Hepatitis B Community
hbv is not Cytopathic, but some mutants selected by nucs are hence USE ...
About This Community:

This forum is an un-mediated, patient-to-patient forum for questions and support regarding Hepatitis B. Topics in this forum include but are not limited to, Causes, Diagnosis, Family and Relationships, Living With Hepatitis B, Research Updates, Treatment, Success Stories, Support, Symptoms.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

hbv is not Cytopathic, but some mutants selected by nucs are hence USE OF LAMIVUDINE, ADVEFOVIR and TELBIVUDINE IS "CRIMINAL"!


said in easy words, less potent nucs make hbv monsters mutants that damages our cells directly when infected........
although low genetic-barrier NAs may decrease viral load and increase survival in the short term, we predict that there may be long term detrimental effects in patients who have selected these variants. Supporting data comes from a recent study(Hosaka et al. 2010. Hep Res) where the rtM204I variant, which can cause sW196*, was shown to be a significant risk factor for the development of HCC, whilst the rtM204V variant, which does not result in truncated HBsAg, was not.

hence USE OF LAMIVUDINE,  ADVEFOVIR and TELBIVUDINE IS "CRIMINAL"!


Directly Cytopathic Drug-Resistant HBV Variants
N. Warner1; S. Soppe1; D. Colledge1; L. Selleck1; S. A. Locarnini1
1. VIDRL, North Melbourne, VIC, Australia.

Background: Treatments for CHB include antiviral nucleoside/nucleotide analogues (NAs) which target the virus by inhibiting reverse transcription. NA resistance is widespread, characterised by point mutations in the overlapping polymerase/envelope genes which encode amino acid changes in the reverse transcriptase domains of the HBV polymerase, and can encode two types of changes in the surface proteins; 1) stop codons at the C-terminal end of the surface proteins, and 2) amino acid changes that do not truncate the surface proteins. In this study we examined the pathogenicity of these variants in vitro.
Methods: Huh7, HepG2 and PH5CH8 cells were transfected with genotype D HBV infectious clones or surface protein expression constructs encoding 1) surface stop codons rtM204I/sW196*, rtA181T/sW172*, rtV191I/sW182, or 2) full-length surface proteins rtA181T/s172L, rtA181V/sW173F, rtM204I/sW196S, rtM204V/sI195M. HBsAg expression and secretion were measured by Western blotting and quantitative serology. Proliferation, apoptosis, and intracellular HBsAg levels of transfected Huh7 cells were measured using flow cytometry up to 5 days in culture.
Results: HBV variants encoding surface stop codons were completely defective in HBsAg secretion, which could be partially rescued by co-expression with wt HBV. HBV encoding full-length surface proteins were secreted from the cell with varying efficiency. Flow cytometry was used to show that the truncated surface proteins accumulated to high levels intracellularly. Cells transfected with these stop codon variants had low levels of proliferation and high levels of apoptosis. The most cytopathic variant was rtM204I/sW196*, followed by rtV191I/sW182* and rtA181T/sW172*. This cytopathic effect was shown to be directly due to expression of the truncated surface proteins. HBV encoding full-length surface proteins had wt levels of apoptosis, proliferation and intracellular accumulation.
Conclusions: HBV surface stop codon variants selected during NA therapy accumulate inside, and are directly cytopathic to the host cell, causing apoptosis. Apoptosis and chronic liver injury are strongly associated with disease progression and the development of HCC. Hence, although low genetic-barrier NAs may decrease viral load and increase survival in the short term, we predict that there may be long term detrimental effects in patients who have selected these variants. Supporting data comes from a recent study(Hosaka et al. 2010. Hep Res) where the rtM204I variant, which can cause sW196*, was shown to be a significant risk factor for the development of HCC, whilst the rtM204V variant, which does not result in truncated HBsAg, was not.
Related Discussions
58 Comments Post a Comment
Blank
Avatar_m_tn
Professor Locarnini is always scary. He has been warning about mutant hbv for several years now. He is worried that these may already escape into the general population and may not be deterred by vaccination.. Mutants infected patients may be harder to treat.
Blank
Avatar_f_tn
hence USE OF LAMIVUDINE,  ADVEFOVIR and TELBIVUDINE IS "CRIMINAL"!

