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hbsag quantity
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hbsag quantity


today i received my hbsag quantity which is 250iu/ml, if i only knew about this before starting therapy we would have choosen interferon since etv has little/no impact on this.

interferon leads to hbsag seroconversion when hbsag is less than 1600iu/ml which is the level of inactive carriers, etv has almost no impact on hbsag and cccdna eratication so it was a wrong choice.

i will keep monitoring and taking sun to increase vitamin D level which might have helped on hbsag level and wait to receive and start alinia which has a proven impact in lowering hbsag

i do suggest to check hbsag and although it is rare on cronic (chronic) hbv to have it lower than 1600iu/ml (on cronic (chronic) is usually 3000-10000) but it is better to check it so correct therapy can be choosen from the begining
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Avatar_m_tn

too good to be true, i think i will have to wait for the doctor to tell me if they used wrong assay
it just says >250iu/ml so 250 should not be the quantification although i don't see the point to measure upto 250 and not all higher numbers since cronic (chronic) is in the 3-4log numbers
got to wait doctor....
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Avatar_m_tn
damn...they made wrong test, kind of qualitative instead quantitative, i will have to remake it
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1242578_tn?1268357589
what i want to know is that ,if the dna is not und,
does the hbsag quantity will tell you something?
i heard that ,if your dna change from not und to und , your hbsag quantity will increase a lot than before;
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Avatar_m_tn

hbsag level depends only on your immune system response and correlates only with cccdna which is the virus in the liver cells (all other parameters says nothing about amount of virus but only replication or low replication), but of course on very high hbvdna also hbsag is high.hbsag tends to be very high on hbe positive with active hbv and lower on hbe-ab.
hbvdna is not correlated directly with immune response, you can be inactive carrier with hbvdna 5log iu/ml, even when you seroconvert to hbsab you can have little hbvdna, immune responce is correlated with hbsag mainly or with your being active or inactive.

there is a precentage of lucky ones on cronic (chronic) hbv and a huge number of inactive carriers that have it at 1000-1600iu/ml.
Since interferon can lower hbsag 1-2logs it can make seroconversion on most of these low hbsag.
also antivirals lowers hbsag but very slowly, 1-2logs in 2-3years, so even antivirals can make seroconversion but only when hbsag is low.there is some data on tdf+ftc lowering cccdna, and i found a case of hbv+hdv eradicated by interferon+tdf+ftc in 10 months.trials are very slow on this, even trial on tdf+ftc is still at eraly stage but tdf+ftc is used on hbv-hiv coinfection by years, on recent reports they had a hbsab seroconversion at 11% per year even with depressed immune system on hiv (11% per year is higher than interferon)
also alinia has been found to lower directly hbsag and hbeag in combo

usually on cronic (chronic) hbv hbsag is 3000-10000 or even higher so in this case chance of seroconversion is almost impossible, so having very low hbsag i would try all potent combos to seroconvert on the contrary if hbsag is high i would just make therapy for life long antivirals keeping in mind antivirals can have sides if used for decades so only safe combos with little sides
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1024307_tn?1292002086
Hello, I'm reading this info about HBsAg quantity and I didn't even know there is a difference between HBV DNA and the amount of HBsAg. I'm still learning.:) My husband had only HBV DNA checked.How to find out about the quantity of HBsAg? Is there a special test? I'm sorry to be so naive in this subject. Thank you for your reply.-April.
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1242578_tn?1268357589
Quantity of hbsag: if you have hbv ,the quantity of hbsag will be detected(almost the whole);
DNA: not like hbsag, the dna is may be not detected ,when you are a hbv carrier,May be you need not to care about it ,if your DNA is und without any treatment;
Quantity of hbsag: hard to decrease; ,1-2 years decrease for 1-2 log for antivirals
DNA :easy to decrease, one or more months will be undetected in blood test for antivirals

if you can change the dna to und and hbeag from pos to neg ,hbeab from neg to pos and last for more than 1 year ; that means you may have finished your hbv curing,even if the hbsag is pos not neg;

And changing the hbsag from pos to neg ,is very very hard
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Avatar_m_tn

actually only the best research hospitals are using it, at least in italy, all the others are using s/n unit which can be obtained from the old qualitative assay hbsag and of course this is cheap because they spend the same price as before.
i have found in a study that there is a formula to get from s/n to iu/ml but the forula was not shown, also abbott which is the producer of the kit didn't answer me clearly so i moved to the research center to have the iu/ml test done (this is even better because if needed they will check all dna mutations and cccdna as well).

