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hep b Test results

Can Any one tell me ....what is to be done for my results
HbsAg - 2650 IU/ml
Anti HBs - 67.5 IU/ml
HbeAG -Negative
HBV DNA PCR- 24 IU/ML
LFT - Normal

Pl. suggest for further. I am healthly Carrier for 8 years(Since I know)
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Avatar_f_tn
Dear Stefano,
Can you pl. tell me
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Avatar_m_tn

since you were cronic (chronic) 2 things are possible, you are seroconverting or you have had a hbsag mutation

HbsAg - 2650 IU/ml
Anti HBs - 67.5 IU/ml

if you are not taking any treatment you might try nitazoxanide (alinia) or hbv vaccine to see if hbsab gets higher and hbsag lower/negative.what the liver specialist say about this situation?
once hbsab is positive you should get rid of hbsag slowly, is it hbsag stable or decreasing?

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Avatar_f_tn
Hi, Stefano,
Thanks for reply,

Last year I checked and observed that HBV DNA - NEGATIVE.
But last year I dont know about Hbsag(as in india this year only they started HBsAg quntitative test., befor that only 2.4 cut off value) antiHbs -3.5 IU THAT TIME.
So, My doctor advised me to take HBV vaccine 3 shots.+ 1 shot after a year.
I had taken 3 shots and 1More booster dose is pending this month.
Currently I am not taking any medicine.
This week end only I will get appointment from my doctor.

what is hbsag mutation?.
Pl. advise
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Avatar_m_tn

what is hbsag mutation?
a mutation in the a determinant of hbsag so that hbsab antibody will not work anymore

So, My doctor advised me to take HBV vaccine 3 shots.+ 1 shot after a year.
good suggestion but that is not enough.in italy they made trials to make hbsab in people with liver transplant so that they could make hbsab after hbsag gets negative.they made monthly shots, i'd try this

i'd also try nizonide500 (alinia), 2-2.5g daily, one pill 500mg every 5 hours with food.since you can check hbsag quantification and hbsab you can easily see if it works or not.
the only thing looking strange is that hbsag is quite high for hbsab to be higher than 10miu/ml but anyway there is nothing to lose since both alinia and vaccine make no sides.nizonide should work even in case hbsag has mutated
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Avatar_m_tn

also lowering cholesterol can weaken hbsag production you can try supplements like fish oil (3g per day) and red yeast rise (which contains natural lovastatin) or directly a lowering cholesterol drug like simvastatin
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Avatar_f_tn
Hi Stefano,

Today I met my doctor.
He advised me to take booster shot of HBV vaccine by this month.

But he is quite surprised about the HBV DNA PCR result of 24 IU/ml as it was Negative last year.(Both were from different labs).So he advised me to repeat the test  from another lab and if result is positive then I need to take treatment (tablets).
If the result is negative then I can stay without treatment.

Anilia tab will be available in india? is it antiviral?

I am losing lot of foreign job opportunities due to Hbsag-positive.

will wait for your comments...
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Will inteferon treatment work for me?
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Avatar_m_tn

it has many sides i'd try ntz and vaccine with or without simvastatin first and if you see no hbsag lowering by 6-12 months go for interferon with a liver specialist because it is 99% a mutated hbsag.mutated hbsag are weaker to interferon
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Avatar_f_tn
Dear Stefano,

Pl. answer my previous questions about anilia?
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Avatar_m_tn
Anilia tab will be available in india? is it antiviral?

yes it is it is called nizonide500 by lupin (also nitarid by cipla but lupin is better).it is not antiviral it is an immune modulator, it lowers hbsag and once hbsag is low/negative also hbvdna gets negative

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Avatar_f_tn
thank you very much stefano
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Avatar_m_tn
Hi ,

I"m from India. Could you please tell me where they are taking HbsAg Quantative  tests in India?  
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Avatar_m_tn

nitazoxanide is believed to work inside liver cells infected blocking secretion of antigens this way the suppressing effect of them on immune system is decreased, they also act in a way similar to interferon but don t have interferon sides since ntz gets activated only in infected cells

they are studying another compund similar to ntz (thiazolides) which has more potency on hbv and also slow release versions of ntz to increase dose to 2,7g but they are not available on market yet, still on trial
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Avatar_f_tn
Stefano,

I started using Alinia and taken hbv vaccination too.
My urine colour is Yellow due to alinia and I am feeling tired.
My worry is will it lead any sides as I am taking without doctor consultation.