And what about entecavir?
Blank
Avatar_m_tn

rate of mutations is very low, only 1.2%, on the contrary if you see lam and adv monotherapy (especilly lam) they make so many primary and secondary mutations

one thing is certain only tenofovir can be conisdered extremely safe on monotherapy, there are italian studies by ultra deep sequence while on nnucs, these might show if etv monotherapy is dangerous or not by detecting mutants that are not even selected, they can quantify the mutants from as low as 0.01% population

i should have results ready by one month, i am sure they will apply the ultra sequence to me since cirrhosis
Blank
Avatar_m_tn

in any case i asked researchers in pisa if etv mono might develop hbsag mutants but they said it is extremely unlikly

they just collected etv data from etv treated patients in italy, all geno a or d and hbeag neg (very very very few other geno or hbeag pos, usually imigrants).the rates of resistance was extremely low, maybe just one patient with previous lam resistance
Blank
Avatar_m_tn

Professor Locarnini is right if you get an epidemic of these mutants population is not covered by vaccines and they may be very dangerous and untreteable......
despite no hbsag and no hbvdna when virus gets cleared the cccdna inside the cells keeps making hbsag which is not released and damages dna making cancer cells/cirrhosis development and how do you treat that since we have no drugs to target cccdna?
Blank
Avatar_m_tn
How do you treat? The mutant form of cccdna produces truncated HBsAg that are not released from the infected cell, eventually killing the infected cell. Since these HBsAg are defective, I assume no new Dane particles are made and released, so no new cells will be infected by this mutant hbv. Therefore, we can survive if we don't have too many liver cells infected by this mutant.

Pure speculation on my part. I have asked before, but never got an answer:
what if two hepatitis B patients got married, which genotype will dominant, or co-exist, or...?
Blank
Avatar_m_tn

i dont think cccdna gets cleared at all because this mutants are those present  in occult hbv and it doesn t stop by itself but goes on for decades

myracludex could be the only drug in this case plus interferon and i guess those cells gets cleared, but i guess because i dont know if immune system can see and clear those cells with cccdna if no virions are produced

to note that cccdna can muliply as those cells with cccdna multiply, if there is no immune system killing i guess they can go on for a very long time
Blank
1738923_tn?1327330269
i went to a gastroenterologist sometime ago and he's prescribing LAM when i showed him my latest test results, the moment he said "LAMIVUDINE" i never went back to him anymore. the problem though is that, accdg to him, he PRESCRIBES this to ALL his patients needing treatment...

OMG...
Blank
Avatar_m_tn
is this an old doctor? sad & disturbing :(
Blank
Avatar_m_tn

i believe many doctors are pushed by drug makers to prescribed failed drugs like lamivudine, adefovir, telbivudine, clevudine.all these drugs are out of guidelines and all of them worsen hbv infection so there is no other explanation for doctors prescribing such rubbish

the worst thng is doctors have becoe so ignorant and unreliable that we, not doctors, have more much more knowledge than them, at this poit it would be better to get these doctors removed by suing them or reporting them to medical boards regulators before they make more damage, such choices can easily lead to death of a patient by time making hbv untreateable monsters
Blank
Avatar_n_tn
I have observed from this forum that you are so knowledgeable with HBV. Can I have your honest opinion on this:

Which is a better antiviral treatment for a chronic HBV HBeAg-ve patient of more than 18 years now, 57 1/2 year-old Asian lady with HBVDNA of 27,400 and ALT of 31 and AST of 34., with osteopenia. NO genotype and fibrosure tests yet at the moment.
Will I use entecavir or tenofovir given the above situations. Thank you.
Blank
Avatar_m_tn

osteopenia is caused by hbv infection and is very common on hbv carriers because virus lowers vitamin d, the only thing to cure this that i know of is gcmaf
vitamin d suplements are a must although it is now very late, so i'd start d3 10000iu daily and check vitamin d25oh to get higher than 50ng/ml as fast as possible and serum calcium.serum calcium is important because as we get older our balance of calcium works less well and while on vit d it may happen to have too much calcium absorption

as to hbv treatment it can t be based on hbvdna alone, a fibroscan and genotype would be necessary, but if these are not available and there is history of hcc in the family or hbv in the area is geno c i'd go with tenofovir

while on tenofovir you have to check carefully creatinine before and after started, about every 4 weeks at start, if you see any change in creatinine better switch to entecavir

if you can afford fibroguard this product can reverse fibrosis of the liver and improve kidneys function, so creatinine will stay normal in any case

tenofovir has no effect on bone mineral density if vitamin d and calcium are kept at optimum levels
Blank
Avatar_n_tn
Thanks so much Stef.

I started with vit D32000 and it gave me so much headache. I switched to D31000 which is tolerable. I take it with caltrate and expose myself in the sun as much as possible.I take these 2 in the morning. I also juice 1 carrot, 1 beet and 2 small apples which I take when I wake up in the morning in an empty stomach which I started more than a week ago. I thought it wouldnt harm to drink this so-called "miracle drink".

