help with my lab test & dr reaction to chanca piedra

[bigmoviebuff]

My blood test from 1 year ago -

HB Core AB - reactive
HB Core AB (IGM) - non reactive
HEP B Surface AB - non reactive
HBSAG - reactive
HEP BE AG - non reactive
HEP E AB - reactive
AST - 80 (10-40 U/L)
ALT - 94 (9-60 U/L)
Dr did not take my viral load.

My most recent blood test -
HEP BE AG - non reacrive
HEP BE AB - reactive
HBV DNA QUANT 262,384 UI/ml
AST - 71 (1-50 U/L)
ALT - 76 (1-53 U/L)

Questions
1. My ALT/AST went down. I am not taking any drugs the past year. just eat/drank lots of anti-oxidants (green tea, bluebuerry, etc...) and avoided alcohol. Is this a good sign? or Are these normal fluctuations or maybe because it is a different lab?

2. I ask why he didn't do a HBsAG quant test. He told me it is unecessary& expensive. That info is only useful when deciding to take someone off the drug once they start developing antibodies. Does this sound right?

3. He told me since I am genotype C and have BCP mutation he highly recommends me to go on nucs eventhough my viral load is not very high.

4. I ask him about Chanca Piedra. He told me he has not heard about it but is adamant it will not work. He said if there is a herb that works, the medical community would've heard about it. Told me not to waste time trying it since the the hep b i have is very agressive.

[R_2012]

As all of us here are not doctors, it is best to do your own research and consult with your doctor.  Usually the doctor will know more about it than just someone giving advice on internet.  Yes, they are bad doctors out there but you are the you own best advocate, so do your own research and choose a doctor that you trust.  

With that said, you need to gather some more information about the virus.  Is there any liver damage?  Fibroscan or Biopsy can confirm.  Your ALT is twice the UL, so you may want to check DNA for next few months to see a pattern.  Better to measure 10 times and cut once!  Gather all information about the virus and liver status, before starting treatment.  

Obviously, being hbeag negative, your viral load at 1million copies places you for treatment if you look at this point in time.  .  Interferon has very little effect on HBVDNA.  According EASL Drug treatment success, Und DNA happens in only 19% of patients after one year.  Normal ALT for 59% and HBsAG loss at 4% (little more than natural clearance at 3%).    Compare that with NUCs at 90-93% Und DNA which means that they stop the progression of liver damage in vast majority of patients.  It will all depend on your situation.      

So you need to be honest with yourself on what the goal of the treatment should be.  The evidence for clearance of HBsAg thru combo treatment (40-60%) is done for people with Undetected HBV DNA for several years usually achieved thru antivirals and low quantities of HBsAg.  There is great information on this site about the studies that provide enough evidence for you to make an informed decision.    

[veteranB]

I have been on etv for 6 years.

Major issue is that I have developed high blood pressure while on this junk.

As for genotype c being less responsive to interferon yes it is said that it is. But your chances are still better then on antivirals.

That is what these doctors dont get here. We have an immune system problem. Rebuild it and it breaks the virus.

Instead they are giving us anti HIV agents  and call it hbv treatment.

When you start to understand your disease and realise how they should really treat compared to what do you will get extremely angry.    

[bigmoviebuff]

i did not know about Alinia. I will ask  him about it next time i see him.

[bigmoviebuff]

thanks. i guess i needed more confirmation before i decide to start taking the drugs.

veteran,
I did ask him about peg-interferon. He told me for Genotype C, it has a very low success rate so he does not recommend it. I think he said Genotype A and/or B has a much better chance.
My mom & sister have been on nucs for 3+ years with no issues. How long have you been on it? what kind of issues are you having?

[veteranB]

Heaving said that with your dna you do need treatment. Take etv for now like he wants supress the virus - normalize alt summer time comes add interferon. Nucs are shown to be safe up to year to take. I get this info from some doctors off the record. But you do need to suppress your dna. So i would take etv for now.

If you want to go ahead with chanca piedra try it without  nuc first and monitor your dna monthly. And report your results.

[veteranB]

I agree with Rome.

Since your alt is elevated and you are viral load positive combo nuc plus antiviral is best. But in the US yes this is how they treat it. Drug companies totally control doctors decisions on top of insurance companies  that tell them to keep the cost down. Interferon is a tough drug to take patients need close monitoring.  So from insurance end point nucs are more cost effective for them.

Also your doctor is repeating everything he was told at a liver conference sponsored by those same drug companies. Where yes they recommend start with one drug then add a second nuc.

totally ignoring the fact that it is the immune system that needs therapy to clear hbv with viral suppression.

I am in the same boat as you man. I cannot find anybody here that will do interferon. They are scared of using it. If the great doctor Gish here is not using combo therapy that should tell you what we have to deal with. They want us on an indefinite antiviral treatment so everybody makes money. Hbv holocaust  for some is a market.

The next time you see your doctor ask him. Why he is overlooking interferon  that has up to 50% chance to clear hbv. And why he wants to use etv instead of Alinia that is proven to lower hbsag quantity.

I ask mine docs and they flip out in anger knowing that I now know the truth about this game. That our viral disease is on purpose is being treated with the wrong drugs. Hbv is not HIV. In fact it is  very treatable if you are in the right hands.

So far as here in states not much available. Either submit to how they want us to treat with two nucs. Damage kidney and mitochondria along the way. Or leave the US and go abroad to get treated where medicine is less of a business and doctors have higher standards in medical ethics.

[Rome70]

1. Alt/ast change is not suffitient. Could be anything.

2.  For nucs treatment HbsAg is not so important, but it is best to quantify it anyway to know the starting point.  To check if one dvelops antibodies you should test antibodies -   anti-Hbs.

3. Your viral load is high, not so high is 10 times less. So you are a candidat for treatment according to current medical guidlines.

4. Nothing but nucs and interferon are used for hbv treatment now, all natural remedies do not have any proved success stories.

5. From the nucs the most modern and potent drug is Tenofovir. Combo treatment with interferon is considered as good alternative and disscussed here in abundance.

[bigmoviebuff]

also i ask him why he perscribed baraclude over viread. he said that he thinks it is better to start with baraclude so that we have an option to switch to viread if it does not work. He is willing to switch me directly to viread though if i prefer to.