbeab=Pos
Alt=29
Ast=18
Hbv dna= 77 iu/ml
Hbv dna= 448 copies/ml

Thanks
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yes that s normal, you will see a change in urine and feces colors because drug is eliminated that way instead of kidneys like other drugs
also very rare the white in the eyes can change a little but not too yellow like when bilirubin is abnormal, that s also nothing.
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bad news on my hbsag, i got the 12 weeks result and it has stopped decreasing and got 455iu/ml higher
30 march 4873iu/ml (baseline at start of alinia) mainly 1-1.5g dose
30 april    2292iu/ml reduced to 1g ntz till end of may
25 june    2769iu/ml kept 1.5-2g dose

etv increses hbsag on my status hbeag negative so only ntz could have had impact on hbsag march drop, i will try to keep the 1.5g continuous dose and see if hbsag stays steady or is decreasing again, next blood check should be 26 july

hbvdna<20iu/ml, alt 36
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well, really bad news...
I guess there is a threshold and need something to overcome the barrier.
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Did your researchers give you a range within which changes are considered random and do not mean better or worse?

In China, quantitative test of HBsAg is the norm and even though HBsAg in the thousands is considered more HBsAg than HBsAg in the tens, not much is read into changes in the hundreds.

Hat off to you for being such a pioneer!
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Did your researchers give you a range within which changes are considered random and do not mean better or worse?

455iu/ml range for hbsag means nothing but it gotta decrease at the 24-48 weeks checks.
without therapy on hbe negative from long time the changes of hbsag are very slow and with therapy the same ecept etv increases it and tdf not known

just consider that interferon lowers hbsag on 11% patients only and these are the max mean results on fast hbsag responders:
0.5log hbsag in 24 weeks and 1 log in 48weeks,i acutally got almost 0,5log in 4 weeks so i can only think:
etv has got hbvdna undetectable at end of may june and it is known it suppresses immune response when reaches und so hbsag relapsed a little
there are fake or expired pills among the ones i bought from online canadian pharmacy

so it is smart to check if at 24 weeks we have a 0.5log decrease and at 48weeks (about 1 year) 1 log decrease

i will see the researcher on the 26th of july and the plan is to start interferon
he doesn t like etv at all for me snce he has seen that my immune system is quite reactive with the high alt flares i always had and low hbvdna so etv was the worst choice according to him.
of course i will keep taking alinia and i will buy some brand pills just for 100% security
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i have also seen interferon+entecavir trials are finished but the results have not been published yet, in march the researcher said we will see if to keep entecavir or not maybe he was waiting for these results
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another thought might be the 2g dose mixed with etv is less synergic and might interfere so the alt from 37 to 45 when i switched to higher dose is just less efficent combo

but all these are almost useless thoughts, i think we must compare with the only other drug which lowers hbsag without taking 10years therapy which is interferon and just consider the 24week and 48week drop to say it works or it doesn t
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I remember reading IFN works better with high ALT and low HBVDNA, so your researcher has support from existing literature.

One concern that I have which may not be necessary is: could the taking of different pills actually weaken your immune system in their clearing of HBsAg?  Even for those whose HBsAg turns negative, many of them report their clearing months after they stopped taking the drugs.
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well they discovered hbsag quantification, hbe negative hbv and hbcab Igm quantification, and make all drug human trials, they're one of the best internationally for sure but they don t care about ntz at the moment

could the taking of different pills actually weaken your immune system in their clearing of HBsAg?
no only etv can weaken immune response but we have to see latest research result of these combo.for example they made the trials interferon+lamivudine and interferon+adefovir and they said there is not much difference in combo but there is when staggered.but since i am on cirrhosis staggered can be dangerous for me

hbsag negative is not enough the key is the antibody hbsab titter and then very slowly stop antivirals because hbsab blocks viral entry in the liver cells but cccdna and hbvdna are still there for about 3-6 months



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Is that possible to contact with Replicor and ask for more information about human trials?
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Oh well,..Be patient. It is always a good thing to stick with one drug concentration in your blood.
Why would the pills be fake? Does it mean that we can not trust online pharmacies? Personnally, when I mentioned using Viread generic Dr said do never buy online, it is not safe! but I don't believe all licensed phamacies are just selling fake drugs, it wouldn't be good for their reputation.
I am not sure about entacavir since you have been taking it since a long time now and Alinia was still able to lower your HBsAg in combo with ETV.
Give it some more time. I guess your next results will be determine wether you will go with Interferon or not.
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already did, andrew vaillant answered to check under news but nothing has happened until now and nobody talks about it
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As you know, I am following an approach that emphasizes caring, protecting and nurturing the liver by minimizing taking chemicals with their toxins, eating right and resting right to creature an internal environment unfitting for HBsAg gradually weakening and eliminating it.  It is a long and patient process and involves change of lifestyle that is not for everyone.  Its goal is not necessarily to kill HBsAg, cccdna, hbvdna etc. but just to live one's natural life span.