I also take milk thistle and phospatidyl choline for liver support which I take right after lunch and dinner.

I also take vit C after my night snacks.

I dont think we have a family history of HCC.

Which anti-viral treatment are you on? How is it doing with your HBV DNA? How long have you had HBV and are you HbeAg-ve or HBeAg+ve. I have read so much about tenofovir being used successfully to treat chronic HBv without any resistance so far. Some patients have developed resistance to entecavir and takes longer time for HBVDNA to undetectable level than tenofovir; although latter is not so good to kidneys and bone density with me being an older lady. However, as you suggested Vit D and calcium and fibroguard can help.

Is fibroguard an over-the-counter meds or supplements?
Blank
Avatar_m_tn
Which anti-viral treatment are you on?

entecavir+nitazoxanide+simvastatin (i will slowly discontinue ntz in 2 weeks and keep usig sim instead)

i am also on an immune modulator therapy waiting to add interferon lambda when available.this immune modultor was necessary even if no hbv because my level of nagalase was 6.7, at these levels all immune sytem is suppressed and there is great danger for HCC.

gcmaf

antioxidant therapy to regress cirrhosis

hepatitis technologies products, this is the one working fast thanks to hbvdna und, fibrosis has already regressed in 1.5years and now we are just looking at histology but thru ultrasound so just looking at nodules to disappear
i add to these products liposomal glutathione and vitamin c

How is it doing with your HBV DNA?
undetactable at 7-8 months and less than 50iu/ml by 5 months

How long have you had HBV and are you HbeAg-ve or HBeAg+ve.

life long and always hbeag negative, it became positive only one time with an acute hbv at 19yo and after this i had hbeab too

Is fibroguard an over-the-counter meds or supplements?

no it is a special combo of antioxidants and antifbrotics made a a team of researchers (some of the more advanced researchers in the world on liver diseases), you can buy only online

i also prefer tenofovir, making mutants is too dangerous but when you reach cirhosis kidneys are little damaged so i could not stand tnf,mybe now i can thanks to fibroguard but i think i will wait to be on interferon to use tenofovir+interferon lambda+simvastatin, entecavir was too poor results on interferon combo
Blank
Avatar_n_tn
What normally are the symptoms of cirrhotic liver? Do you feel like always bloated and having liver pain?

It was nice to hear that you were undetectable at 7-8 months. How old are you if you dont mind? It could be the age too. I read somewhere that it takes 96 weeks to reach undetectable level with ent and 48 weeks with tnf.

My doctor doesnt like the idea of liver biopsy.

She suggested treatment since one year ago and I am still hesitant to start. She said she is happy starting me with it as well as not starting with it. However, in September, she told me to start already but starting with it is the hardest thing to do because it is hard to decide which one to use between ent and tnf, given my osteopenia problem. Do you think the virus had done damage to my liver in that span of one year? And I should not keep waiting anymore?

When you send your blood samples to India, who would draw your blood for you? It seems hard.

I read somewhere in this forum a person from Cameroon got cured of chronic HBV with traditional meds. Have you any idea about that traditional meds? For all we know, those antioxidants in the fibroguard you suggested are herbals, dont you think so?

So you think fibroguard will help better than the milk thistle I have been taking for more than 10 years now.

It looks like you said antiviral treatment is more effective if your body has correct amount of Vit D3. I hope the Vit D3 1000 that I can tolerate taking will help along with Caltrate and exposure to sun in any possible way.

Blank
Avatar_m_tn
I started with vit D32000 and it gave me so much headache. I switched to D31000 which is tolerable - do you test your vit D level ? (vitamin d25oh)

Try also a to get a fibroscan (this is a alternative to liver biopsy).

Blank
Avatar_m_tn
What normally are the symptoms of cirrhotic liver? Do you feel like always bloated and having liver pain?

there are no symptoms or abnormal blood tests, only when you are about to dye all tests get abnormal.you can detect it only by fibroscan, US can detect only when too advanced with liver nodules becoming visible.it is now regressed with no fibrosis detactable by fibroscan

It was nice to hear that you were undetectable at 7-8 months. How old are you if you dont mind? It could be the age too. I read somewhere that it takes 96 weeks to reach undetectable level with ent and 48 weeks with tnf.

it depends on hbv quasispieces (the mutations of the virus you have), ultra deep sequence studies in italy confirmed this, and also confirmed that if quasispieces slow or stop while antivirals hbsag gets negative

