Aa
Baraclude (Entevir) What are the risks?
Thanks HR.Pls find my added comments below
HepatitisResearcher:
Baraclude is currently the anti HBV antiviral that has the lowest rate of resistance and the highest antiviral power.
While it should be used more for fist line therapy it is typically not in the US, because of its cost.
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Laurentia: U mean it's expensive in US hence baraclude isnt widely used? We're in Malaysia,sought treatment in Singapore. The cost of medication(baraclude 0.5mg + 2 other supplements) for 3mths comes out to USD900.
----------------------------------------------------------------But what is the viral load of HBV? Before treatment started?! This is important information. e antigen status is important.
---------------------------------------------------------------
BEFORE tx:
HBV DNA done by Roche, Cobas Amplicor: 5480 IU/mL OR 28824.8 Copies/mL
Tumor marker- Alpha Fetoprot:5.8 ug/L CEA:1.6 ug/L
Viral studies- HBsAg REACTIVE; HBsAb NON-REACTIVE (HBsAb count <1.0 mIU/ml)
Hepatitis C Ab-NON REACT; Anti-HAV Total-Reactive;
HBeAg-NON REACT; HBeAb-Reactive
RA Quantitative 143 IU/ml
VD(RPR) Non REAC
Other blood counts are within normal range; except Platelet-107 ths/ul; WBC 3.45 ths/ul
No biopsy,not sure abt endoscopy, but ultrasound for sure. Spleen & liver size appear normal, but the echoe shows 'roughness' consistent with cirrhosis. Rough quote fr the report; may have used the wrong description here. Do you think my father stands high chance of recovery?
-------------------------------------------------------------
HepatitisResearcher:
Baraclude is currently the anti HBV antiviral that has the lowest rate of resistance and the highest antiviral power.
While it should be used more for fist line therapy it is typically not in the US, because of its cost.
----------------------------------------------------------------
Laurentia: U mean it's expensive in US hence baraclude isnt widely used? We're in Malaysia,sought treatment in Singapore. The cost of medication(baraclude 0.5mg + 2 other supplements) for 3mths comes out to USD900.
----------------------------------------------------------------But what is the viral load of HBV? Before treatment started?! This is important information. e antigen status is important.
---------------------------------------------------------------
BEFORE tx:
HBV DNA done by Roche, Cobas Amplicor: 5480 IU/mL OR 28824.8 Copies/mL
Tumor marker- Alpha Fetoprot:5.8 ug/L CEA:1.6 ug/L
Viral studies- HBsAg REACTIVE; HBsAb NON-REACTIVE (HBsAb count <1.0 mIU/ml)
Hepatitis C Ab-NON REACT; Anti-HAV Total-Reactive;
HBeAg-NON REACT; HBeAb-Reactive
RA Quantitative 143 IU/ml
VD(RPR) Non REAC
Other blood counts are within normal range; except Platelet-107 ths/ul; WBC 3.45 ths/ul
No biopsy,not sure abt endoscopy, but ultrasound for sure. Spleen & liver size appear normal, but the echoe shows 'roughness' consistent with cirrhosis. Rough quote fr the report; may have used the wrong description here. Do you think my father stands high chance of recovery?
-------------------------------------------------------------
everywhere at pharmacy but this is not an hbv cure, it can only block liver damage and not the virus
tenofovir is more potent than entecavir and cheaper but again not a cure for hbv, it only block liver damge
so you have to check first if hbv has made liver damage on you, on very few patients hbv makes liver damage so these antivirals may be useless for you
the only cure for now is sequential tenofovir for 1-3 years and then peginterferon add on for 2 years.all very expensive, extremely good and updated liver specialist needed
tenofovir is more potent than entecavir and cheaper but again not a cure for hbv, it only block liver damge
so you have to check first if hbv has made liver damage on you, on very few patients hbv makes liver damage so these antivirals may be useless for you
the only cure for now is sequential tenofovir for 1-3 years and then peginterferon add on for 2 years.all very expensive, extremely good and updated liver specialist needed
I had titled my post, "I know this is an old post", but I guess I got the last of my title cut off...I'm wondering, is this a bug in the system?, or are really old posts supposed to pop up all the time? Just wondering...thanks for all you do!
