Aa
Baraclude vs. Viread
Hi All,
I am an male in my mid-20's of southeast Asian decent, and I'm quite torn about how to proceed. I acquired HBV through vertical transmission and am currently in the immune clearance phase.
My ALT levels are 5-6 times normal.
I am e-antigen positive, e-antibody negative.
My viral load was 30 million in Oct 2008. Since then, I've been taking a cocktail of herbs intended to treat hepatitis (including milk thistle) and in Jan 2009, it is now 13 million.
I am torn because my family would like me to stay with herbal cocktail, but several doctors want me to begin treatment. The doctors say the fluctuation in viral load is natural and not necessarily tied to my use of herbs.
Firstly, has anyone had success with the herbal remedies?
Secondly, if I begin treatment, the goal would be sero-conversion (i.e. e-antigen negative, e-antibody positive). Would that essentially mean I'm cured and won't need to worry about HBV anymore?
Thirdly, my doctor says it's pretty much a flip of the coin to decide whether to go with Baraclude(entecavir) or Viread(tenofovir). There seems to be very little data about the success rate of either. Can anyone please help me to decide which route to take? For example, comparison of side-effects, success rate(i guess that means sero-conversion) in asians, etc.
And finally, how much of a difference would it make if I start treatment now or in, say, 6 months?
Being 25, I will potentially be taking this pill for many many years, so I'd like to make the right choice.
I'm new to this forum and would very much appreciate your time.
I am an male in my mid-20's of southeast Asian decent, and I'm quite torn about how to proceed. I acquired HBV through vertical transmission and am currently in the immune clearance phase.
My ALT levels are 5-6 times normal.
I am e-antigen positive, e-antibody negative.
My viral load was 30 million in Oct 2008. Since then, I've been taking a cocktail of herbs intended to treat hepatitis (including milk thistle) and in Jan 2009, it is now 13 million.
I am torn because my family would like me to stay with herbal cocktail, but several doctors want me to begin treatment. The doctors say the fluctuation in viral load is natural and not necessarily tied to my use of herbs.
Firstly, has anyone had success with the herbal remedies?
Secondly, if I begin treatment, the goal would be sero-conversion (i.e. e-antigen negative, e-antibody positive). Would that essentially mean I'm cured and won't need to worry about HBV anymore?
Thirdly, my doctor says it's pretty much a flip of the coin to decide whether to go with Baraclude(entecavir) or Viread(tenofovir). There seems to be very little data about the success rate of either. Can anyone please help me to decide which route to take? For example, comparison of side-effects, success rate(i guess that means sero-conversion) in asians, etc.
And finally, how much of a difference would it make if I start treatment now or in, say, 6 months?
Being 25, I will potentially be taking this pill for many many years, so I'd like to make the right choice.
I'm new to this forum and would very much appreciate your time.
new drug from Gileard will be use like the exit point for Tnf Ent or ? ... I don't quite understand what is the porous of this new drug
** correction **
I am HBsAg + and HBsAb-, HBeAg -, and HBeAb +, which was the driving decision to treat.
I am HBsAg + and HBsAb-, HBeAg -, and HBeAb +, which was the driving decision to treat.
Do you have a link to the source for FDA approval of HBsAg Quant?
I posted the info below to the HBV mail-list, for anyone to read:
Hello all,
I just got back from my visit with Dr. Gish. I am going to start taking Viread (Tenofovir) today in order to reduce my risk for HCC. I am HBsAg negative and HBsAb positive, so I thought I was supposed to take Baraclude (Entecavir), but Dr. Gish recommended Tenofovir because it has 0% resistance, is going off patent in 2014, and has little (if any) side-effects. He said we just had to monitor my kidneys as 1% of patients who take this drug have kidney issues. I asked him about bone loss, and he said there is a very low probability of that, and to counteract any bone loss, start taking vitamin D3, which I already take.
I also asked him about the new study on statins reducing HCC risk, and he said that was indeed possible, especially if you have an elevated triglyceride level. But he said it would also reduce cancers in other areas as well. He referred to the same study that I saw on this mail list from a few days ago.
I asked him about the HBsAg Quant test being available in the USA, and he said he's been pushing for that for years (along with the Fibroscan). He said that info is very useful, and the USA is so far behind the curve when it comes to HBV treatment. Dr. Gish told me that I may be included in one of his upcoming studies that he is going to be doing with some sort of company (drug company?), and in return for giving some blood, he will be able to get me my HBsAg Quant information from that company, which will be very useful for him.
He also let me know about a clinical trial that may be coming up with Gilead. He said they are developing a drug for people who are on Tenofovir or Entecavir, which they can take that will enable them to stop having to take these drugs for life. It sounded like the new drug would have to be taken very short term and then it could be stopped. Not much info on this yet, but maybe someone else has heard of this trial?
Finally, I asked him about the therapy they are doing in most of Europe where people take Tenofovir for 48 weeks, then they include a Peg-Interferon (info from stef2011), with approximately 40% of patients clearing the surface anitgen. He said that therapy did work pretty well, and a lot of people cleared the virus for good. However, he told me to keep in mind, that regimen and the reports examined Caucasians who were chronically infected later in life, so the results may not translate to Asians who were infected from birth.
All-in-all, a very informative visit, with a lot of new information and new possibilities in the pipeline.
Matt
I posted the info below to the HBV mail-list, for anyone to read:
Hello all,
I just got back from my visit with Dr. Gish. I am going to start taking Viread (Tenofovir) today in order to reduce my risk for HCC. I am HBsAg negative and HBsAb positive, so I thought I was supposed to take Baraclude (Entecavir), but Dr. Gish recommended Tenofovir because it has 0% resistance, is going off patent in 2014, and has little (if any) side-effects. He said we just had to monitor my kidneys as 1% of patients who take this drug have kidney issues. I asked him about bone loss, and he said there is a very low probability of that, and to counteract any bone loss, start taking vitamin D3, which I already take.
