Aa
regressison of cirrhosis 48weeks etv+alinia
a wonderful update after 48weeks of my treatment with baraclude 0.5mg (entecavir) plus alinia (nitazoxanide) 1.5g daily
i also changed diet with antioxidants known to reduce fibrosis in anima studies:bluberries, melatonin,omega3,green tea
cirrhosis regressed (not reversed), fibroscan 9kpa about f2 to f3 borderline, i started with a baseline value of 15.9 november 2009, 16.3 in march 2010, 13.9 in july 2010.
(cutoff values for F0 4.0kpa, F1 about 6.5, F2 about 7.1, F3 9.1 and F4 12.5)
this confirms baraclude as the most fast antiviral in cirrhosis regression while viread is better on less fibrosis stages
to talk about cirrhosis reversal (which takes years of hbvdna und)
in december we will check deeply by ultrasound to see if nodules have been absorbed or are disapearing and if structure of the liver is slowly getting back to normal, it is also important to reach F0 at 4-5kpa, if all this happens we might talk about cirrhosis reversal and not only fibrosis regression, but anyway this is not important because even if the structure of the liver is not like before cirrhosis the liver can adapt and work perfectly if fibrosis is zero
i also changed diet with antioxidants known to reduce fibrosis in anima studies:bluberries, melatonin,omega3,green tea
cirrhosis regressed (not reversed), fibroscan 9kpa about f2 to f3 borderline, i started with a baseline value of 15.9 november 2009, 16.3 in march 2010, 13.9 in july 2010.
(cutoff values for F0 4.0kpa, F1 about 6.5, F2 about 7.1, F3 9.1 and F4 12.5)
this confirms baraclude as the most fast antiviral in cirrhosis regression while viread is better on less fibrosis stages
to talk about cirrhosis reversal (which takes years of hbvdna und)
in december we will check deeply by ultrasound to see if nodules have been absorbed or are disapearing and if structure of the liver is slowly getting back to normal, it is also important to reach F0 at 4-5kpa, if all this happens we might talk about cirrhosis reversal and not only fibrosis regression, but anyway this is not important because even if the structure of the liver is not like before cirrhosis the liver can adapt and work perfectly if fibrosis is zero
thanks for the articles, they are very very interesting and get right to the point of hbv persistance (drug makers don t like these studies for sure), i will read them carefully tonight
If a carrier of chronic HBV having blood test result with Hbsag negative and Hbsab positive does he/she still possesses a potential risk spreading HBV to other? If YES, in which most possible route? Assuming no occult HBV is found on PCR test. TIA
Hi,
I found the article:-
Control of cccDNA function in hepatitis B virus infection
http://www.jhep-elsevier.com/article/PIIS0168827809003894/fulltext
Massimo Levrero
Teresa Pollicino
Jorg Petersen
Laura Belloni
Giovanni Raimondo
Maura Dandr
satimis
I found the article:-
Control of cccDNA function in hepatitis B virus infection
http://www.jhep-elsevier.com/article/PIIS0168827809003894/fulltext
Massimo Levrero
Teresa Pollicino
Jorg Petersen
Laura Belloni
Giovanni Raimondo
Maura Dandr
satimis
Hi stefano,
Lot of thanks for your detail advice.
Scientists are now casting their eyes on cccDNA and its eradication. That is ultimate therapy. They are now heading on combined antiviral drugs and immune activator to clear cccDNA.
I have been searching heavily on Internet without much result. Maybe it is just started.
I found:-
Hepatitis B Virus Replication Is Regulated by the Acetylation Status of Hepatitis B Virus cccDNA-Bound H3 and H4 Histones
http://www.gastrojournal.org/article/S0016-5085%2806%2900002-3/abstract
Siete italiano ?
I'm looking for the article:
Tallone d'Achille di epatite B
(Achilles heel of HBV)
written by Prof Massimo Levrero of Sapienza Università, Roma
English version preferable, if possible.
Parlo poco Italiano solo
Potete aiutarmi? Per favore
Grazie
B.R.
satimis
Lot of thanks for your detail advice.
Scientists are now casting their eyes on cccDNA and its eradication. That is ultimate therapy. They are now heading on combined antiviral drugs and immune activator to clear cccDNA.