From this viewpoint, it would be best if the researchers also pay close attention to the healthy status of the liver when their eyes are focused on their lab results of lowering HBsAg, cccdna, hbvdna etc.  I have posted elsewhere in this site cases of patients whose HBsAg has actually become negative with years of taking entecavir yet their liver and related organs have been so weakened that they don't feel they have won the battle against HBV.

You are right that extra caution is needed when interferon is considered in the presence of cirrhosis.  How about your general health status?  Apart from lab results indicating HBV, do you eat, sleep and work normally?  Any symptoms?

Pray for your success and that of your researchers.
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Why would the pills be fake? Does it mean that we can not trust online pharmacies?

well that's just a though because 2500iu/ml down in 4 weeks on hbe negative is not normal at all on etv so i am considering anything, so even if much more expensive i have bought one month supply from daxon which is the same as romark (romark licenced daxon for mexican market) so that everthing is doubled checked

but I don't believe all licensed phamacies are just selling fake drugs
i also think the smae the most are ok especially antivirals for hbv and hiv since you see immediately if they work or not so it is their interest but the most important thing is to find reliable sources because also fake pharmacies exist.whenever possible i'd use official distributors or real pahrmacies

Give it some more time. I guess your next results will be determine wether you will go with Interferon or not.
i'll give more time to alinia for sure but i prefer to follow researcher advice for interferon plus i don t want to stay on entecavir monotherapy longer than one year since i have cirrhosis and a secondary mutation present i want to be as close as possible to 100% security for resistance

actually there is no sure data on this rtq215s mutation in vivo because rare to be present naturally.all the data is from patients with the lam+adefovir mutations, so even on this i want to be extra safe
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I just sent an email to Replicor. The CEO replied quickly and said REP 9AC would not be available for the public before a few years. Their preliminary results seem very promising though. Let us hope for the best!

Enolia.
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Good Job,
hope we see it very soon
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i have found one year hbsag data comparison of etv on hbe negative (my baseline therapy) and peginterferon hbe neg (the drug that lowers hbsag most but only on 11% patients), so that we can judge the kinetics of my hbsag on ntz+etv
in the first 4 weeks ntz i had a reduction of more than 50% hbsag, almost 0.5log reduction, while if i kept etv monotherapy i should have had an increase of hbsag of 0.1log in a year
interferon has about the same reduction i had in 4 weeks but it takes one year, 0.56log reduction of hbsag.
so first results are good anyway since these are the medium results, let's hope the decreasing pattern will start again even if little towards my 24 and 48 weeks combo

link of the italian study presented in vienna:
http://www.kenes.com/easl2010/Posters/Abstract908.htm
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am I included with your group, remeber, I take tnv plus ntz 1000 evry day since two weeks a go,
hope all is well
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remember to email me back your blood tests data so that we can record it since the group is big and if we don t collect data it is difficult to see who is improving and there are so many differences between every patient that we need to collect all details

i think tnf+ntz started on hbe negative and hbvdna detectable (i think this is you) is one of the best combos after ntz+interferon
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good news in general, just go back from pisa check up:

477iu/ml flactuations in hbsag, researcher said it s nothing and these fluctuations are normal even day by day.
also bigger fluctations are normal what matters is that the genral curve after 3 months go back downwards and always below the hbsag baseline level

i have also had a big improvement in firoscan readings (cirrohosis about 12kpa)
nov     2009  15.9
march 2010  16.3
july     2010  13.9

it is difficult to say what did this, i think antioxidant diet and especially bluberries/melatonin can have done this:
nucs lower usually 0.5kpa per year with hbvdna und and normal alt.i just reached an hbvdna<20iu/ml (but still detactable at any number between 1-19iu/ml), alt 36 (normal below 30)
wrong baseline reading is difficult since in march we even had an increase in liver stiffness.
it will be very useful to see the fibroscan at one year from august 2010 if hbvdna has got und and alt lower than 30
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congratz,

I have problem finding a lab that will test hbsag and hbsab quantification, here localy in florida, no one knows what i am talking about. sad to say, but still looking
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did you call abbott to know who bought their machine abbott architet in florida?

