After 2.5 years my HbeAg become positive

[hanhhoang76]

Hello All,

I have been on Virkil (Tenefovir) on since November 2011 and in August 2013 I had my HbeAG negative as 0.99  and the HBV DNA is undetectable but I just got the test today and my HbeAG become positive as 1.36. Please let me know if it means that my Virkil does not work anymore.

Many thanks.

[02081989]

dear sir,
                      good day... i am ravi from india. . i have a doubt.please clear my doubt....i got too much confused in my life becoz of this .......i am working in singapore.but last time i came to india.and went medicals for rejoining..i found that hbeag positive........what is the diff between hbeag and hbs ag.i want know the detail about hbe ag.because my company asking me only about hbeag. pllease tell me. how many percentage chance is there to become the hbe ag value less than 1......... today i got my latest result .my hbe ag value is 3.4 .....my last value is 4.9.......my LFT is also  normal.   sgot----31
              sgpt----41
              gt---------19.
              alkaline phosphate------96
              bilrubin total........0.7
              bilrubin direct........0.
        
     total protein      ------6.8
      albumin-------------3.7
globulin----------------3.0
a/g ratio------------1.24

[hanhhoang76]

Hi All,

Thanks for your suggestions and advice. Really appreciate your support!

I will try resistance test.

Many thanks!

[stef2011]

after using all those antivirals the wrong way you may have developped so many mutations and resistance that antivirals might not work, let's hope the tenofovir made in india was fake, although i dont think so

you have very little left to try after all the missuse of drugs from your doctor, a resistance test is a must for you at this point to see which drugs work

tenofovir is the one you must keep, it has no known resistance and according to the resistance test result combo with another drug that works...it could be you can combo tenofovir with entecavir or tenofovir with telbivudine

[calebz]

After putting you on LAM after ETV resistance I would change the doctor.

[flyinsky]

hi
just follow what your doctor says becaue he know your file very well and for the increasing of dna ;me too it  happened to me after delivery of baby because our immune system during pregnancy is totaly weak and the virus find a way to multiple  ( what my doc said)
yes its very deficult to manage with children (god help you)

[hanhhoang76]

Sorry I forgot to tell I did not know my fibroscan before that.

[hanhhoang76]

Thanks for getting back to me so quickly.

ALT: 21 AST: 23

I have used ETV in the past (12 months) and then stopped and the virust went up 10(5) with high ALT AST then the doctor gave me Lamivudine and Zadaxin stopped to have baby and the virus went up with high ALT AST. Started treatment on TNF Virkil since November 2011 - after 6 months HBV DNA underdetechable and but HbeAG still positive. And yesterday HBV DNA 3.2 *10 (2).

I will not able to afford PEG -IFN, not only the cost but the side effect. I have two small daughers and no support from family.

Thanks for your support mustthinkpositive! Appreciate your advice or thoughts on this!

[mustthinkpositive]

What was your fibroscan result before that?

Can you please post your ALT/AST?

Yes, definitely change to TDF (US version) or even to ETV.

Also, depending on your lifestyle, consider PEG-IFN.

[hanhhoang76]

Hi Everyone,

I had my HBV DNA it's flare up 3.2 x 10(2) = 320 coppies/ml.

My doctor said that VIRKIL (tenefovir made in India) is not very good and suggested me to change to another Tenefovir but imported from US. The cost is a bit higher. My ALT, AST and other blood test are within the normal range.

My fibroscan is F3.

I feel very tierd recently, lost appertise.

I would aprreciate your advice on whether to the change the drug.

Thanks!

[hanhhoang76]

Thanks very much for your support! Will get the HBV DNA test soon

[stef2011]

Yes important on nucs therapy or baseline to start pegintf while there s no data yet while on peg

[yibok]

Thanks Stef , Good abstract , So IP >350 pg/ml gives good response .

[stef2011]

http://www.ncbi.nlm.nih.gov/pubmed/24012614

in europe you can get it at synlab

[yibok]

Hi stef

What is IP 10. is it a kind of lab test that can be done to find out if we will respond to peg.

Thanks

[stef2011]

No the only useful marker of response is ip10, dont remember exact number but elevated over 350 should allow best response

[The_PS]

In case if we are on TDF for 3 years, is it necessary to wait for elevated ALT to start peg?

[stef2011]

As long as hbvdna is und tenofovir is working.antivirals have almost no effecton antigens so the fact hbeag is positive maybe a good sign of reduced mutants population of precore/bcp

Be sure your hbvdna is less than 20iu/ml

if you want to lower hbsag and clear hbeag you need to add peginterferon to tenofovir, wait until you are 3 years on tenofovir and then add on peg, if hbsag declines by 24weeks of add on the therapy is working and you may clear hbv definitively