all this about hbsag is from 2009-2010 research and the need of it is because hbvdna assays are not sensible enough to see how much virus is in liver cells and if therapy is working very well, resistance is an issue or not because of too much cccdna replicating and if immune control has been achieved or not.

hbvdna means the virus is replicating less but doesn't say if replication is stopped at cccdna level, if immune control has been achieved, if cccdna replication is too much and antiviral monotherapy can have resistance issues.
unfortunately cccdna keeps replicating in the liver even during antiviral therapy, using hbsag and cccdna detection you can see if a combo is more potent and if you are slowly clearing cccdna or if your immune system is clearing it.unfortunately there is a luck of tools to monitor therapy and hbvdna is not enough.

if hbsag keeps declining it means that cccdna cannot replicate and the virus is declining, this is a very good tool.

most of liver specialist cannot read hbsag because it is still at research level but anyway all of us and all doctors can have an idea of improvement if it declines and reaches levels less than 1000iu/ml, and after all once you are und they have no tool to monitor furthur anyway.

so if you can have a liver specialist very uptodate who can make hbsag or research center who can detect cccdna in the blood you can monitor everything very efficently once you have reached und state, otherwise you just have to relay on hbvdna und which only tells replication is less.
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Avatar_f_tn
hello
please can you inform me what shall i do..
Dear sir

I  found that i have affected by hepatitis diseas. I know it is very serious and have spend a lot of money to check it.
my Hepatitis B core. total antibody is 0.15 -reactive
my  Igm antibody is 0.5 -non-reactive.
my LFT is normal.
sgpt 22
sgot 23

I have checked HBV and DANN and found 16000 IU/ ml.

So can you please inform me that it is a more serious and what treatment shall i do.
It would be very heplful if you can inform me what i shall do.
Thanking you alot
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Avatar_m_tn

first of all find a very good liver specialist who goes or has collegues that go to conferences to be updated on latest research.HBV is at a crucial point and wrong choices made by old giudelines can be dangerous

some tests that you made are not useful alone but it looks like you are inactive carrier, you just need to make complite test to know where you are and make future choices:
alt/ast, they are below 30 so you have no active liver damage at the moment, altogether with hbsag quantity and hbvdna quantity they can tell if you are truly inactive carrier at the moment.alt/ast must be monitored every 3 months in your case

hbvdna, 16000iu/ml is low, below 200iu/ml would be better but you can just monitor this and check that it doesn't get to 5 logs (it is 4 logs now)

you are missing hbsag quantity in iu/ml so you can see if you are truly inactive carrier ( truly inactive <500iu/ml or inactive cronic (chronic) hbv 1000-2000iu/ml closer monitoring of alt/ast and hbvdna)

you are missing hbeag and hbeab tests, if you are hbe negative and hbeab positive this is very good and can confirm you are inactive at the moment

the most important test to see if therapy is needed or if we can just monitor every 6 months (except alt every 3 month) is: fibroscan to detect if you have liver damage, ultrasound to detect if you have cirrhosis/liver cancer and prevent these ones

so just check hbsag quantity, fribroscan and ultrasound, if these are ok just monitor because you don't have active disease
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Avatar_f_tn
Dear stefano.

how are you there?

its me again, i want to be heal, but since i forget my password i create a new account, with 2 behind.

stefano, what is the meaning of result of hbsag quantitative test?
what is the difference with the result of hbv dna test?

i mean, both of them show some numbers, what do they measure actually? what is the difference?

and if, my hbsag quantitative result is increase, is it means that my hbvdna result will also increase, or is it not always like that? i dont know what is the correlation between these 2 kinds of test.

really many thanx for your help

i cant find any reliable info about this on the internet


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Avatar_m_tn
stefano, what is the meaning of result of hbsag quantitative test?

reflects immune system response always, number of infected cells, cccdna

http://www.natap.org/2010/HBV/040710_01.htm

what is the difference with the result of hbv dna test?
it has nothing to do wtih hbvdna, hbvdna is virus replication which correlates only with liver damage when undetactable, it doesn t correlate with infection, clearance of virus or immune system response, it correlates perfectly with response to drugs

and if, my hbsag quantitative result is increase...
you are getting more infected cells and your immune response is lowering

is it means that my hbvdna result will also increase....
hbsag has nothing to do with hbvdna, usually on antivirals hbvdna is und and infected cells increase or remain stable.actually hbvdna has no meaning but no liver damage when undetactable but it can also be elevated with little liver damage and response to drugs

i dont know what is the correlation between these 2 kinds of test.
absolutely none, some research try to find a very poor correlation and there is some poor correlation on hbe pos but it is poor so i'd say none
you might have some low hbvdna even if you cleared hbv, hbsag and made hbsab.i'd just conisder it for response to drugs or when very elevated more than 5logs liver damage/hcc risk


