no keep tdf and increase vitamin d to 90-100ng/ml, no need of an alt flare, if tdf has been taken for long enough to rescue immune response hbsag will be cleared with notmal alt
Combo i mean administration of two drugs at one time ( Immunomodulator- i.e IFN with Tenofovir ) to focus HBsAg , which may work in synergistic manner,One planned to enhance immune system and another to protect from any Viron replication.
What about ALT???? can we stop antiviral drugs for a while to take a chance for ALT surge
No idea ! came to know at age 27, No any B patient in family or in family history , Even vaccinated during early age , no any surgical approach in my historical back ground .
sorry i dont understand well, combo IM?what us it?
hbsag 1000iu/ml and hbvdna und, best therapy is pegintf, if already under tdf add on peg
@taj
are you infeceted since birthj? the dna is pressy low for EAG+ve..
Gr8.... Stef in case pt is on therapy his HBV DNA is Undetectable currently with HBsAg levels around 1000IU, pt want to switch over combo IM and antiviral but his ALT is normal, can we stop the antiviral therapy prior to IM combo for some time to raise his ALT? coz ALT should be raised if therapy considered with ifn and antiviral like Tenofovir.
Thanks for continuous and satisfying response.
when hbsag is und and hbsab>10miu/ml the infection is over, cccdna is und
even if some cccdna remains (no possibility to detect it because too low) it can t do nothing but wait to be destroyed by cell death/cell division.virions even if formed cannot infect other cells because hbsab blocks entrance to cells, so the virions are killed in a very short time
okz.....
in case patient cleared his Bdna and surface antigen during therapy , there would be no any problem even if cccDNA would be present, as cccDNA is not infectious as per your version even if it replicate its replica would be covalently closed circular dna only? which cant do any harm......plz give some light on it
quite possible that it carries cccDNA too right?
no cccdna can exsist only inside cells, when the cells dye also cccdna gets destroyed.cccdna keeps multipling only by new virions infection and cell division
only hbvdna is infectious, hbsag, hbeag are not
interesting point arises here Stef ...... Being semen/sperm has DNA only is it quite possible that it carries cccDNA too right? so intercourse may cause transmission of virons even without tissues damage?
no too low and even if you do the people having this kiss must receive so much blood in your saliva and have open wounds in the mouth........all this is very unlikly
plus consider that most are vaccinated today and if not they will clear it because adults
hbsag is not infections, it only suppresses our immune system to save hbv
most patients with hbvdna und in blood are und even in semen
Thanx Stef2011 for your reply. Can u answer the 2nd part too? And I have reduced my weight and changed my food habits since last 1.5 yrs.
nothing to worry about because normal fibroscan is less than 6kpa but if you have fatty liver you must change quality of food and improve your vit d levels/oxidative stress level/hdl levels
fatty liver is making your reading of fibroscan higher