confused about results

[man12345678]

all results are of this year 2015.i am on entacavir 0.5 from march onwards.Unltrasound/aarfi/liver doppler test all normal.
1)why is the hbsag quantitative fluctuating
2) bilrubin levels also keep fluctuating
3)hbv dna levels are reducing however hbsag are fluctuating.does this mean liver is getting damaged.
4)dont know whteher its because of this but have started experiencing wierd sensations on my ankles.have a constant little muscle pain.

[stef2011]

also no reason and even against dumb guidelines to combo tdf+etv if hbvdna so low as 21iu/ml, u responded to etv already

this said etv is weaker in hbsag lowering, tdf is more potent in every aspect and more safe (except on patients with kidneys problems)

[stef2011]

says entacavir is better than tenofovir when it comes to reducing hbv dna

change doctor, too ignorant or paid to sell etv, absolutely not reliable

[Jatashankar]

Tenofovir is superior to entecavir in every aspect. It is more effective than etv cheaper and negligible incidence of hbv resistance. U must shift to tenofovir. U have no meaning to do combo tdf and etv. Dna reduction in hbeag negatives on nucs has a very weak correlation with hbsag reduction. so don't bother if it fluctuates this much. It happens with all of us I ve seen. Hbsag reduces on long term nucs as other member say. Apart from nucs u may take black seeds and honey but they r not proven to reduce hbsag.
If u wish to shift to tenofovir then do combo of tdf+etv 1month and then continue tdf thereafter. Steff says to shift like this.

[man12345678]

Hi stef/jatashankar

so i met my doctor on friday and he has asked me to continue entacavir. he says entacavir is better than tenofovir when it comes to reducing hbv dna count.He has asked me to meet him after 3 months post which he will put me on entacavir+Tenofovir provided my hbv dna becomes undetectable.
He also said that reduction of hbv dna is the most important thing currently.He has asked me to get the below test before meeting him next time
HBV DNA quantitative
HBSAG
HBEAG
anti HBE

My latest test results are
LFT :normal
HBV DNA 21iu/ml
HBSAG quatitative:6133 iu/ml

[amar0015]

hi steff i posted my fibroscan result with which is F0.OR <237 OR 3 KPA.can you advice anything other than vit d3 to reduce hbsag

[stef2011]

every 2 days can be ok i dont think it goes down so fast in tissues

eggs, meat and all vegetables are ok no calcium from that food

[Jatashankar]

No not 60k iu in 2weeks but 60k iu cap at 4days interval ie two caps in a week I take.
It is not feasible to avoid the dairy diet here. Milk tea, butter, cottage cheese, eggs, bakeries, sweets etc. I am a vegetarian so problem not arises with non veg diet as meat is big source of calcium.

[stef2011]

its because the infection and it is universal to all chronic diseases, hbv included.

there is no fibroscan with scale 237, fibroscan is in kpa, i dont think you had fibroscan

[man12345678]

is this vitd3 issue because of hepb or the anti virals because i started having muscle pains only after i started taking entecavir. Didn't have this problem before.

[amar0015]

what else other than vitd3 i can take to reduce hbsag and prevent fibrosis.i m patient for over 5 years

[amar0015]

steff i got me fibroscan result today and is <237. F0. can you advice any protein supplement which i can take with hbv for supplement

[stef2011]

remember that vit d3 works only daily, if you check your intact pth you will be able to know if 60.000iu every 2 weeks are doing something or still deficient

[Jatashankar]

Though I am not taking doses as u recommend I take 60000 iu twice a week. Coz our indian diets are full of dairies and it is very very tough to avoid them completely or significantly. I won't test vit d but continue this only. Initially I used to take alphacalcidol .25mcg in gaps but u said to stop so did that. U r guiding good ppl on vit d. Thanx

[Jatashankar]

May be u r rite Steff coz  I used to have 1 -2 episodes of mild knee pain in a year but for past 6 months no pain issue on vit d.

[stef2011]

among tests you miss vitd25oh and intact pth, they are extremely important for hbv carriers health

[stef2011]

with minor arthritis probably

its all due to vit d deficiency we have, unless we supplement vit d we are at high risk for:
osteoporosis
various cancers/lymphomas
general back pain/bone pain

[Jatashankar]

Hbv or most of other viral diseases are associated with minor arthritis probably due to idiopathic immune origin which may vary in intensity and is episodic

[man12345678]

i have attached it as a  picture in the 1st post.All values are in iu/ml

[stef2011]

hbsag goes up and down and results are of little meaning unless you get a 1log decline which is from 10.000 to 1.000

[stef2011]

the antiviral has no effect on hbsag especially first years and especially etv, you may have a decline after 3-5years if hbvdna goes und but dont expect hbsag results like tdf

be sure hbvdna gets und between 6 to 12 months, since etv has resistance it is not safe if hbvdna remains detectable for longer than this

[Jatashankar]

What are the values in numbers of ur test results? Present and past both
Hbsag quantitative
Hbeag status
Hbv dna level
Alt and ast levels
Bilirubin
Fibroscan or liver biopsy status
S.Creatinine

[man12345678]

these are the results  i have :-(

[Jatashankar]

Can u give the values of ur hbsag quant and dna and alt from march onwards. It will then be more predictive

[man12345678]

Hi stef,

please help by giving your point of view