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hep B

I was diagnosed chronic hep B in June 2010 and given Baraclude 0.5mg prescription. Before treatment, my ALT was 98 (ULN<58); hbvdna 50,000,000 IU; hbeag +ve. After 9 months, my latest results are: ALT 50; hbvdna 1,700 IU; hbeag still +ve.
Has Baracule become less effective in my body? frds of mine can achieve hbvdna und within 6 months of treatment.
Should I go for other treatments? Thank you for your advice.
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Avatar_m_tn
I was diagnosed chronic hep B in June 2010 and given Baraclude 0.5mg prescription.

did they check your biopsy or fibroscan to know if you have liver damage since entecavir (baraclude) is useless on virus?the only reason to use it is stop and reverse liver damage or full the poket...of somebody with money

Before treatment, my ALT was 98 (ULN<58); hbvdna 50,000,000 IU; hbeag +ve.
no meaning to understand number of infected cells, liver dmage and possibility to clear hbv but entecavir (baraclude) comboed with interferon and alinia might eradicate hbv if hbsag declines during entecavir (baraclude) therapy and hbeag becomes negative.entecavir (baraclude) monotherapy is almost useless only 5% eradicate hbv in the first 1-2 years of treatment, probably they were already clearing hbv themselves since 5% is close to the normal eradication per year without tretment (1-3%)

After 9 months, my latest results are: ALT 50; hbvdna 1,700 IU; hbeag still +ve.
yes it is not working and you are at risk of virus mutation, according to guidelines you should add tenofovir but i'd consider interferon and alinia since tenofovir doesn t eradicate hbv eather.the choice of this therapy almost useless and possibly making more damage, i'd change doctor and clinic.according to guidelines you  must absolutely add tenofovir at 12 months if hbvdna is so elevated.
also consider that infected cells might have increased during tese months, hbsag quantity by architect might tell, so if you stop baraclude you get acute hbv with a alt flare since as i said previously infection worsen during nucs therapy

Should I go for other treatments? Thank you for your advice.
absolutely yes, and you have to check polimerase mutations too because you may already have mutants

if you follow my posts you will see i have also used entecavir (baraclude) to regress my cirrhosis, and baraclude can do this very well and i have comboed with alinia to prevent resistance and try to lower hbsag
i am about to try adding gcmaf and if it fails i will have the combo of entecavir+alinia+interferon later this year

in your case therapy has totally failed
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Avatar_m_tn

act as soon as possible because such a high hbvdna level after 6 months is extremely dangerous for mutations already present or about to come

tenofovir would have been the best choice because it has no resistance even if hbvdna remains detactable.maybe the easest is to add tenofovir to entecavir for the next 6 months and check if hbvdna gets und, keep combo other 3-4 months after hbvdna has got und and then add interferon and alinia

see international liver congress 2011 in berlin and the poster about antivirals+interferon comboes (maybe there is some posts in this board too)
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Avatar_m_tn
thank you for your advice, will see another specialist to seek help
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