I have been searching heavily on Internet without much result. Maybe it is just started.
I found:-
Hepatitis B Virus Replication Is Regulated by the Acetylation Status of Hepatitis B Virus cccDNA-Bound H3 and H4 Histones
http://www.gastrojournal.org/article/S0016-5085%2806%2900002-3/abstract
Siete italiano ?
I'm looking for the article:
Tallone d'Achille di epatite B
(Achilles heel of HBV)
written by Prof Massimo Levrero of Sapienza Università, Roma
English version preferable, if possible.
Parlo poco Italiano solo
Potete aiutarmi? Per favore
Grazie
B.R.
satimis
your point is correct but once hbsab is present the entrance to other cells is blocked so there is no way hbv can rise again to make a lot of damage, hbsab must lower to less than 10miu/ml but for this to happen the immune system needs to be very very damaged, even people with aids have enough immune system to keep producing hbsab
in any case even after hbsag seroconversion it is good to check for hbvdna pcr below 10iu/ml because residual viremia is present in some and here you got the point perfectly, this condition is called occult hbv, but a perfect liver with no fibrosis has no problems with occult hbv or residual viremia
in the case of cirrhosis it is another story, hbsag seroconversion is not enough and antivirals must be kept until cirrhosis has complitely regressed to a very safe stage, this is because even very low viremia keep making remarkable damage to a cirrotic liver and liver cancer can develop even after hbsag seroconversion in cirrotic livers
in my case even if i achieve hbsag negative and hbsab positive i will keep making hbvdna checks every 3-6 months, ultrasound every 6 months and will keep entecavir+alinia until the liver is complitely recovered, i prefer to stay on the very safe side, this is also the point of view of the most expert researchers on cirrhosis
in any case even after hbsag seroconversion it is good to check for hbvdna pcr below 10iu/ml because residual viremia is present in some and here you got the point perfectly, this condition is called occult hbv, but a perfect liver with no fibrosis has no problems with occult hbv or residual viremia
in the case of cirrhosis it is another story, hbsag seroconversion is not enough and antivirals must be kept until cirrhosis has complitely regressed to a very safe stage, this is because even very low viremia keep making remarkable damage to a cirrotic liver and liver cancer can develop even after hbsag seroconversion in cirrotic livers
in my case even if i achieve hbsag negative and hbsab positive i will keep making hbvdna checks every 3-6 months, ultrasound every 6 months and will keep entecavir+alinia until the liver is complitely recovered, i prefer to stay on the very safe side, this is also the point of view of the most expert researchers on cirrhosis
Hi,
> as an example why aids patients get all kinf of
> viruses/bacteria/cancers once immune system is
> destroyed, the viruses were already inside the
> body and once immune system lose control they
> attack the body
If I understand your advice correctly, the viruses are existing inside the body but dormant (or inactive). It is because the immune system of the body being in sound condition putting them to that state but can't remove them.
Applying this principle on HBV, the virus, replicated by cccDNA, is inside the body but being non active when the immune system of the body is in sound condition putting them under control. Once the situation changed due to an unsound condition of the immune system the HBV will become active again attacking the liver.
That is my point. The source of the virus- cccDNA, taking the liver cell as the place of abode, continues replicating HBV even in slow production and waiting for a chance to retort. We never know when the immune system, the body's defense, will become weakened. In such circumstances the patient has to attend follow-up medical consultation at regular base for the rest of his/her life. In parallel he/she may have to resume therapy against HBV when the situation changed.
B.R.
satimis
> as an example why aids patients get all kinf of
> viruses/bacteria/cancers once immune system is
> destroyed, the viruses were already inside the
> body and once immune system lose control they
> attack the body
If I understand your advice correctly, the viruses are existing inside the body but dormant (or inactive). It is because the immune system of the body being in sound condition putting them to that state but can't remove them.
Applying this principle on HBV, the virus, replicated by cccDNA, is inside the body but being non active when the immune system of the body is in sound condition putting them under control. Once the situation changed due to an unsound condition of the immune system the HBV will become active again attacking the liver.