Do you think the virus had done damage to my liver in that span of one year? And I should not keep waiting anymore?

damage doenst depend directly on virus, it is a balance of liver regeneration, your antioxidant defence, your immune system activity...too many parameters involved so there is no time to have damage, the only good thing is monitoring by fibroscan and taking as much antioxidants as possible but all extracted from natural sources, the synthetic ones made in labs are useless

When you send your blood samples to India, who would draw your blood for you? It seems hard.

well i ahve the tests done here initaly.you just get a lab to make it and ship it to india or get a nurse or doctor to draw the blood and prepare it to ship by fedex.labs know how to do it because they ship samples for special tests, if they are not stupid they should help

Have you any idea about that traditional meds?
that s spam or a coincidence, we would be all clear of hbv if a traditional medicine was wroking on hbv

those antioxidants in the fibroguard you suggested are herbals, dont you think so?
spieces mainly....cucurmin, pomegranate, reservatrol from grape, green tea, lycopene and so on.i think the doses and extraction process is the most important thing and this is made by researcher not just a commercial thing

So you think fibroguard will help better than the milk thistle I have been taking for more than 10 years now.
just google hepatitistechnologies, the full pack has also milk thistle and vitamins, they are all usefull

It looks like you said antiviral treatment is more effective if your body has correct amount of Vit D3

it is all your general helath to benefit, but it is very strange you feel something from 1000iu d3, i dont think that is the reason or maybe the product is not good, in 1hr sun you make 20000iu or more of d3 so it can t be it
Blank
Avatar_n_tn
Thanks as usual Stef for your generous knowledge on HBV and everything surrounding it.

I am leaning towards entecavir for now because of my osteopenia issue. My sister said there is no cure for it. ANd the Caltrate and Vit D3 I am taking will prevent it from going to osteoporosis.

May I know the best recommended dosage for entecavir for someone who will be on anti viral for the first time? How much are you taking?

Blank
Avatar_n_tn
Thank you for your recommendation of getting fibroscan. Stef has recommended that too. But I think regardless of its results, I am leaning now to starting with treatment that my doctor has recommended doing since the start of this year and I have kept holding off due to side effects I have been reading.

However, I talked to my general med doctor and she explained to me very well that these anti viral meds were FDA approved because they believe that the benefits outweigh the side effects. And another one said, what would one rather have: liver cirrhosis that can lead to liver cancer or low bone density or kidney problems. As what Stef has recommended, one can take Calcium and Vit D3 for bones and Fibroguard. Besides,kidney functions will be monitored closely while on these meds. And I read too that dosage can be changed if some results on kidney functions change.
Blank
Avatar_m_tn
gcmaf and osteoporosis

http://www.medhelp.org/posts/Hepatitis-B/for-april9903-or-others--gcmaf-cures-osteoporosis--Asthma-and-autism/show/1591497

gcmaf.eu
research and trials on gcmaf

i'd make resistance test before using entecavir, lam mutations make resistnce on entecavir.as to dose 0.5mg is better because this drug had lung cancer on mices during studies but no cancer on monkeys, so better stay on the low dose, 1mg dose has little more potency









Blank
Avatar_n_tn
My doctor prescribed 1 mg although what I have been reading is 0.5 mg for naive-treated patients. I thought "naive" here meant patients taking anti viral for the first time.

I have an appt with her on Nov 22 and will ask her more and I know she will not like it that I havent started yet my anti viral meds. It is just so many concerns, issues and questions. It is just so hard to start, because once you start there is no turning back. Stopping it will make more viral replications. I am also waiting for an answer from another doctor his opinion on the dosages

I'm sorry but what is gcmaf?
Thanks.
Blank
Avatar_m_tn

if you make hbv resistance test 1mg is not needed we still dont know if etv can make lung cancer on long term use, i d definitely stay 0.5mg

the difference between 0,5mg or 1mg is very very little in potency

gcmaf is an albumin protein present in the blood of healthy people and it mainly activates immune system (but it has many other roles too), people with cancer and cronic (chronic) diseases of any kind (both viral, bacterial and unknown reason) have low gcmaf and immune system non response or immune suppression all research can be found on gcmaf.eu or gcmaf.nl
Blank
Avatar_n_tn
My next appt with my hepatologist is Nov 22. Which means I will have to wait for her new prescription to say 0.5mg. Almost one month of waiting again.

If you think that the difference between 0.5mg and 1 mg is very very little in potency, then I guess it is ok to take 1 mg then?