I also asked him about the new study on statins reducing HCC risk, and he said that was indeed possible, especially if you have an elevated triglyceride level. But he said it would also reduce cancers in other areas as well. He referred to the same study that I saw on this mail list from a few days ago.
I asked him about the HBsAg Quant test being available in the USA, and he said he's been pushing for that for years (along with the Fibroscan). He said that info is very useful, and the USA is so far behind the curve when it comes to HBV treatment. Dr. Gish told me that I may be included in one of his upcoming studies that he is going to be doing with some sort of company (drug company?), and in return for giving some blood, he will be able to get me my HBsAg Quant information from that company, which will be very useful for him.
He also let me know about a clinical trial that may be coming up with Gilead. He said they are developing a drug for people who are on Tenofovir or Entecavir, which they can take that will enable them to stop having to take these drugs for life. It sounded like the new drug would have to be taken very short term and then it could be stopped. Not much info on this yet, but maybe someone else has heard of this trial?
Finally, I asked him about the therapy they are doing in most of Europe where people take Tenofovir for 48 weeks, then they include a Peg-Interferon (info from stef2011), with approximately 40% of patients clearing the surface anitgen. He said that therapy did work pretty well, and a lot of people cleared the virus for good. However, he told me to keep in mind, that regimen and the reports examined Caucasians who were chronically infected later in life, so the results may not translate to Asians who were infected from birth.
All-in-all, a very informative visit, with a lot of new information and new possibilities in the pipeline.
Matt
you can trust him, just tell him if he agrees to sequential combo treatment entecavir+interferon or tenofovir+interferon, interferon add on will be in 1-2 years so plently of time before that
stef2011,
that is funny, your second link to the General Book of Ignorance was done by the doctor that I am going back to see on Tuesday. I have a mixed message, should I trust him, or should I try to figure out on my own?
that is funny, your second link to the General Book of Ignorance was done by the doctor that I am going back to see on Tuesday. I have a mixed message, should I trust him, or should I try to figure out on my own?
My one concern with treatment is that I am worried it may cause me more long term problems than it will solve. For one, I will no longer be considered "naive" to treatment, and future treatments options may not work if I've already started this therapy.
complitely wrong, both tenofovir and interferon have zero resistance, you can stop them if used combo as many times as you like with no difference.note that non response to sequential interferon+nucs was 10% and it was a patient using lam+adv two ridiculous drugs which failed for hiv and used on hbv just to make some money and of course failed on hbv too
after this combo the chances are that you will end up with clearance or such low hbsag which will clear off therapy itself
Also, since I am HBeAb positive and HBeAg negative with somewhat low viral load, isn't that considered the normal endpoint for treatment anyways?
yes for what your liver specialist proposed, antivirals for life..... but what i am posting here is to clear hbv or to keep it complitely inactive off therapy plus even if you fail it makes no difference from the situation you have now
And, Entecavir can cause lactic acidosis, liver damage, and even HCC. Some of these side effects seem pretty bad.
only lactic acidosis, not the rest...and only in end stage cirrhosis (end stage cirrhosis mean slow dying people)
Finally, I am worried that if I start antivirals, the medication will "wake up" my somewhat dormant, low viral load HBV and cause it to try to start replicating more, possibly causing weird mutations that are untreatable.
no this will happen if you dont use drugs almost for sure, hbv makes new mutants all the time until it breaks the little immune control you have now.on tenofovir and interferon hbv will have very little to do
i suggest you read more posts you have very little knowledge of hbv, you need to know much more you can just make blind choices and doctors are not so reliable.check here:
http://www.medhelp.org/tags/health_page/3466/Hepatitis/HepB-Introduction--Welcome-Page?hp_id=34
http://www.medhelp.org/tags/health_page/3466/Hepatitis/the-general-book-of-ignorance-about-hepatitis-B?hp_id=1152
complitely wrong, both tenofovir and interferon have zero resistance, you can stop them if used combo as many times as you like with no difference.note that non response to sequential interferon+nucs was 10% and it was a patient using lam+adv two ridiculous drugs which failed for hiv and used on hbv just to make some money and of course failed on hbv too
after this combo the chances are that you will end up with clearance or such low hbsag which will clear off therapy itself
Also, since I am HBeAb positive and HBeAg negative with somewhat low viral load, isn't that considered the normal endpoint for treatment anyways?
yes for what your liver specialist proposed, antivirals for life..... but what i am posting here is to clear hbv or to keep it complitely inactive off therapy plus even if you fail it makes no difference from the situation you have now
And, Entecavir can cause lactic acidosis, liver damage, and even HCC. Some of these side effects seem pretty bad.
only lactic acidosis, not the rest...and only in end stage cirrhosis (end stage cirrhosis mean slow dying people)
Finally, I am worried that if I start antivirals, the medication will "wake up" my somewhat dormant, low viral load HBV and cause it to try to start replicating more, possibly causing weird mutations that are untreatable.
no this will happen if you dont use drugs almost for sure, hbv makes new mutants all the time until it breaks the little immune control you have now.on tenofovir and interferon hbv will have very little to do
i suggest you read more posts you have very little knowledge of hbv, you need to know much more you can just make blind choices and doctors are not so reliable.check here:
http://www.medhelp.org/tags/health_page/3466/Hepatitis/HepB-Introduction--Welcome-Page?hp_id=34
http://www.medhelp.org/tags/health_page/3466/Hepatitis/the-general-book-of-ignorance-about-hepatitis-B?hp_id=1152
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