That is my point. The source of the virus- cccDNA, taking the liver cell as the place of abode, continues replicating HBV even in slow production and waiting for a chance to retort. We never know when the immune system, the body's defense, will become weakened. In such circumstances the patient has to attend follow-up medical consultation at regular base for the rest of his/her life. In parallel he/she may have to resume therapy against HBV when the situation changed.
B.R.
satimis
i forgot to tell you to add nac (acetylcisteine) too from start, this is a potent antioxidant/immune booster which helps liver and kidneys work better, the dose in heptech protocol is 2400mg daily and i am using this dose from 15 sept
if you see cirrhosis from ultrasound it is well advanced, you should have monitor by fibroscan and not blood tests, we now know all blood tests are useless in terms of fibrosis and liver damage
you must get immediately hbvdna<10iu/ml or und, alt<30, hbe negative, so that the virus can make no damage to you
follow through the posts the same antioxidants i used not only bluberries, when hbvdna is und, hbe negative and alt<30 you can add all the list posted here:
http://www.medhelp.org/posts/Hepatitis-C/Research-supported-antifibrotics---do-they-exist/show/346752
it is better to use all of them when antiviral has suppressed all virus to avoid interference
you can also get all these supplements from hepatitistechnologies, if you google it you will find it
entecavir is the best choice but it is necessary to make a resistance test before you start it because it doesn t work if LAM mutants are present, these mutants can be present naturally or after therapy with this drug
it is also very important to check liver by fibroscan every 3-6 months to see improvement in fibrosis
i also used alinia (nitazoxanide), at the moment it is better not to use it because it is off label and we don t have any proff it can also act as antifibrotic, but if you see no improvement by fibroscan after 6 months you should try to add alinia too.it has a stong effect on apoptosis of cells so theoretically it might have a little effect on fibrosis too but there is no proof so do not use it at first
also follow my posts about alinia and if you see i get hbsag negative or very very low you might add it too because a reduction of hbsag in vitro has shown to reverse HCC growth
i wish you can reverse cirrhosis as soon as possible, do post your fibroscan results and check for liver cancer every 6 months by ultrasound because you have the highest risk of liver cancer until fibroscan is more than 10kpa, any value of fibrosis lower than 10kpa is safer
you must get immediately hbvdna<10iu/ml or und, alt<30, hbe negative, so that the virus can make no damage to you
follow through the posts the same antioxidants i used not only bluberries, when hbvdna is und, hbe negative and alt<30 you can add all the list posted here:
http://www.medhelp.org/posts/Hepatitis-C/Research-supported-antifibrotics---do-they-exist/show/346752
it is better to use all of them when antiviral has suppressed all virus to avoid interference
you can also get all these supplements from hepatitistechnologies, if you google it you will find it
entecavir is the best choice but it is necessary to make a resistance test before you start it because it doesn t work if LAM mutants are present, these mutants can be present naturally or after therapy with this drug
it is also very important to check liver by fibroscan every 3-6 months to see improvement in fibrosis
i also used alinia (nitazoxanide), at the moment it is better not to use it because it is off label and we don t have any proff it can also act as antifibrotic, but if you see no improvement by fibroscan after 6 months you should try to add alinia too.it has a stong effect on apoptosis of cells so theoretically it might have a little effect on fibrosis too but there is no proof so do not use it at first
also follow my posts about alinia and if you see i get hbsag negative or very very low you might add it too because a reduction of hbsag in vitro has shown to reverse HCC growth
i wish you can reverse cirrhosis as soon as possible, do post your fibroscan results and check for liver cancer every 6 months by ultrasound because you have the highest risk of liver cancer until fibroscan is more than 10kpa, any value of fibrosis lower than 10kpa is safer
What makes the patient achieving above results is the medical therapy which suppresses the active of cccDNA. But if therapy halted cccDNA may be active again. The root is still there. It is the source of HBV. This kind of therapy is only a temporary cure.
hbv persists because it suppresses immune system mainly by hbsag, if you remove hbsag the underlaying antibody hbsab takes control of hbv and cccdna slowly decreases to und by our assays but it is not zero, it may persist all life.