I wish my hepatologist is very knowledgeable like you. She said she is making a study about the role of antivirals on chronic hepatitis as part of her research.

If that is so, I am  wondering why she did not recommend checking my genotype and fibrosure before start of treatment. It seems that she based treatment acc to the number of years I have had HBV, my age  and my HBVDNA of 27,400 (not sure if IU or copies). Acc to her once HBVDNA on chronic HBV HBeAg-ve patients reach more than 10,000 it merits treatment regardless of ALT and AST. She also never recommended Vit D3 check.
Blank
Avatar_f_tn
I am 53y old infected for 22y(100%sure)living inSW US where doctors don't know much about hepb,one of the reasons i am holding treat.I saw 2 hepatologists in Europe this summer, one told me to treat with antivirals based on myHBVDNA 20.000iu/ml .The second one based on my labs ,US and fibroscan 4,2kPa,SR 100% said just monitor.He said my liver is better than his.I tried to have my genotype and precore mutants but the result came nonconcludent(it should be D).I just wanted to say that i am lost and confused like you.
Blank
Avatar_m_tn
try als to have a look on qHBsAg (HBsAg quantitative) and also base on this you can made a decision, especially base on your expectation.

If you find qHBsAg to a low value, you can try to start antivirals until - you put HBV DNA und and after that start INF to force a seroconversion.

If you find qHBsAg at a high value you are on a the same like now, you can try or you can monitor.
Blank
Avatar_f_tn
HBs Ag  37845 ui/ml in 2010 and 37182,58 in 2011 .25 0H vit D 35,2ng/l in 2010 and 48,3 ng/l in2011 all at the same lab. in my east E town.The rest of tests  and the hepatologists it was in Germany.The one who recommend ed treat. said no to interferon for the HbeAg negative status but viread or baraclude.He didn,t have a fibroscan so a month later I saw a different one where I had a US and fibroscan and he said just monitor.They belong to the same teaching hospital ,so strange.In 2010  my HBVDNA was 20.000 copies at  the same lab in Germany this year.(120.000 copies)
Blank
Avatar_m_tn
Increase from 20.000 to 120.000 can be a indication that treatment can be considered. Also age have to be considered and in you case also this indicate that treatment can be considered.

Treatment can be considered even if no harm is done by hvb, only for prevention.

I don't know what to say on this case if is ok or not to start treatment , but @stef2011 can have a comment on this, he have more knowledge on this.

to treat or not to treat is always a hard question.

Blank
Avatar_f_tn
I know ,it is always a risk ,the question which one is bigger.I was infected at the age of 31,no drugs ,alcohol or other disease and yet I didn't clear the virus,must be luck!
Blank
Avatar_m_tn
how do you know that you have infected at age of 31 ?
Blank
Avatar_f_tn
I worked in health care in a country where hepb was spread like flu.(needle stink from a patient w acute hep b)It is the onlything that i am 100% sure about this disease.I don't want to go into details here,but i'll try to send you a pm later.I have tu go now.
Blank
Avatar_m_tn
have a look on this link http://www.hepbnet.org/ maybe it will help you to chose for the 2'nd (3'rd) opinion.
Blank
Avatar_n_tn
I am as confused as you are, I could see. Only because it seems that my hepatologist is not that knowledgeable, and with the so many things I read online, it confuses me more.

She wanted me to start treatment since Jan 2011 with tenofovir. I held off because of toxicity to kidneys and can cause bone loss. Then I met her again in March and my HBVDNA went down to less than 10,000; so I held off again. This time I told her to check my bone density. In April ,results came back that I have osteopenia; so she recommended Entecavir.

I am still not confident so I came to this forum for opinions. Then everyone said, get fibrosure and genotype. Until now I havent gotten it yet because I do not know where to get them her in US.

Are u HBeAg-ve as well? It is really hard to start treatment. For people like us, treatment could be lifetime. Only for HbeAg+ve that treatment can be stopped at a certain point.

What do you feel right now, since u hv had this for 22 years now? Do u feel bloated somehow or do u experience liver pain?

Are you doing something with ur diet or taking liver supplements meanwhile?