Do you anybody from the our post with good changes with only alinia?

Pl. reply.
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Avatar_m_tn

urine yellow color, stools green color is not a sides effect it is just the drug eliminated.on some also eyes get a little yellow but it is not bilirubin or have anything to worry.my sister has eyes little yellow while i don t


My worry is will it lead any sides as I am taking without doctor consultation.
it is one of the rare drugs allowed on 1yo babies because of its safety the only sides you can get are diarrea (diarrhea) and stomach pains if your gut is weak

i wouldn t worry about sides but i would check hbsag and hbsab weekly so that if you see an increase of hbsag you can stop immediately, since hbsag is so low you should see results very fast maybe even within a week
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Avatar_f_tn
Thanks for yr reply.
I will update u the results after a week as for the last 6 days I am taking alinia.
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Avatar_m_tn
HbsAg - 2650 IU/ml
Anti HBs - 67.5 IU/ml

sorry i confused with another member with hbsag 3iu/ml, your hbsag is not low so check hbsag and hbvdna after 3-6months, not earlier.
alt/ast are not important and should get elevated at first, that means immune system is killing infected cells.

feeling tired might be 1000 things but mainly hbv can be more responsible than alinia
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Avatar_m_tn
"nitazoxanide is believed to work inside liver cells infected blocking secretion of antigens this way the suppressing effect of them on immune system is decreased, they also act in a way similar to interferon but don t have interferon sides since ntz gets activated only in infected cells"

I read about nitazoxanide acting like interferon in one of the references you gave me. It was a paper by Emmet Keffee. But I have not heard of nitazoxanide acting inside cell to block secretion of antigens. Can you give me a reference?

How is your exercising going?

Cheers,

Stephen
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Avatar_m_tn

it is on a research paper from an italian researcher in rome, she is studying effect on flu viruses but said the effect is the same on all envelopped viruses while on non envelopped viruses there is no effect.maybe the name of researcher is santoro but i am not sure

try a google search with nitazoxanide influenza viruses santoro, you can also try search in the community because i posted a link to it.at the end of research paper she talks about flu, hbv and hcv and says this ipotesis
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Avatar_m_tn
How is your exercising going?

lost 3kg in 2 weeks from 77,5 to 74, end point is 71 by 4 weeks/month

next week i will check alt/ast to see if liver inflammation has decreased the ipotesis was insulin resistance and visceral fat did it but it can also be the virus which increases lipids to make more hbsag
my ipotesis is that fish oil can decrease inflammation and losing fat and insulin resistance will make hbsag production more difficult.

if alt/ast get to normal range lower than 30 i might also try to lower cholesterol by red yeast rice also a low cholesterol should help lower fat in the liver and make hbsag production more difficult but i need alt/ast to normal range because red rice has natural statins and i need to see if alt ast stay in low normal level taking statins (even if they are natural and very low dose and at this level have no sides)
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Avatar_m_tn

forgot to menthion vit d which also proved to regulate lipids and immuen system, i am going to check it next month.it is very strange i could never reach high normal levels of vit D even in the summer and using high dose supplements, there is probably something which downregulate it
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Avatar_m_tn
http://jb.oxfordjournals.org/content/127/4/543.full.pdf

http://vir.sgmjournals.org/cgi/reprint/36/1/207.pdf

the fact that cholesterol owering drugs and diabetes drugs (especially insulin) have an effect on hbsag (not a cure but hbsag lowering and less infectivty of virions) can be confirmed by these 2 articles that show hbsag composition