do not rely on old studies because they use wrong words or are wrong, for many viruses and hbv family also, eradication doesn t exist they can only controlled to und by immune system but the template is hidden inside cells, herpes, papilloma virus, citomegalovirus and many others, they all have the residual template hidden but until immune system works you might say they are cured or und
This kind of therapy is only a temporary cure.
no if it is immune system to take control it is definitive.we have millions of viruses/bacteria inside us in a balance with immune system, if you like you can consider it hbv eradication because it makes no difference until you have an immune system.
as an example why aids patients get all kinf of viruses/bacteria/cancers once immune system is destroyed, the viruses were already inside the body and once immune system lose control they attack the body
at present there is no way to eradicate hbv cccdna, herpes virus, papilloma virus and many others, they stay hidden inside cells in a balance between immune system and virus.actually is a similar concept of health, health is a balance, perfect health doesn t exist
hbv persists because it suppresses immune system mainly by hbsag, if you remove hbsag the underlaying antibody hbsab takes control of hbv and cccdna slowly decreases to und by our assays but it is not zero, it may persist all life.
do not rely on old studies because they use wrong words or are wrong, for many viruses and hbv family also, eradication doesn t exist they can only controlled to und by immune system but the template is hidden inside cells, herpes, papilloma virus, citomegalovirus and many others, they all have the residual template hidden but until immune system works you might say they are cured or und
This kind of therapy is only a temporary cure.
no if it is immune system to take control it is definitive.we have millions of viruses/bacteria inside us in a balance with immune system, if you like you can consider it hbv eradication because it makes no difference until you have an immune system.
as an example why aids patients get all kinf of viruses/bacteria/cancers once immune system is destroyed, the viruses were already inside the body and once immune system lose control they attack the body
at present there is no way to eradicate hbv cccdna, herpes virus, papilloma virus and many others, they stay hidden inside cells in a balance between immune system and virus.actually is a similar concept of health, health is a balance, perfect health doesn t exist
greeting,
is u have mention about the blueberry,melatonion,omega3,
dear friend i am a patient from 2003 to hepatitis b upto 2009 i repeat every year the DNA test it was negative each year without any medication.but now in 2010 i tested positive for DNA i consult the doctor he advise me enticavir for 2 years.my liver ultasound show cirhosis impression.
my question is that can i used these three ingridients and also tell what HBeAg means.
thanks
is u have mention about the blueberry,melatonion,omega3,
dear friend i am a patient from 2003 to hepatitis b upto 2009 i repeat every year the DNA test it was negative each year without any medication.but now in 2010 i tested positive for DNA i consult the doctor he advise me enticavir for 2 years.my liver ultasound show cirhosis impression.
my question is that can i used these three ingridients and also tell what HBeAg means.
thanks
Sorry I still haven't got the point.
HBsAg, which indicates current Hepatitis B infection, is the surface antigen of the Hepatitis-B-Virus (HBV). An antigen is a molecule recognized by the immune system
A "negative" HBsAg test result means that the person is NOT infected with the hepatitis B virus.
HBsAb is the hepatitis B surface antibody. The antibody protects against Hepatitis-B-Virus (HBV) infection.
A "positive" HBsAb (or anti-HBs) test result indicates that the patient has recovered from hepatitis B infection. This result means that the patient is immune to hepatitis B infection.
What makes the patient achieving above results is the medical therapy which suppresses the active of cccDNA. But if therapy halted cccDNA may be active again. The root is still there. It is the source of HBV. This kind of therapy is only a temporary cure.
HBsAg, which indicates current Hepatitis B infection, is the surface antigen of the Hepatitis-B-Virus (HBV). An antigen is a molecule recognized by the immune system
A "negative" HBsAg test result means that the person is NOT infected with the hepatitis B virus.
HBsAb is the hepatitis B surface antibody. The antibody protects against Hepatitis-B-Virus (HBV) infection.
A "positive" HBsAb (or anti-HBs) test result indicates that the patient has recovered from hepatitis B infection. This result means that the patient is immune to hepatitis B infection.