Blank
Avatar_f_tn
thanks for the link,I am working on this.I'll have to pick one,at least i can have my tests free,wish me luck!
Blank
Avatar_f_tn
I ignored this virus for 20 years,getting tests not quite every year .Two years ago I had my first viral load 1090iu/ml.I am HbeAg- ,don't have any pain in my liver but I just found that I have osteopenia in some bones,even osteoporosis in others so another thing to worry about.I take from last yearLegalon forte(milk thistle),vitD3 2000iu brand Carlson and started to take Rebuild osteoporosis formula brand Metabolic maintenance.I also take ALA 600mg and B-complex phosphorylated but I am not good in taking pills.I started to eat much healthier ,I was never a junk eater and ate pretty much homecooked meals.I don't exercise,walk sometimes and very active.Let us know about your decision.
Blank
Avatar_n_tn
From te time Iw as diagnosedin 2000 till June 2010, my doctor said I did not need treatment with HBVDNA at 1780IU/ml and with normal ALT (below 2X UL of 19, i.e. below 38) and my ALT till now has always been 31 and below.
However, she wanted to start me with treatment since Jan 2011 when HBVDNA started to replicate for 6 consecutive months. The latest being 27400 in July 2011.
The only hesitation right now is the dosage, Her prescription was 1mg and website on entecavir says 0.5mg for nucleoside-naive patients. I thought for first-time treatment from what I have read is 0.5mg and 1mg for those who were on diff antivirals bnefore who became resistant to it i.e.those who used lamivudine and became resistant and switched to entecavir has to use 1mg.
I wil ltry to see my doctor tom even tho my appt is still 3 weeks from now to ask why 1mg. Otherwise I am really leaning on starting with treatment. After so much hesitations and reading I thought we should lower the viral count in our blood and at this moment in time, only antivirals it seems like can lower it. I dont think that at this point diet will help. HAving a well-balanced diet will certainly be good for the liver, however I dont think that it will lower viral replication. Even with treatment, liver is still infected but my doctor told me that if I were her family, she should start treatment. When I have always expressed concern about hesitation with treatment, she asked me why do I want the virus in my body. I thought that diet can lower replication and it looks like not maybe because of age and immune system.She recommended entecavir because of my osteopenia.
Besides avoiding fats and red meat, I try to juice an apple, a carrot and a beet when I wake up in the morning and drink it with empty stomach. Try to google-search "miracle drink" and see if this will be beneficial. I thought there is no harm to drink this. Vegetables are good for the liver, besides being cancer-fighting foods. I eat brown rice instead of white and whole grains and whole wheat bread instead of white. Also, I try to avoid sugar. I eat fish esp salmon which is a very good source of Vit D, but very very seldom meat. They say to eat plenty of carbohydrates for energy and foods that are easily-digestible.I also read drinking water with freshly-squeezed lemon 3X a day is good for the liver, as well as juicing fresh oranges 2X a day and drinking it with empty stomach. I also line-dance as my form of exercise and a lot of walking. I live in NY and we do a lot of walking here. I never drink. not even white wine nor red wine, altho red wine is healthy for the heart. Never smoke either.
Blank
Avatar_m_tn
good luck and keep us informed about the discussion results and decision.
Blank
Avatar_m_tn
good luck with your doctor and keep us informed about the discussion results and decision.

as regarding the rice, I notice that you mention brown rice, maybe you should try read rice (look for red rice in this website).
Blank
Avatar_n_tn
Yes. I read about red rice also. Maybe I should try that too. But I would like to recommend you to google-search about "miracle drink". There are 2 versions which are I though equally good: juice 1 carrot, 1 beet, and 1 apple OR 1carrot, 1 potato and 1 appleand drink it with an empty stomach in the morning when you wake up. Then you can have breakfast after an hour. We cant go wrong on this "miracle drink". We eat these vegetables and apples on a daily basis. Only we are taking these in the form of juice. Absolutely, there wouldnt be side effects nor toxicity, BUT only health benefits. Beets for one along with carrots, are really very very healthy. SOme others include cucumbers and celery in the juice.

Are you also on anti viral meds?

Blank
Avatar_m_tn
no, I'm not on antivirals.

My HVB DNA is around 100 UI/ml and the other result are good (you can see my results at http://www.medhelp.org/posts/Hepatitis-B/My-result/show/1568816?personal_page_id=2249050) so is not need for antivirals consideration in my case.  
Blank
Avatar_n_tn
Hi Stef,

Maybe I missed most of your posts because I have been here only since early Oct. What did you do/eat to get rid of fatty liver?

With the so many vit/antioxidants you are taking, how do you schedule them in such a way that they dont interfere with each other along with your combo antiviral treatment?

Are you able to split a 1mg entecavir pill to get a lower dosage of 0.5mg?
I thought that as you advised that I should be on 0.5mg and I think that I will be more comfortable taking 0.5mg because that is the dosage recommendation by Bristol-Myers for nucleoside-naive patients (like me), and 1mg is for lam resistant patients who are trying to switch to ent. If it is alright to split the 1mg ent I have, I will do so and start the treatment today , I am thinking at 4 p.m. (2 hours after my lunch and 2-3 hours before dinner). When do you take yours? They say to take it 2 hours after and before a meal.