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Avatar_f_tn
hi,

sorry im get lost

so if my hbsag increase, is it means my condition is worse?

my alt is 15, and ast is 19, perfectly low and normal, im getting confuse here.

if i get more cell infected, my immune is lower, then why my alt ast is getting better?

if my hbsag quanti increase is it means my condition is worse?

what does it means anyway?

what is the difference with the result of hbv dna test?
it has nothing to do wtih hbvdna, hbvdna is virus replication which correlates only with liver damage when undetactable, it doesn t correlate with infection, clearance of virus or immune system response, it correlates perfectly with response to drugs

what is correlates perfectly with response to drug? hbv dna?

i dont know what is the correlation between these 2 kinds of test.
absolutely none, some research try to find a very poor correlation and there is some poor correlation on hbe pos but it is poor so i'd say none
you might have some low hbvdna even if you cleared hbv, hbsag and made hbsab.i'd just conisder it for response to drugs or when very elevated more than 5logs liver damage/hcc risk

what does your it regarding to? if my hbsag quantitative elevated? how to measure it with logs? its juts the number become twice now, form around 40.000 to almost 80.000

thank you
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Avatar_m_tn
so if my hbsag increase, is it means my condition is worse?

yes but as i told you earlier hbvdna is liver damage by virus replication and hbsag quantity is infection which can spread to new cells with hbvdna und

it is not easy to understand if you don t have clear virus, virus template and hbsag.virus itself (hbvdna) makes damage but the infection is lead by cccdna the virus template (not the virus itself) and hbsag reflects cccdna.cccdna is integreted inside liver cells and cannot be seen or destroyed by immune system that's why infection can spread and get worst without virions around (hbvdna)

what is correlates perfectly with response to drug? hbv dna?
yes hbvdna because antiirals just act on it while usually decrease immune response, they do nothing to hbsag, only interferon/ntz can act on immune system, hbsag, hbvdna

its juts the number become twice now, form around 40.000 to almost 80.000

logs is the number of zeros, 40000-80000iu/ml is 4 logs, almost no immune response and very low probability to decrease hbsag to very low/und by interferon of ntz.it is better to wait your immune system will lower it slowly by years.these high hbsag is usually on hbe pos young people while it decreases to 2-3logs on hbe neg older people
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Avatar_f_tn
ok ok, i'll try to understand your point

so, if my hbs ag increase, not always the hbv increase as well?

it might be a wider infection, but not a wider liver damage?

am i correct?

and if i am, so what about alt ast? isn't it measure how the liver damage?

isn't hbv dna show viral load ( how much virus is in my body) ?
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Avatar_m_tn
so, if my hbs ag increase, not always the hbv increase as well?

yes it is more infected cells or decreased immune response but liver damage is not correlated to it
in any case low hbsag is better because a decrease of 70% hbsag showed a regression in case of liver tumors, so if possible a lower level is better probably there is less risk of HCC development

and if i am, so what about alt ast? isn't it measure how the liver damage?
they just show liver damage in that moment not liver damage accumulated by time.although a high alt is liver damage for sure a low alt is not always correlated with no damage unless very very low like 15 maximum

also a low alt with high hbvdna is very high risk of hcc especially in asians where this happens frequently

isn't hbv dna show viral load ( how much virus is in my body) ?
not exactly it just reflects replication and even if und it doesn t mean there is no replication
and also you need to consider that the virus template cccdna/hbsag is also more important than just hbvdna
the best tool to monitor infection would be cccdna (te virus template) but it can be detected only inside cells so a biopsy is needed.since hbsag is mainly produced by cccdna they are using hbsag quantity now to follow infection and response to immune modulators drugs while they use hbvdna for antivirals
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Avatar_m_tn

in the end if your hbvdna is undetactable just monitor hbsag quantity only in iu/ml unit so you will now if you are clearing the virus or just getting more infected, kinetics are very very slow so you can check it every 6 months or once a year unless you take interferon or alinia (ntz)
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Avatar_f_tn

Stefano,

i think i got your point already.

so now, i ever read your other comment on other post, about your [plan to keep antivirals when u reach hbv und, until hbsag negative. in this point, when u mean hbsag negative, its also mean that hbsag quantitative is also negative / und?

so both hbsag qualitative and quantitative is negative?

am i right?

what can we do to develop our imun to make hbsag quantitative staedy or lower by ourself without taking interferon?