he bad is that machine only is not enough, it is also needed a specialized tech for the diluitions to get the values higer than 250iu/ml
try also standford university, romark made trials there, but that would be a big surprise if nobody has it, US healthcare would get worst than a third world country in this case
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forgot to mention i also had a small iperecogen focal lesion 6mm big, it should have been an angioma since HCC is rare in that liver area and also usually not iperecogen but not impossible to be a HCC.
we found it at march ultrasound and rechecked in july because if it didn t grow it was more angioma than HCC, at july US complitely disappered

angioma is a benign liver tumor very comon on liver and skin of cronic (chronic) hbv carriers, in the skin it is a small red spot, it can grow but never become a cancer
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That is good news! Your Fibroscan results are really good!
I have questions:
* You mentioned there is 477iu/ml flactuations in hbsag. Does it mean it is 477iu/ml lower?
* Do you have bluberries/melatonin daily since you started treatement? How much do you eat and where do you find melatonin? Also, doesn't Vitamin E replace those? It is known to be a strong AntiOx...
Thanks and take care.
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* You mentioned there is 477iu/ml flactuations in hbsag. Does it mean it is 477iu/ml lower?
no it is the fluctuation we had at end of june, in 3 weeks i will have the end of july result and then the test at end of october, that will tell us of much ntz worked and if there has been a relapse
hbsag decline is so slow that also yearly test are ok to see

Do you have bluberries/melatonin daily since you started treatement?
no bluberries since jan when i saw first articles about it
melatonin, i use it since many years, i read many years ago it delays aging and actually i look about 5 years younger if not more for some other people

i have also other antioxidants in the diet, i posted them somewhere in the community

as to the fibroscan result we cannot yet say if it is fibrosis or inflammation reduction because it measures both.we will know that at least after one year after hbvdna is und and alt normal since inflammation is the first to be reduced fast


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update on my sister's results at 14 weeks ntz monotherapy, hbe negative, hbvdna 5 log iu/ml, genotype D:

hbsag decline from baseline 335.71s/n to 220.11s/n, s/n is cannot make an hbsag quantification but when number declines a lot there is an hbsag decline.
she is in the high range of hbsag at 17000iu/ml we are not making the iu/ml tests because it is too high and will follow with s/n test for now

hbvdna, baseline 273000iu/ml, we will have result in 5-10 days
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forgot to say: one month ago switched to 2g daily from 1g at the begining, no sides at all.
she tried interferon in the past with memory/depression sides so now she doesn t want any therapy except ntz because it has no sides
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bad news from hbsag level end of july, i have all monthly tests now (they save the blood of all blood tests so they can recheck at any date)
from monthly tests it becomes very clear that only 1,5 and 2g daily work and 1g relapse, researcher said that while entecavir made hbvdna und we lost the immune response to hbsag, we will see keeping a continuous 1,5-2g dose

hbsag on etv mono and on etv+ntz
09/02/2010  301,04s/n (s/n cannot tell quantity of hbsag but a big decresing number has the meaning of less hbsag) etv mono
26/03/2010   4873iu/ml start of etv+ntz 1-1.5g staggered
30/04/2010   2292iu/ml etv+ntz lowered to 1g
21/05/2010   5397iu/ml etv+ntz increased again to 1,5-2g
25/06/2010   2769iu/ml etv+ntz decreased to 0.5-2g
tried 2g every 4-5 hours and 2g altogether twice a day.2g dose altogether made my stomach bloat, no diarread no pain but very frequent stools and alt increased to 45 so in july i decreased for about one week to 0.5g and then to 1g for the rest of the month.2g every 4-5 hours has no sides and no alt increase
26/07/2010   7272iu/ml, etv+ntz 1.5g

on september i will go back to the 2g dose every 4-5 hours and decrease to 1,5g only in case of alt increase.i will also start entecavir+tenofovir+nitazoxanide combo since being on cirrhosis i cannot risk any resistance possibility.
i will not consider interferon anymore since hbsag is too high to have any result and it might worsen cirrhosis instead, also i cannot wait longer than 1 year on entecavir monotherapy, too risky for resistance.plus i have precore, BCP and rtq215s mutation already and high risk of liver cancer so i must keep hbvdna in liver tissue as low as possible (hbvdna und in blood is not enough at all).
hopefully i will be able to check intraepatic hbvdna and cccdna in blood lymphocytes as soon as available out of trials, these test are the most sensitive to rule if therapy is working at intracellular level

as regards the other values:
09/02/2010  hbvdna 464iu/ml alt 49
26/03/2010  hbvdna 135iu/ml alt 47 hbcab igm 0.17s/co
30/04/2010  hbvdna 51iu/ml alt 47
21/05/2010  hbvdna 38iu/ml alt 44 hbcab igm 0.15s/co
25/06/2010  hbvdna <20iu/ml alt 45
26/07/2010  hbvdna und (lower than 1iu/ml) alt 40 hbcab igm 0.11s/co

tenofovir is also necessary to lower alt possibly <20 or at least <30.the fact that alt is still at 36-40 is due to intraepatic hbvdna which is still too much even though hbvdna in blood is und.if i keep etv+ntz i will get slowly to alt <30 but i prefer to fasten the process by combo with tenofovir

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