hbv dna interpretation

[balong_hans]

hi my husband has been diagnosed with liver cirrhosis compensated from chronic hep b Oct last year. He has been taking baraclude entecavir since then. The result of his first HBV DNA is 15,686,233 IU/ml and he had another test just last week and the result is 99 IU/ml. ALT before was 56.69 now its 55. He underwent liver biopsy and that's how we found out that he already has liver cirrhosis. Please help me interpret the sudden decrease in the viral load. and for patients with liver cirrhosis do they ever get well? Please help me. Thanks

[stef2011]

alinia, the one i am using now, is active against all hbv resistant strians, so it might prevent virus mutations better than tdf combo and make hbsag negative in 1-2years in a high rate (this is early clinical data) but i cannot suggest it on cirrhosis because it is off label

[stef2011]

you must also make test for antiviral resistance because you might be resistant to antivirals like lam or etv by natural virus mutation so you are sure etv (baraclude) is the best choice

when hbvdna will be zero and alt below 30 the liver damage stops and can be reversed by 5-6 years therapy in a high rate if PT 92 +/-9, platlets 185 +/-76.
also low bmi<25, albumin 44 +/-3.5 are better although not very relevant

in october we will have first data about etv+tdf combo and in 2012 this trial will be finished, HR (a researcher) suggested this combo from the begining to be 100% safe on cirrhosis

[stef2011]

i am in the same situation and hbvdna must get to zero (undetactable) as soon as possible, if it doesn't lower to zero within 6 months or below 50iu/ml within 6 months i would make combo with tenofovir.also alt must get below 30 as soon as possible.
check also ultrasound because the cancer risk is highest under cirrhosis

many are suggesting combo for cirrhosis from the begining because resistance might be deadly or very dangerous for one with cirrhosis but i cannot suggest that or say it is not useful because trials are still on the way, but from first data it appears combo is better on cirrhosis

check also hbsag quantity and if hbe is negative, if hbsag is low you might consider interferon to eradicate virus or alinia but to do this you need an advanced research center with all tests because interferon can be dangerous on cirrhosis and alinia is off label.
follow my posts because i am followed by one of the most advanced international research center with  the team of one of the most advanced researcher and will be trying interferon because my hbsag is very low in combo with etv or mono, i am also testing alinia