Firstly, Hepatitis Researcher is still not back :(
HR's post is in January '07.
***@**** responded to an old post and this old thread was bumped up. And to your question, I think you should follow your MD advice to take Baraclude since the goal of treatment is to supress viral replication. If you don't have resistance to other HepB antivirals, Baraclude is excellent in terms of antiviral power and low resistant profile (Less than 1 % in 4 years of use). So hopefully before you develop resistance, new treatment option will be available.
Many chronic HepB individual develope this type of mutant over time. What's your age and do you know your age of infection?
HR's post is in January '07.
***@**** responded to an old post and this old thread was bumped up. And to your question, I think you should follow your MD advice to take Baraclude since the goal of treatment is to supress viral replication. If you don't have resistance to other HepB antivirals, Baraclude is excellent in terms of antiviral power and low resistant profile (Less than 1 % in 4 years of use). So hopefully before you develop resistance, new treatment option will be available.
Many chronic HepB individual develope this type of mutant over time. What's your age and do you know your age of infection?
Welcome back. Great to see you again and hope all is well with you and family these days.
TnHepGuy
TnHepGuy
I have Normal AST * ALT, 34900 Copy/ml HEP B. DNA QT HBEAG-Non Reactive HBE antibody-reactive; BCP Mutants detected in my blood, and a healthy liver. My doctor wants me to take Baraclude .5mg. Shall I take it? Or shall I wait two more year?
MEDICAL PROFESSIONAL
Living donor liver transplantation is an option for your father if he should need it. But you will probably see an improvement in his LFT parameters within a few month after the has started antiviral therapy.
Dont forget to ask your Dr. for the combotherapy. If he does not understand, he can call me and I will explain. This is fully clear only to a handful of hepatologists specializing in HBV treatment, that you need to be preventative against long term resistance since the treatment might last for decades. If 5 years from now your dad develops resistance against Entecavir/Baraclude, what exactly will he use then? Tenofovir of course, in combo with FTC, will be the smart answer. Then 5 years later if he is resistant against this combo, what will he get then? Hopefully by then newer drugs will be developed, is again the smart answer.But there is only a tiny chance that a drug that will work against this resistance profile will be in place then, you will say/ask? Well, we all have to die somehow, the answer might be. But if we would have used this combo from the start, there would be no such resistance, you will say, so this tragedy could have been prevented. Yes, you are right he will say - in 2017 - we now all these things now.....Sorry..
Dont forget to ask your Dr. for the combotherapy. If he does not understand, he can call me and I will explain. This is fully clear only to a handful of hepatologists specializing in HBV treatment, that you need to be preventative against long term resistance since the treatment might last for decades. If 5 years from now your dad develops resistance against Entecavir/Baraclude, what exactly will he use then? Tenofovir of course, in combo with FTC, will be the smart answer. Then 5 years later if he is resistant against this combo, what will he get then? Hopefully by then newer drugs will be developed, is again the smart answer.But there is only a tiny chance that a drug that will work against this resistance profile will be in place then, you will say/ask? Well, we all have to die somehow, the answer might be. But if we would have used this combo from the start, there would be no such resistance, you will say, so this tragedy could have been prevented. Yes, you are right he will say - in 2017 - we now all these things now.....Sorry..
Thanks for the comments. I will find out if baraclude can be obtained without prescription here, to see what are the possibilities of getting them for those in the States.
As for the aspect of Living donor liver transplant, do you think it'd be an option for my dad (a 65 year old) now or in the event the cirrhosis has progressed to a different state?
(OR better to do transplant earlier before it's too late?)
Other than medication, he doesn't smoke, drink. And we try to cut down oily/greasy food; try to make sure he sleeps early like 10-11pm; eat a variaty of fresh fruits a day, more fish, and cut down protein from meat and no milk. But since he has rhematoid,osteopaenic changes of lumbar spine and left neck of femur with increased risk of fracture & osteopanic; it's somehow worrying how he should improve this since we dont encourage calcium supplement and milk intake for his liver. (also heard that milk, sugar are food that feeds cancerous cells.)
As for the aspect of Living donor liver transplant, do you think it'd be an option for my dad (a 65 year old) now or in the event the cirrhosis has progressed to a different state?
(OR better to do transplant earlier before it's too late?)