HR protocol has also phospholipids, i don t know if they can help hbsag formation but since i had an increaseof hbsag while taking the protocol suggests that it is better to avoid antinflammatory and pcc supplementation when using immune modulators drugs

unfortunately cholesterol lowering drugs are not potent enough to lower cellular cholesterol but in any case both lovastatin and simvastain have showed in vitro effect on hbsag  and probably can help interferon and alinia.
simvastatin has been used already with interferon in vivo for hcv and both sim and vitamin d have increased the percentage of svr
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Avatar_m_tn
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951407/

Polyunsaturated liposomes are antiviral against hepatitis B and C viruses and HIV by decreasing cholesterol levels in infected cells

i guess it makes sense to find ways to lower cellular cholesterol content for those hbvdna und and low hbsag titers (1-2logs) especially on interferon or alinia
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Avatar_m_tn
Thanks for the wealth of information. You are certainly throwing everything at the HBV. On Vitamin D, the picture is very confusing. Read the article from Scientific American, especially the comments from readers.
http://www.scientificamerican.com/article.cfm?id=which-pills-work&WT.mc_id=SA_CAT_BS_20110211

Santoro is a consultant to Romark. Romark is indeed investigating Alinia for Influenza A.

Ciao,  Stephen
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Avatar_m_tn

never be fooled by newspapers or journalists and even fooled by researches, always read and compare data yourself

the article is pure rubbish froma journalist, you have to make a study, trial and show results.the journalist should shut up because just an ignorant journalist that made no study

we have just to focus on the trials of hbv and hcv with vitamin d supplementation and results are already a fact on hcv, we just need to see the results on hbv which is on trial from 2010 and should be published within a year
as to infections researchers have already seen on potent microscopes the lymphos do not activate without vitamin d so this is 100% proff
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Avatar_m_tn

vitamin d between 50-60ng/ml is good for sure with us of course it doesn t mean we will clear hbv because of this but i think taking sun or sunbed moderately is healthy (except very white skin with family history of melanoma)

i really hate articles without study behind especially when they try to say it is not needed when vitamin d at those levels have no harm while low level does.
as a part of the story some drug makers in US even asked to patent vitamin d as a cancer treatment naming drug as D analogs......very rediculous like the FDA story with red yeast rice, american FDA is very very dangerous to trust 100%

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Avatar_m_tn
The point is not whether we need Vitamin D - we do. But whether we need supplement or just spend a little more time in the sun. Here we can get a milk product that supplies the daily requirement for Vitamin D, so I tossed the expensive Vitamin D tablets that I bought and buy that special blend of milk.
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Avatar_m_tn

oh i see, to my experience moderate sun is much better, at least for skin color in sothern italy since we have almost zero melanoma risk
skin can produce very high amounts of vitamin d but i have to use both sun, suplements because it does not increase more than 30ng/ml (i just reached 47ng/ml by supplements and 1hr un exposure everyday).

maybe getting low wheight/low bmi it will be easier for me, fat content, fibrosis and fatty liver contribute to less vitamin d even with hgih doses

as to wheight and bmi you have to consider that visceral fat is the main problem and not only obesity, and visceral fat is not very visible
so the problem can be present even in people like me with bmi 25 and wheight 77kg which is just a little more than normal.
now i have moved to bmi 23 and wheight 73 and maybe vit d kinetics get to normal
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Avatar_m_tn

for those interested
sun burns must be avoided absolutely because they suppress immune system, aloe vera can decrease immune suppressive cytokines in case of sunburn.

exposure time must be calculated to avoid burns, skin protection creams are not usefull because they block vit d production, also glass in the windows or car blocks vit d production
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Avatar_f_tn
Hi,
After taking HBV vaccine and 15 days alinia. My blood results are :
Hbsag quantitative 2945 iu/ml
Anti hbs 385 iu/l .
I am confused about the raise of both Hbsag and Anti hbs.(pl. see mail previous result)

What do you feel and I continue alinia ?

