please Guide me

[neeli83]

hello eveyone,i am 33 years old female,last week i went for my routine tests about hbv,i am chronic hbv carrier,my Dna result was 3000iu/ml,Ast was 21 Alt was 29.ultrasound was ok,can i start treatment now ?or wait?no fibroscan in my area can any body help me,can i have more kids after starting antiviral???

[Aduiski]

were you on any medication when you took you latest ALT test?

[FingHb]

I would wait, I m not a doctor, when you are hbeag-, it doesn't mean you need to go in treatment as soon as you are above 2000iu.  
Have you had a liver biopsy done?  

[neeli83]

          My Doctor has told that my insurance company does not cover the medicine. So where can I reliably buy the medicine online  ????
I am planning to go for Tenofovir  . Is there any side effects for this medicine on the kidneys  ???
  I am already taking Vit D3 10000/iu , 1 softgel daily. Is there anything else recommended  ???

[Liverpatient]

What I wrote was a citation from a research paper here: http://www.uptodate.com/contents/hepatitis-b-and-pregnancy#H231281766. However, "no resistance whatsoever" is even better than "low resistance"; so no problem there.
Below is a not so good news about possible resistance of hbv against tenofovir in previously entecavir resistant patient. But this could just be an isolated case.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085295/

[neeli83]

My alpha Feto protein is 3.5 ug/L

[neeli83]

Hi StephanCastlecrag,
In actual ,, per doctor recommendation I should not be starting the medication for now. But I want to start the medication. I am HbeAg negative. But I want to start the Medication . On my insisting , Dr told me to start with  Baraclude 0.5mg (Entecavir) . Should I start this or should go for Tenofovir  ????
What is the major difference between the two  ???

[StephenCastlecrag]

Baraclude (Entecavir) is a class C drug for pregnancy, Tenofovir is class B. Doctors do not recommend Entecavir during pregnancy, so you may have to stop Entecavir if you are planning to have a baby. Tenofovir is recommended  during the third trimester and many women had also taken it during the whole of pregnancy. Talk to your doctor.

[StephenCastlecrag]

You are in a grey area regarding whether to treat or not. Your hbvdna is fluctuating and seems to be rising. Your ALT is slightly high for a female ( F2 fibrosis. I suggest you repeat your liver function test(ALT, platelet count, etc), hbvdna, HBsAg in the next few months. The results may clarify the picture, one way or the other.  I assume you are HbeAg negative.
Just my opinion.

[stef2011]

because it has low resistance

tenofovir doesn t have low resistance, it has no resistance whatsoever in any case

[Liverpatient]

Yes, you can, of course, have more kids after eventually starting antiviral therapy. So far, based on limited experience, the drug tennofovir is prefered for hbv positive pregnant women on treatment, because it has low resistance and its safety to the fetus is better than other antivirals.

[Liverpatient]

The term "fetus" should be corrected by "newborn" in the above message.

[Liverpatient]

Hi,
You wrote: "As far as I am aware pregnancy shouldn't be an issue at all". I think there is a high risk of passing the virus to the fetus if the mother is HbeAg positive and a high, >2000iu/ml hbv viral load. However the risk could be dramatically reduced if the newborn is given Hepb immune globulin and hbv vaccination within 12 hours after birth.

[Anonymiss123]

Hi there, it's good you have the diagnosis. Did you see a specialist, they'll be able to tell you if you need to take a treatment depending on you full blood test results.

As far as I am aware pregnancy shouldn't be an issue at all.

[neeli83]

My mother and all brother and sisters are HBV negative.

[Aduiski]

be more specific as to the both dates and values of your past ALT tests. Were you on any medications when you were testing ALT values...as some medication can raise ALT values

[neeli83]

two years before my DNA was 133 IU/MI in 2014 May ,in 2013 it was 2500iu/ml. in 2010 after my daughter birth it was 20iu/ml Alt And Ast keep rising after my daughter birth,Hbsag quantitative was 1439 iu/ml 3 years before.

[Aduiski]

be more specific as to the both dates and values of your past ALT tests