THank you as usual. Your extensive knowledge has been of great help to everyone.
Blank
Avatar_m_tn

vitamins/antiox dont interfere with antivirals, except maybe milk thistle, you better restart it when hbvdna und

as to etv it has been a failure on me and i will be swtching to tenofovir soon, probably combo.as i lowered nitazoxanide hbvdn is back detactable although less than 20iu and alt is 35

if you start etv better use 1mg dose, as i have always thought it is less potent than tenofovir
Blank
Avatar_n_tn
Hello 4est,

I did see my doctor last Wed Nov 9th and I asked her why she prescribed me 1mg ent as opposed to 0.5mg recommended by the manufacturer of Ent (Bristol-Myers) and her answer was: "that is the dosage recommended by American Liver Association."

Then I told her that the drug manufacturer suggests 0.5mg for nucleoside-naive patients like me and she said," one can do 0.5mg or 1 mg" ; however she said "here, (meaning the hospital where she is), we give 1mg following the Amer Liver Assoc."

Obviously, 1mg will be more potent and since ent has an issue of resistance, (small) compared to tnv, which has none so far, then maybe 1mg will work better? I hope and pray.

Then I asked her if it is going to be toxic and she said "NO".

I have to start treatment at some point, and it has to be soon. I have waited long enough holding off treatment which I should have done beginning of this year;  and I think I have gotten enough answers to my questions and issues, and I must do something now to lower my viral replication, regardless of whether I am confortable with it or not. No matter what I do with my diet, no matter how much liver support supplements I take and no matter how much vitamins and antioxidants I take, it looks like it will not lower the viral replication. Virus has a mind of their own and it will continue to make "copies' and it is scary, unless we do something to put it under control.

With God's help, I hope I am able to tolerate this medication that at this point in time, I cant overlook and hold off anymore.
Blank
Avatar_n_tn
Hi Stef,

Sorry to hear that you think ent was a failure for you. However, 20IU/ml is not bad, isnt it? In one study I read conducted by the drug manufacturer (Brsitol-Myers) they were discussing HBVDNA of less than 50IU/ml and for them that was undetectable, after 96 weeks. The study compared ent monotheraphy and  ent plus tnv on nucleoside-naive chronic HBV HBe Ag+ve and HBV HBeAg-ve patients . I am trying to look for the link so I can post it here. I read it last nite.

How long have you been taking ent?  Although  your result of less than 20IU/ml is still undetectable to some labs.
Blank
Avatar_n_tn
Did your doctor followed up by increasing your dosage to 1mg from 0.5mg you were taking?
Blank
Avatar_n_tn
I mentioned a study conducted by Bristol Myers on entecavir monotherapy versus ent plus tnf.

Just try to goolge-search "study by Bristol Myers on Entecavir monotheraphy". The results came out just 2 days ago.
Blank
Avatar_m_tn

studies from drug manif are done to fit data in order to maximize sells, they are not done on patient's sake focus

the hbvdna in the serum must be as low as possible, they used 50iu/ml at the time of the study just because there were some old machines with that bad sensibility

my point is making hbvdna und as much as possible in the liver, not in the serum.if you hve so much hbvdna you rik resistance because it is much more in the liver, infact my alt are always abnormal (by the way the study also uses alt normal 40 or 45, a piece of cake to boost good results doing like this)

in my case, cirrhosis, there must be no hbvdna and normal alt as soon as possible, to my point of view this antiviral has been a total failure, if it wasnt for hepatitistech antioxidant therapy who knows how my liver would have been
Blank
Avatar_m_tn

as LA researcher said in mid 2010, etv is only partially active on me and ntz probably suppressed the mutants

it can also happen to have some hbvdna detactable from time to time for others and it is not dangerous if it goes und again the next month, but in my case i prefer no risks
Blank
Avatar_n_tn
Hello Stef,

How much was your HBVDNA when you first started with your anti viral treatment of 0.5 mg of entecavir? And how long have you been on entecavir? Are you feeling better now than before you started with your anti viral medications?
Thank you.
Blank
Avatar_m_tn

