is age 22 too early to start treatment?

[afif120]

Hi all, I'm new to this forum and need your opinion...my son, 22 yo, was diagnosed of having hepa B 5 months ago. His HBV DNA is 2.5X10log8, ALT 85, HbeAG positive. He had a test called HBsAG titer when firstly found of having heap B and it was reactive at 285.28 (not sure what was this). His doctor has suggested him to start treatment using tenofovir as his HBVDNA is still very high and therefore can not use Pegasys.  As he is still in his early 20s, I would appreciate your opinion whether it is a good decision to start treatment at his age?  Thanks a lot for any info.

[stef2011]

not yet, second human trial in combo still ongoing

you may ask about personalized hbv treatment by sequential combo treatment of tenofovir mono followed by intf add on to clear hbsag (which means clear hbv definitively), this sentence will rule out the doctors immediately even before appointment if not updated

this combo is used in italy, france and germany in the most advanced hbv centers and some asian countries, so most may not be able to do that treatment although it is not especial and quite easy, info on this is available on the 2010, 2011, 2012 hbv intl conferences on the net

[afif120]

Thanks Stef for the info.  Yes he is also  hbeag positive. While he is the best doctor in my city, tenov is just recently approved to be used in my country so he may not have experiences with tenov. He therefore doesn't have any experience in combining tenov with pegasys. He said to use tenov for minimal 2 years, depending on results.

After  reading your responseI I am thinking of looking for second opinion from doctor on whether he should start treatment now from doctor experienced with tenov and combo with pegasys.

Is information on myrcludex available in the website?

Thanks again.

Afif

[stef2011]

treatment would not be indicated with antivirals at his age, too young, unless the doctor is very expert and updated and his plan is not lifetime use of antiviral, this is because we dont even know long term sides effects of these antivirals

his liver has no damage, with todays processed foods most livers of uninfected are between 6-7kpa......

in the case the doctor is very updated it is rathional to start treament eraly since the virus has less mutants and it can be easier to clear hbv on combo intf plus nucs.is he also hbeag positive?

this is the only treatment which clears hbv in a very high percentage which can be superior to 50%, while starting treatment to keep tenofovir monotherapy is useless:

personalized treatment of hbv by sequential combination:
tenofovir monotherapy for 3-5 years (if hbeag pos there is hbsag clearance of 16% by 3 years, hbeag neg almost 0%)
peginterferon add on for 2 years (50% clears hbsag by year 1, both hbeag types)

my guess is in 3 years we will have myrcludex which will clear hbv for sure on these combos

[afif120]

Just to add to my previous posting. My son has also undergone fibroscan and  the result is 6.8 kpa or <F2 according to his doctor. Thanks again.