exercise or any special diet or any other thing?

many thanx
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Avatar_f_tn
Stefano,

sorry, another questions.

if someone in stage carrier because taking interfereon, hw wil get hbv und, and hbsag decrese since its imune react to interferon. after end of inter usage, the body imun is already stong to keep the carrier stage by itself. so it means that hbsag will remain steady after that? just like hbv?

i mean, the goal form interferon medication is so after that the body imun can act on themself to maintain both hbsag quanti n hbv steady, right?

many thanx
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Avatar_m_tn
Dear Stefano,

What abt your results after taking Alinia. Any decrease in Hbsag ? Please update .
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Avatar_m_tn

interferon has a response rate between 11% and 30% (this higher response is interferon+lam 2 years), in these percentages hbsag declines fast or slowly and hbsag negative is achieved in 5-10 years with continuous decrease after stopping interferon.
when there is an hbsag decrease even if slow it is better to keep taking interferon even for 4-5years, when there is no hbsag decrease by 24 weeks interferon is useless and you fall in the rest of non responders

in terms of hbvdna it can lower hbvdna on about 50% but it is not useful since interferon rarely suppress hbvdna like antivirals and if there is no hbsag lowering after stopping interferon the most relapse to cronic (chronic) active hbv
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Avatar_m_tn
i dont have gen 20 results, in december there was an increase of about 1500iu/ml while taking hr protocol which i stopped imediately and increased alinia to 2g daily.

i am going to check hbsag again next week in a local hospital, this result will refer to the dec-febr period while taking 2g continuatively
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Avatar_f_tn
my hbv dna is already come,

the hbv dna result is exactly steady, it not increase, means not getting worse

both my ast alt is normal, even getting lower. ( 15 and 19 )

only my hbsag quanti get increase.

any comment stefano? looks like i have to wait until my alt / ast get increase, in order to achieve the best result for interferon?

since i believe no liver damage at all by now.

thank you
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Avatar_m_tn
looks like i have to wait until my alt / ast get increase, in order to achieve the best result for interferon?

yes increase of alt/ast or increase of hbcab igm quantity, this means immune system is getting activated while now it is stable/dormant

taking alinia first increases response to interferon (alinia 4weeks before interferon), i d definitely try alinia and see if it makes any difference
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Avatar_m_tn
Hi stefano,
My HBVDNA level is 66K iu/ml (4.6 log).  what would be chance for getting HCC?
Right now i am on medication (siddha - indian medicine) for a month.  I will be taking the DNA test after seeing the doctor next week.

Thanks a lot for your data points.  It is really helping to understand things better.

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Avatar_m_tn

there are many things that increase the chance of getting HCC but in any case it is a very low percentage of risk so it doesn t make much sense to make hbvdna undetactable if there is no liver damage, no family history of HCC, no mutants like precore and others to promote hcc risk, genotypes differenty than C

the bad side is that most healthcare systems and insurances focus and allow only tests to use antivirals and make money from you instead of checking the real tests to see your health, especially in US there is only hbvdna which is just a test to push towards antivirals and so getting money from patients and not making what is really healthy for them

so you need more than just hbvdna:
genotype
precore-bcp muattions
hbsag quantity in iu/ml (a lowering of more than 70% hbsag reduces HCC in vitro)
liver damage by biopsy or fibroscan

or if you just want to cut all of these take tenofovir but this is not the best choice because this antiviral has sides effects on the long period
hbvdna undetactable prevents HCC but not totally HCC develops even if hbvdna und although the percentage of patients is much lower
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Avatar_m_tn
Again, thanks for your clarification.  Have another question.

My Mom died of cirrhosis due to HCV.  is there any chance for me got infected from my mom (that's what My wife and I believe).  is it possible to get HBV from HCV infected person?
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Avatar_m_tn
I happened to read the discussion on Milk thistle and started digging it in the net and found some promising info.  It helps curing the damange of liver cells as well as helping the growth of new cells.  Milk thistle is part of siddha (indian) medicine and i have asked a siddha doctor about the dosage, side effects among other things.  Will keep you all posted about it.  If it is going to help the liver and no side effects why not using it in recommended dosage?
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Avatar_m_tn

no it is not but you should check for both hcv and hbv then

milfk th: we know it since we were babies...i actually used it for sometime when i was 19yo, it is just an antioxidants as all the others, read the ingredients in hepatitistechnologies you will find milk th and all the other antioxidants necessary

all antioxidants and many vitamins are good to keep oxidation stress undercontrol in those with cronic (chronic) infections, especially hbv or hcv or cirrhosis
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Avatar_m_tn
thanks.  what are all the tests recommended for HCV?
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Avatar_m_tn
Is it possible for a person to be infected with both HBV & HCV?
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Avatar_m_tn

of course, coinfection is possible especially in countries where healthcare settings are poor

hcvab
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Avatar_m_tn
hello can you tell me what should I do.