What makes the patient achieving above results is the medical therapy which suppresses the active of cccDNA. But if therapy halted cccDNA may be active again. The root is still there. It is the source of HBV. This kind of therapy is only a temporary cure.
once hbsag is negative your immune system will work again like for all other people who cleared hbv, hbsag is the main immune system suppressor
the ways to lower hbsag already available are:
interferons, boosting interferon effect by nitazoxanide and entecavir or tenofovir.the best way is start with ntz follwed by entecavir or tenofovir after 4-12 weeks because also hbvdna suppress immune system and some interferon non responders become responders after hbvdna is und by entecavir or tenofovir, so the combo of these drugs will make hbsag lowering (results from previous trials interferon+adefovir better results than all other therapies but still too weak, telbivudine+interferon sides)
very near future:
interferon lambda which is by far better than normal interferons with no sides will be the way of the future since combined with etv and tnf will have no issues
who knows when:
rep9ac from replicor
> once your immune system has hbsab you dont need to
> care about the tiny amounts of cccdna left
The point is how to keep hbsab postive permanently? After stopping therapy cccdna will becomes active again. The bomb is always there. In such a circumstance the patients have to taking medical treatment for the rest of their life.
> care about the tiny amounts of cccdna left
The point is how to keep hbsab postive permanently? After stopping therapy cccdna will becomes active again. The bomb is always there. In such a circumstance the patients have to taking medical treatment for the rest of their life.
cccDNA is the source of hbv. Suppressing it from being active only slows down hbv replication. It'll become active again, similar to keeping a bomb in a drawer. When the bomb will explode?
hbsab blocks viral entrance so the infected cells with cccdna will slowly dye together with cccdna.the bomb will never explode unless you destroy your immune system
once your immune system has hbsab you dont need to care about the tiny amounts of cccdna left
hbsab blocks viral entrance so the infected cells with cccdna will slowly dye together with cccdna.the bomb will never explode unless you destroy your immune system
once your immune system has hbsab you dont need to care about the tiny amounts of cccdna left
Hi,
Following article states how "cccDNA" comes.
Intrahepatic HBV cccDNA Pool
http://www.medscape.com/viewarticle/581590_6
During HBV infection, cccDNA accumulates in cell nuclei and persists as a stable episome and acts as a template for the transcription of viral genes ......
Following article states how "hepadnavirus is replicated" - by an unknown mechanism
Mechanism for CCC DNA Synthesis in Hepadnaviruses
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0008093
Hepadnavirus replication requires the synthesis of a covalently closed circular (CCC) DNA from the relaxed circular (RC) viral genome by an unknown mechanism.
I'm interested to find the information re "study on cccDNA eradication". I have been searching heavily on Internet without positive result. I'll continue when time allows.
Following article states how "cccDNA" comes.
Intrahepatic HBV cccDNA Pool
http://www.medscape.com/viewarticle/581590_6
During HBV infection, cccDNA accumulates in cell nuclei and persists as a stable episome and acts as a template for the transcription of viral genes ......
Following article states how "hepadnavirus is replicated" - by an unknown mechanism
Mechanism for CCC DNA Synthesis in Hepadnaviruses
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0008093
Hepadnavirus replication requires the synthesis of a covalently closed circular (CCC) DNA from the relaxed circular (RC) viral genome by an unknown mechanism.
I'm interested to find the information re "study on cccDNA eradication". I have been searching heavily on Internet without positive result. I'll continue when time allows.
Hi,
Thanks for your advice and links
>> Whether it includes complete eradication of cccDNA?
> this is an impossible end point for both acute hbv and cronic hbv,
> hbv can only complitely control by immune system by hbsab
> antibody which blocks virus entrance in liver cells.
cccDNA is the source of hbv. Suppressing it from being active only slows down hbv replication. It'll become active again, similar to keeping a bomb in a drawer. When the bomb will explode?
I read some articles on Eastern medicine claiming able to eradicate cccDNA. But there is no lab nor clinical proof. The medicine which slow down cccDNA replication is only a temporary control or temporary solution. It is NOT a cure. However it is better than NONE.
satimis
Thanks for your advice and links
>> Whether it includes complete eradication of cccDNA?