Pl. advise.
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Avatar_f_tn
also the test instrument is not ABBOT and it is Editis
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Avatar_m_tn
from HbsAg - 2650 IU/ml to 2945 iu/ml
there is no difference, too small, not important

Anti HBs - 67.5 IU/ml Anti hbs 385 iu/l
this is very good

it is too early to say results of alinia, at least 3-6 months are needed but the fact that antihbs has got higher is very good.it maybe vaccine or alinia too eraly to say

i'd keep taking alinia at least 6 months, the ideal test would be a hbsag mutation test to see if you have the mutated form
maybe if this test is not available you might try the old elisa test, it doesn t get many hbsag mutants and you might end up with hbsag neg and hbsab pos, it would confirm the mutated hbsag
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Avatar_m_tn
from HbsAg - 2650 IU/ml to 2945 iu/ml
this little increase probably the vaccine

if you happen to have the hbsag mutant the virus is probably weaker than the wildtype and both interferon and nitazoxanide are more effective, their combo is best.this is from clinical cases of hbsag mutants after lamivudine therapy, after muattion interferon was started and hbv eradicated
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Avatar_f_tn
hi stefano,

my latest report
hbsag 15560 iu/ml
antihbs 220iu/l

I am more worried about this huge increase. I stopped alinia too last week before.
Totally confused....with in short one month 5 times viral load increase!!!!!!!!
pl. help
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Avatar_m_tn

did you take vaccine too?

it is very difficult to understand what is going on, maybe you suppressed the mutated hbsag and returned to the production of the wild type, it is impossible to say because we have no tests to see.
what about hbvdna and alt/ast?

at this point you can try only interferon when hbsag decreases again since interferon works on low hbsag less than 1500iu/ml, on higher values like 3000 nd more it owers hbsag on some but eradication is extremely rare

the other option might be gcmaf if somebody tries it and it works, maybe i wll try it
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Avatar_f_tn
No i have taken vaccine in feb only as per my previous chat.
I have given test for hbv dna and alt/ast also. wil get results this week end only.
I was shocked abt this result and i am little bit confused because of alinia viruse gone up /?
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Avatar_m_tn
@manmadan,,, l don't think its because of Alinia the Virus went up. Just be calm , be in touch with your doctor and listen to advice on the forum also. You will be fine. We shall all die one day with or without Hbv,earth is not a permanent place. I was scare at first but now **** the virus.shall do my treatment, and wait for miracle. Alinia reduced the virus on me meaning its working so its cant increase your virus guess something else,pls find that out. Best of luck
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Avatar_m_tn

unfortunately your virus is different from ours and has very little studies since rare, the hbsag mutants maybe even different one from the other and act in a different way

what about using biopsy and counting cccdna directly in the liver, this may be the best way to know how the situation is, cccdna count is the best tool, especially in ur case





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Avatar_f_tn
i got the ast/alt results---- normal.
hbeag negative
lft normal
on saturday will get the hbvdna result
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Avatar_f_tn
hbv dna  179 IU/ML

Viruse started increasing
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Avatar_m_tn

i'd definitely try interferon monotherapy or interferon+alinia+tenofovir, these drugs are active on your immune system except tnf so they cannot change or boost virus

in any case dont worry about hbvdna at 24 or 179 the difference is non significant conisdering you are not on antivirals
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Avatar_m_tn
the full articl might be interesting on hbsag/hbsab cronic (chronic) hbv, i dont understand what they mean by serotype
you should check both the genotypes of your hbv infection to know if you are infected with more than one genotype and the hbsag a mutation in a research lab.in any case both interferon and the other drugs work in ur case