I just have medical test and then I know i have affected by hep B

here the result:
in June 21 2011
SGOT 87
SGPT 139
and my HBs Ag (eclia) 3122
and then I have consultated to doctor

in july 1 2011
SGOT 69
SGPT 120
HBs Ag 3188

I life in indonesia
So can you please inform me that it is a more serious and what treatment shall i do.
It would be very heplful if you can inform me what i shall do.
Thanking you alot
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Avatar_m_tn

see other answer to your post, the tests done are useless for a cronic (chronic) carrier

alt/ast can have a meaning with hbvdna pcr and hbsag quant
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Avatar_m_tn
my hbsag quantitative
  cut of value 0.05 IU/ml
  patient value 19 IU/ml

test is performed on the fully automated and integrated Abbot Architect Ci8200 system utilizing
Chemiluminescent technology. The assay has a sensitivity of <0.05 IU/ml. The numerical value of the
patient’s result represents viral load and can be used to monitor therapy for hepatitis B.

Please help me with the interpretation
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Avatar_m_tn
I am 21, and HBV reactive. I am diagnosed with HBV last 2007 when I was in a nursing school. Unfortunately, I need to change degree and school. My last lab result was 2009.

here are my results:
HBeAG - positive (4.84) TV Negative (0.10)
Anti_HBe - negative (0.95) TV Positive (0.40)
HbsAg - Positive (15.22) TV negative (<0.13)
SGPT - 72 U/L normal range 24-54 U/L
HBV DNA Result - 4,021,537 IU/ML

Can anyone help me interprete these results, and what should I do?
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Avatar_m_tn

being hbeag positive you have more chances to clear hbv on interferon plus tenofovir

to know your status you need hbsag quantity in iu/ml and not hbvdna

do not wait to become hbeag negative because when it happens the virus has mutated and you have less chances to clear hbv on therapies
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Avatar_f_tn
im asian girl.. i found out i have hep be when i made some blood test.... im a hbsag possitive... then i do to my doc for more info.. she said i should under go dna test.. so i have it... sorry i dont bring my copy here.. but the dna test result is i have 1thousand virus out of 110 thousand..ul something.. then the other virus is i have 9thousand out of 950 virus... my sgpt is 20 so pls answer my question... im going to USA... soon as fiancee visa do they have the screening of hep b? and what is all about that test i have.. am i worse? pls help...
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Avatar_f_tn
im asian girl.. i found out i have hep be when i made some blood test.... im a hbsag possitive... then i do to my doc for more info.. she said i should under go dna test.. so i have it... sorry i dont bring my copy here.. but the dna test result is i have 1thousand virus out of 110 thousand..ul something.. then the other virus is i have 9thousand out of 950 virus... my sgpt is 20 so pls answer my question... im going to USA... soon as fiancee visa do they have the screening of hep b? and what is all about that test i have.. am i worse? pls help...
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Avatar_f_tn
Dear Stefano,

how are u? hope u are fine and everything is going well.

i'd like to ask re interferon treatment on hepatitis b.

im very cared when i read the side effect for interferon therapy. based on your experience, how bad is the side effect? i do more concern on the emotional side effect? what can happened?

my bottom line is, can we keep working during the treatment? can we have a normal working life? im very scared, please help me.

many thanks
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Avatar_m_tn
i am also scared of the side effects of interferon
My HBsAg last june 19 iu/ml
oct last year 13.5
Now 16

What can i do
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Avatar_m_tn
Nothing we can do. When our time come for treatment, we have to do it. There's always side effects for all medications, it's just a matter of risk vs benefit.

The best thing that we can do is taking care of our body by eating, thinking, relaxing healthily.
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Avatar_f_tn
Hello.
I was monitoring my hvb for 6 years without madication. HbeAg negative, initial hvb DNA 6000 u/no, all other results within normal limits.
Hvb DNA was decreasing to less than 1000u/ml but last year it started to rise, last test 1550 u/ml.
My doctor suggested to start treatment with tenofovir. After 10 months of treatment, DNA is undetectable, hbsAg is 1567 u/ml.
Please advise, should I consider combo treatment with interferon or continue antiviral treatment?
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Avatar_m_tn
wait for hbsag to go less than 1000iu/ml or wait 3 years for peg add on
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