580000iu/ml, but it is the mutants to define response, only very high hbvdna at 10*7-10*8 needs combo sometimes,

in 1 month it got to 3400iu/ml so it just a matter of low level mutants

And how long have you been on entecavir?
2 years

you feeling better now than before you started with your anti viral medications?
of course i do but it wasn t entecavir to make me feel better but heptech products and gcmaf, of course these two work better when hbvdna is und but without them i dont think entecavir alone would have regressed my cirrhosis so fast
Blank
Avatar_m_tn

tomorrow i am rechecking hbvdna, it can be that stopping alinia i just got some hbv between 1-5iu/ml and it just got und again now
Blank
Avatar_m_tn
Stef. Which researcher you have corresponded in LA? I cant locate one to work with me. Those  that call.themselves researhers do product testing for a drug  company/s rather then unitilize available treatments.
Blank
Avatar_m_tn
A word about Etv from my experience living with core promoter mutant. It.suppreses it well. But as soon as i stop it the virus comes back strong again.

Also as a possible  side effect my hair have stopped growing. It is not falling out or anything just not growing. I need haircut like once every six months now.

Also i have developed elevated blood pressure on etv. Something Hiv folks report as a side effect of taking nucs for a long time.

Also  i had sunlight sensitivity from etv.  And cannot stand the hot weather now. My skin turns red and body gets very hot. So i have learned to manage it and avoid being out on the sun  for too long.

Also etv caused me to have headaches - migraines to be exact when I started it taking 1 mg daily. 0.5mg was ok.  
Blank
Avatar_m_tn
Exercising and etv. I try to swim daily to keep muscle loss from taking antivirals to a minimum. And to also oxygenated my body better. Generally i can swim ok on etv. But of course being off the medication the work outs go much easier. Heart rate is less. So that is another thing of antiviral drugs that are not addressed at all.  HIV infected people report also elevated blood pressure from nucs taken for a  period over 3 years. Anybody has any comments about it?
Blank
Avatar_m_tn

gallo under trail in australia admitted hiv was never isolated and less than about 40% of ptients dying of aids had positive hiv tests, so hiv equal aids was never proven.

aids is caused from unhealthy life styles, drugs use, chronic infections of many viruses/bacteria, damage of malt mucosa, chemicals in food....never look at hiv research because there is nothing scientific and much markting in that filed
Blank
Avatar_m_tn

they use combos of highly toxic drugs much diiferent from us, we may look at them just for the sides but since we use tdf mono or etv mono we are very very far from the sides experienced by them

i also dont think hbv can stay after 10 years of tdf or etv if we add intf, it is a fact that hbsag lowers after years and years of nucs and intf add on can just fasten this process
Blank
Avatar_m_tn
I have tested myself for just about all the viruses. Many doctors think I am crazy, but I did a very thorough evaluation of myself.. partly because of that black hairy tongue that after your recommendation has gotten better.. This what else I have antibodies too..

CMV, EBV, ParvoB19, Micoplasma Pneumonia, Toxoplasma. CMV does stress immune system by itself.

Infectious disease doctors tell me that most people have being exposed to these to and to not to worry about. But how do Herpes virus such as CMV and EBV interact with HBV remains unknown and what they do to the immune system that perhaps develops a lag of response to HBV

And this is what researchers should be studying. Instead you see what is going on this side of the pond. Long product testing on  very few people of the drug that can help us.

This is very frustrating..
Blank
Avatar_m_tn

we live with millions of virus, retroviruses and bacteria in us, we are 90-94% not human cells and only 1-4% human cells, this is why it is useless to test for most viruses, we just live in a balace with them and cooperation since many of them allow us to live

what you do need to test is immune system health because this is how we live in balance with viruses/bacteria and diseases but unfortunately there are no tests to measure immune function and those we have mean very little

testin for:
vit d levels
nagalase (less than 0.6 means macrophages work checking our body for pathogens, if more than 5 macrophages can be activated, immune system is blind and immune suppressed)

a part from those tests if you never get sick and never need drugs your immune system is working.
cd count tests, wbc counts are not useful because it is not the number of cells but quality to allow immune system to work.you can have all high numbers but high nagalase so all cells not working
Blank
Avatar_m_tn
There are flow of cytometry  immune tests.. I had those done.. They were looking for HIV in me, I pressed them on.

Is nagalase levels test available in the US?

Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Hepatitis B Community Resources
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
Top Hepatitis Answerers
Avatar_m_tn
Blank
stef2011
Italy
Avatar_m_tn
Blank
StephenCastlecrag
Australia
Avatar_m_tn
Blank
veteranB
CA
9624973_tn?1413019730
Blank
melcul
United Kingdom
Avatar_m_tn
Blank
SafiSifa
Izmir, Turkey
Avatar_m_tn
Blank
mer971