Other than medication, he doesn't smoke, drink. And we try to cut down oily/greasy food; try to make sure he sleeps early like 10-11pm; eat a variaty of fresh fruits a day, more fish, and cut down protein from meat and no milk. But since he has rhematoid,osteopaenic changes of lumbar spine and left neck of femur with increased risk of fracture & osteopanic; it's somehow worrying how he should improve this since we dont encourage calcium supplement and milk intake for his liver. (also heard that milk, sugar are food that feeds cancerous cells.)
Thanks for the comments. I will find out if baraclude can be obtained without prescription here, to see what are the possibilities of getting them for those in the States.
As for the aspect of Living donor liver transplant, do you think it'd be an option for my dad (a 65 year old) now or in the event the cirrhosis has progressed to a different state?
(OR better to do transplant earlier before it's too late?)
Other than medication, he doesn't smoke, drink. And we try to cut down oily/greasy food; try to make sure he sleeps early like 10-11pm; eat a variaty of fresh fruits a day, more fish, and cut down protein from meat and no milk. But since he has rhematoid,osteopaenic changes of lumbar spine and left neck of femur with increased risk of fracture & osteopanic; it's somehow worrying how he should improve this since we dont encourage calcium supplement and milk intake for his liver. (also heard that milk, sugar are food that feeds cancerous cells.)
As for the aspect of Living donor liver transplant, do you think it'd be an option for my dad (a 65 year old) now or in the event the cirrhosis has progressed to a different state?
(OR better to do transplant earlier before it's too late?)
Other than medication, he doesn't smoke, drink. And we try to cut down oily/greasy food; try to make sure he sleeps early like 10-11pm; eat a variaty of fresh fruits a day, more fish, and cut down protein from meat and no milk. But since he has rhematoid,osteopaenic changes of lumbar spine and left neck of femur with increased risk of fracture & osteopanic; it's somehow worrying how he should improve this since we dont encourage calcium supplement and milk intake for his liver. (also heard that milk, sugar are food that feeds cancerous cells.)
MEDICAL PROFESSIONAL
This looks like a case of long term smoldering eAg negative hepatitis B. While the Vl is not high, there can still be substantial hepatic inflammation and injury.
Your father definitely needs to supress this virus to negativity by PCR. You must realize that this antiviral therapy will be required long term, likely lifelong. Stopping treatment can cause a resurgence of the virus to high levels, with a dramatic recurrence of hepatitis - a flare - that can be deadly if cirrhosis is already present. The HBV virus CANNOT BE ERADICATED, sometimes - rarely- the surface antigen becomes negative because its levels get so low that antibodies will trap it, make it "invisible' for the test. Only in this case antiviral therapy can be stopped, carefully, with frequent follow ups.
The Baraclude costs more than twice in the US. Maybe you can help some here that cannot afford it to get it and avoid treatment with less resistance resistant drugs.
Your father can stop or dramatically reduce the HBV related attack on the liver using this antiviral ( see my old comment about combining). He needs to do all the other means to maintain a healthy liver to regress cirrhosis, then chances are high that he can. His ultrasound and AFP values need to be checked every 6 month to detect liver cancer early enough to treat it successfully.
Singapore is a modern advanced state. Things seemingly are done right there for your dad.
Your father definitely needs to supress this virus to negativity by PCR. You must realize that this antiviral therapy will be required long term, likely lifelong. Stopping treatment can cause a resurgence of the virus to high levels, with a dramatic recurrence of hepatitis - a flare - that can be deadly if cirrhosis is already present. The HBV virus CANNOT BE ERADICATED, sometimes - rarely- the surface antigen becomes negative because its levels get so low that antibodies will trap it, make it "invisible' for the test. Only in this case antiviral therapy can be stopped, carefully, with frequent follow ups.
The Baraclude costs more than twice in the US. Maybe you can help some here that cannot afford it to get it and avoid treatment with less resistance resistant drugs.
Your father can stop or dramatically reduce the HBV related attack on the liver using this antiviral ( see my old comment about combining). He needs to do all the other means to maintain a healthy liver to regress cirrhosis, then chances are high that he can. His ultrasound and AFP values need to be checked every 6 month to detect liver cancer early enough to treat it successfully.
Singapore is a modern advanced state. Things seemingly are done right there for your dad.
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