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Avatar universal

Best Treatment for HBv

I am 53 years old last month I have went for preventive health check up and based on the report findings the followings noted; SGOT 83 IU/L ,SGPT 200 IU/L , Doctor recmended me to see the Gastro.consultant , the gastro.consultant advised me to go for others test the result are as follows: Anti-dsDNA 16.6 IU/ml. , HBsAg test value 9520(Reactive) ,HCV,IgG test value 0.12 ( non Reactive) ,Anti Nuclear Antibody ( ANA) 0.12 , Immunoglobulin IgA 279 mg/dl , Tissue Transglutaminase antibody IgA 0.40 U/mL , Anti Mitochondrial Antibody , Serum 0.26 UL/ml , ASMA 2.70 U/mL , LKM Antibody 0.02 U/ml , Hepatitis B envelope Antibody test value (Ab) 43.0 ( Reactive) , Hapatitis Be Antigen ( HBeAg) 0.15 ( Non reactive),AFP 4.38ng/ml  , HBV DNA Quantitative,Real Time PCR 5156250 IU/ml. Based on this the Doctor advised me for the treatment  Tab.Entavir 0.5 mg one daily. Here i went for second opinion with Lever specialist consultant and he advised me to go for Fibroscan which the result is 5.91 Kpa ( Negative for fibrosis).Now the lever specialist advised for Viraferon Peg 80 mg once in a week and monitor CBC & S creatin every 15 days.I have not started the treatment yet as I am going out of India for 1.5 months as Doctor told me that this treatment will be given under there supervision , please suggest which treatment is suitable under these report.Also with vaccine this problem will be solved and how long i have to take this treatment.
170 Responses
Avatar universal
only if hbsag goes less than 1500iu/ml peginterferon add on before 3 years of antiviral makes sense
Avatar universal
You have e-negative hbv

The best trestment so far is Antivirsls like entecavir or tenofovir for a few years and when hbv is very low or undetected add on of interferon. To start right a way with intf for e negative gives very low chsnce to clear the virus. Before starting any treatment test hbsag quantitive test in IU/ml this is needed for monitoring your responce to treatment esp to intf.
Avatar universal
Thank you so much , i shall do this test as well and update accordingly.
Avatar universal
Hi
The test you recommend before starting treatment is done , please find the result:
HBsAg test value = 9520 ( Reactive)
Is there any other test to be done , please suggest.
Avatar universal
Hi,

Is the measurement for HBsAg in iu?

Looks like you are definitely a candidate for treatment (high ALT and viral load). The fact your Dr reco Viraferon, I assume it's the PEG version.

Either anti-virals like ETV or TDF or Interferon, you will have to decide.

Avatar universal
The result is not mentioned any unit but they mentioned  :
Interpretation of test result ( Vitros ECi)

One Doctor advised Tab.Entavir 0.5 mg one a day ,

I went for second opinion with Gasto. & liver consultant , he had asked me to go for Fibroscan which the result is 5.91 Kpa.
He advised me - Viraferon Peg 80 mg once in a week.

Since I was travelling he suggested me to start after I come back.
Can be posible if I start with Tab.Entavir now and switch over to Viraferon Peg 80 mg once i return to India.Thank you.
Avatar universal
first of all the hbsag test you did is useless and absolete, in india you can find hbsag quantificationin iu/ml in best labs, the machines which are old as well, available from 2000, but not absolete from the sixties like the one you used, are abbott architect or roches elecsys.if the labs dont have these machines and the kit for hbsag quantification don t go there

second point, it is useless to start entecavir and peginterferon together, and it is useless to start peginterferon without hbsag quantity.another point entecavir is not the most potent, tenofovir is

the best thing is to start entecavir or tenofovir for about 3 years and then add on peginterferon, only if hbsag goes less than 1500iu/ml peginterferon add on makes sense
Avatar universal
Hi
Thanks for your opinion , i shall check the lab. where i find the facility to check HBsAg quantitative iu/ml.
Get the test done & revert you.
Thank you,
Avatar universal
Hi
I have not started the medicine as yet as I am out of country, need to check with you how long i can delay the treatment if the reports are positive.

Thank you,
Avatar universal
Can you do combo treatment with ETV/TDF and IFN? Suggest that to the Doc.
Avatar universal
Hi Stef

Hope you are doing good ,

I last conversation wity you wherein you suggest to redo the HBsAg test on quantative , it has been done and the result is as below:
Result: 7767.68 IU/mL ( in the report its mentioned as CMIA , i think this is test method.
So far I have not started any treatment please suggest.
Looking forward your response.

Thank you,
Avatar universal
please post also previous hbasg, hbvdna, ast/alt, hbeag/hbeab, genotype and firbsocan

value is too high for pegintf, if any therapy it is tdf to start with
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