http://www.springerlink.com/content/w4g11613k84062pm/

Abstract
The pathogenesis of HBsAg (+)/HBsAb (+) double positive hepatitis B virus infection was investigated by simulating HBsAg/HBsAb coexistence in vitro and establishing HBsAg/HBsAb double positive model in vivo. Eukaryotic expression plasmids PCI-SY, PCI-adw, PCI-adr, PCI-ayw, which expressed S gene product of different serotypes, were constructed and transfected into HepG2 cells. Recombinant proteins were purified from the transfected cells. At the same time, HBsAg mouse antiserum was obtained by immunizing mice with PCI-SY plasmid. HBsAg/HBsAb coexistence was simulated using these antigens and antiserum. Furthermore, the expression plasmids expressing different serotypes of S gene product including PCI-adw, PCI-adr, and PCI-ayw were injected into mice via tail vein. HBsAg and HBsAb in mice sera were tested at the first and 7th day respectively after antigen plasmids injection. Both in vitro simulation and in vivo animal models demonstrated that HBsAg antigen and HBsAb of the same serotypes could not coexist, but HBsAg antigen and HBsAb of different serotype could coexist. HBsAg/HBsAb double positive hepatitis B virus infection could be due to infection of viruses of different serotypes.
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Avatar_m_tn
Hi Manmadan,
Where can i take HBSAG quantitative test in chennai, India?
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Avatar_m_tn
For HbsAg Quantitative (iu/ml)

Try it in Hitech Diagnostic cente ,No.1 Millers Road , Kilpauk Branch Chennai.(ph 044-42919999)

It cost 400 Rupees.Method is ECLIA

If you want Abboht architecture , try it in Ramakrishna Hospital, Coimbatore

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Avatar_m_tn
Thanks a lot.
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Avatar_f_tn
Dear Stef,

after almost a year I checked my blood..
hesag -17700 iu/ml
anti hbs - 173 in/lit

Presently not taking any medicines....
can i go for interferon....injecion....

rgds,
Manmadan
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Avatar_m_tn

what about hbvdna and ast/alt

definitely an hbsag mutated case

have you checked vitamin d25oh levels?

interferon would be good but better prepare to have a good interferon response before going at it:

vitamin d levels 80-90ng/ml, to reach these levels you need vit d3 supplemnts 10.000iu daily and need to check calcium and d serum levels every 3 months

if hbvdna is detactable it is better to use tenofovir for 1-3 years to make hbvdna und, rescue your immune response to hbv so that interferon works

see our posts about: aldara, alinia,vitamin d3, simvastatin, all ahev mild effect but all can boost interferon response

do not start interferon ow because hbsag levels over 1500iu/ml have no hbv clerance, sequential treatment with tdf for 1-3 years and then peginterferon add on worked on levles of hbsag around 8000iu/ml but too little patients so it ibetter to lower hbsag as much as possible before interferon and tenofovir, alinia, aldara cream and vit d3 may help a little on this while simvastatin may boost response when interferon is added
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Avatar_m_tn

hbsag mutants are also at very high risk for cirrhosis and liver cancer so if it was possible to confirm hbsag mutation i d go for treatment immediately

in italy hbsag sequence is available at some hospitals, did you find a place where to have it confirmed?
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Avatar_f_tn
how to check the mutation of hbsag ? what is the test name sothat I would check it in india?

Manmadan
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Avatar_m_tn
I hope Mutation test is available in Hitech , Labs Chennai.

HBV - YMDD MUTATION DETECTION -


_http://www.hitechlabsindia.com/2010/testnew.asp?cat=H
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Avatar_m_tn
it is a research level test, full genome hbv sequencing, you have to look for a research center for it, but if it is difficult to find in india dont worry about it chnces are very high you have that mutant
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Avatar_m_tn
Hi i would like some help
I am Hep B positive
Core negative
HBAg negative
HB Ab positive
my viral load is 2 millions
my doctor told me that i dont need any medication at this point
are there any natural remedies that i should be taking
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Avatar_m_tn
if ast and alt are normal you must not treat, it is not hbv to make damage but our immune system and if you have no immune response you have no damage
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Avatar_f_tn
Hi stef2011,

Last april my test results are:
hesag -17700 iu/ml
anti hbs - 173 in/lit

just checked the AST level is high 67 (normal is 5-45 only).
but alt is normal.
Worried little bit.
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Avatar_m_tn

you look like having mutated hbsag if hbsag stays that high, is hbsag getting lower or stable?
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Avatar_f_tn
hbsag is stable for 1year it ranges from 15500-17700
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