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question about antibody
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question about antibody

Just wondering, I had a liver transplant three years ago.  They said the donor had a HBV antibody but they did not detect HBV.  I decided to go ahead and go through with the the transplant.  The doctors said 1 to 2% chance of HBV appearing.  I had been vaccinated (the three shots) about 15 years earlier and so I have HBV antibodies.  

After the transplant my doctors said I should go ahead and take Epivir just in case they'd missed something.  I want to stop taking it as it's just one more drug and has a few minor side effects.  

If I were to stop taking it and HBV showed up are there effective drugs to control it or cure it?  I don't know much about the treatments and was wondering how much of a risk it really is.  I'd like to get some opinions on that from some of you guys on here.  I'm in no hurry to do something but I'd like to get off the epivir if at all possible.  My doctor said we might go to one pill every other day.  I wonder if it's possible to just stop and see what happens and start back if HBV rears its head.

regards, David
4 Comments Post a Comment
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Avatar_m_tn
Did you test hbsab quantity? If you have enough of antibodies >10 iu/ml ( but better 100-1000) you have immunity for hbv.
Can you get vaccinated again to develop more antibodies so that if you stop the drug and hbv renounces the immune system would response?

Anyway there is a newer drug Tenofovir  that has less side effects and does not produce mutants, maybe you can discuss with your doctor switching to it.
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Avatar_m_tn
Yours is a very special situation. Epivir was taken just as a precaution. It is not clear whether you are even infected with HBV. The HBV antibody in the donor liver could be just from immunization. I wonder whether you should test for HBsAg and hbvdna, or even HBcAb just to see if you are infected? If you are not, I am sure you can discuss with your doctor about stopping Epivir.

Just my opinion.
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Avatar_m_tn
Probably the donor had anti-hbc, otherwise the doctors would not worry about hbv. Anti-hbc means trace of resolved infection, so they did biopsy of the liver to check for ccdna and did not find it, but there is no guaranty that ccdna is not somewhere else, that is why they are worried. Also with the transplant people take immunosuppressive drugs so if hbv is there the immune system may not be able to fight with it. So stopping NUCs maybe a bit risky.  The good idea would be to change for the drug with less side effects.
But I agree that the transplant is a special case and I am not sure even if immunization is allowed. Everything must be double checked with health professionals.
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Avatar_m_tn
Thanks, those were all "best answers."  I'll take some of that to my doctor.  Appreciate your time.

best to everyone, David
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