> this is an impossible end point for both acute hbv and cronic hbv,
> hbv can only complitely control by immune system by hbsab
> antibody which blocks virus entrance in liver cells.
cccDNA is the source of hbv. Suppressing it from being active only slows down hbv replication. It'll become active again, similar to keeping a bomb in a drawer. When the bomb will explode?
I read some articles on Eastern medicine claiming able to eradicate cccDNA. But there is no lab nor clinical proof. The medicine which slow down cccDNA replication is only a temporary control or temporary solution. It is NOT a cure. However it is better than NONE.
satimis
http://www.medhelp.org/health_pages/Hepatitis/HepResearcher-doctor-on-various-topics/show/38?cid=153
very interesting HR posts
very interesting HR posts
Whether it includes complete eradication of cccDNA?
this is an impossible end point for both acute hbv and cronic hbv, hbv can only complitely control by immune system by hbsab antibody which blocks virus entrance in liver cells.
Once hbsag become negative hbsab will appear, in this condition cccdna is very low and not detactable by our assays even on biopsy but it will be present for decades anyway, complete eradication of cccdna might be achieved by 10-20 years of suppressed hbv maybe
anyway it doesn t matter complete eradication of cccdna, but hbsag neg and hbsag pos for immune control
strategies are:
if hbsag continue to decrease, keep etv+ntz and increase etv
if hbsag slow down decrease or doesn t decrease interferon+etv+ntz, if interferon lambda will be on the market by about 1 year i will wait for it because i don t like sides of normal interferon
this is an impossible end point for both acute hbv and cronic hbv, hbv can only complitely control by immune system by hbsab antibody which blocks virus entrance in liver cells.
Once hbsag become negative hbsab will appear, in this condition cccdna is very low and not detactable by our assays even on biopsy but it will be present for decades anyway, complete eradication of cccdna might be achieved by 10-20 years of suppressed hbv maybe
anyway it doesn t matter complete eradication of cccdna, but hbsag neg and hbsag pos for immune control
strategies are:
if hbsag continue to decrease, keep etv+ntz and increase etv
if hbsag slow down decrease or doesn t decrease interferon+etv+ntz, if interferon lambda will be on the market by about 1 year i will wait for it because i don t like sides of normal interferon
Hi,
Re your "new strategies to get rid of hbv:"
Whether it includes complete eradication of cccDNA?
TIA
B.R.
satimis
Re your "new strategies to get rid of hbv:"
Whether it includes complete eradication of cccDNA?
TIA
B.R.
satimis
Hi
Thanks for your links and advice.
> i used part on HR posts and part on a research about
> fibrosis regression on animal studies about blueberries
> and melatonin
Please advise where is the link? Thanks
I found following thread;
The Impact of Diabetes Mellitus on Fibrosis Progression in Patients Transplanted for Hepatitis C
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2006.01408.x/full
B.R.
satimis
Thanks for your links and advice.
> i used part on HR posts and part on a research about
> fibrosis regression on animal studies about blueberries
> and melatonin
Please advise where is the link? Thanks
I found following thread;
The Impact of Diabetes Mellitus on Fibrosis Progression in Patients Transplanted for Hepatitis C
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2006.01408.x/full
B.R.
satimis
melatonin, acetylcisteine, green tea,
http://www.wjgnet.com/1007-9327/15/1452.asp
http://www.sciencedaily.com/releases/2009/11/091118101359.htm
also part of my diet are daily soia, cofee, often bitter cocao, often back rise with cucurmin
i didn t use:
emodin
sylibin
ppc
and others suggested in HR post
http://www.wjgnet.com/1007-9327/15/1452.asp
http://www.sciencedaily.com/releases/2009/11/091118101359.htm
also part of my diet are daily soia, cofee, often bitter cocao, often back rise with cucurmin
i didn t use:
emodin
sylibin
ppc
and others suggested in HR post
http://www.sciencedaily.com/releases/2010/06/100617102706.htm
this is one on bluberries
this is one on bluberries
you should check liver fibrosis regression or similar on pubmed, i actually based antioxidants i used part on HR posts and part on a research about fibrosis regression on animal studies about blueberries and melatonin
i avoided only the antioxidants posted by HR that have an antiinflammatory effect because they might interfere with antiviral and used those who are known for a immune boosting effect
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