After 16 week with Interferron + Simvastatin

[Otan]

Took 1st dose on 21 Oct 2011 and on 11 Jan 2012 HBV DNA not detected.  
Below is the lab history,                          

Date            13/9  20/10  21/10  11/11  16/11  9/12  15/12  6/1/12  11//1/12
                                   1st dose                                   12th dose
SGOT                    35*                          49*             63*                  67*
SGPT                    63*                          78*             89*                  90*
HBsAg     366.44  255.68                                                              176.4*
HBV DNA2.54x10^5                                                                   no detect

Result on week# 16

SGOT  86
SGPT  130
HBsAg  10.49

When HBsAg became zero, then what to do? Is that time to stimulate Anti-HBs?

[studyforhope]

Just use the Entecavir that you still have and then switch to tenofovir. It takes about 3days to fully saturate the liver with the active metabolites of these two antivirals, from there on it is a steady state.

[stef2011]

these antivirals are very slow i dont know if in yuor case it is suitable studyforhope knows kinetics of these antivirals

[Otan]

Steff,
Any problem if I take Baraclude for a month then later I continue withTenofovir. The reason is I have Baraclude 30 tablets I cancelled to take before otherwise I may throw this.
FYI, I took Baraclude July 2012 only a month.

[StephenCastlecrag]

Thanks, I need to do some further googling. LOL. The Canadian study was presented as a poster in 2011 involving 8 patients. I read somewhere that a European researcher remarked that up to 1/3 of patients who lost the HBsAg, do not develop HBsAb. Can we assume that the s-antibodies exist but masked by the s-antigen? It is also interesting that in REP9AC', no HBV vaccine was used in conjunction with Zadaxin, just REP9AC'. Is Alum any good as adjuvant with HBV vaccine?

[studyforhope]

Replicors use of Zadaxin in their unique setting of ultralow surface antigen was quite convincing. If you look at the AASLD 2012 poster and the Ab levels after addition of pegasys or Zadaxin, they had more success with Zadaxin and the boosting was truly impressive. Now these are very small numbers and it would be great to see larger trials to confirm that.
But there were several prophylactic vaccine trials were Zadaxin acted as an adjuvant of sorts and again, the results look promising in this application. Another example is the vaccine trial with Zadaxin 3.2mg added from Canada, that Stefano posted in this very same thread to stabilize the surface antigen seroconversion, just about the same application as we have it here in otans case.

Zadaxins principal ability to stimulate the Tcell development is quite established, however the effect is seemingly not strong enough to show in the setting of chronic hepaitis B or C to be of convincing benefit.

Nevertheless, currrently there is no vaccine with an effective adjuvant approved, maybe with the exception of Fendrix in the UK by smithkline, but that is still a mild adjuvant.

The heplisav development of Dynavax where a CpG adjuvant is used to intensify the immune response and that had quite large trials with over 3000 patients to show, with a clear stimulating effect, has, a few month ago been put on a hold by the FDA advisory committee.

Thus at this time the Zadaxin seems to be the only available option to help stimulate the unadjuvanted vaccine towards a Th1 response for someone who want to be proactive against loosing his/her seroconversion status.

Once lost, the vaccine will not work to reverse the loss, thus watch and wait is an uncertain option.

Of course , the general recommendation is to use the advice of a local doctor who is versed in treating hepatitis B. Most however might not be too familiar with the latest or even older research results to recommend, what is to be considered an experimental treatment. Still, nobody should follow any advice obtained on the internet without carefully checking with his liver specialist..

Please also  check the vaccine trial with Zadaxin trial posted earlier in this thread by Stefano.

[StephenCastlecrag]

I am curious to know why Zadaxin is being promoted as a vaccine enhancer? As studyforhope pointed out before, Zadaxin has failed numerous clinical trials as treatment for Hepatitis B and therefore never gained FDA approval as treatment for Hepatitis B, likewise in Europe. It has been FDA approved as an orphan drug for liver cancer. These days, Sciclone makes a lot of money in China only and it is very expensive. I understand Replicor also used it to induce HBsAb production as well as using Interferon. I wonder why?