only if hbsag goes less than 1500iu/ml peginterferon add on before 3 years of antiviral makes sense
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.
Thank you so much , i shall do this test as well and update accordingly.
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.
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.
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.
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
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.
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.
Can you do combo treatment with ETV/TDF and IFN? Suggest that to the Doc.
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.
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
Please find the previous report:
AST 83 IU/L dated 7/11/13 , AST 48 U/L dated 27/1/2014.
ALT 200 IU /L dated 7/11/2013 , ALT106 U/L dated 27/1/2014
HBsAg : 9250 ( Interpretation of test result ( Vitros ECi) dated 9/11/2013
HBsAg serum ( CMIA ) : 7767.68 IU/mL dated 28/1/2014
HBV DNA : Quantitative ,Real Time PCR : 5156250 IU/mL dated 10/12/2013.
Fibroscan: 5.91 Kpa
Genotype : not tested.
Doctor advised me for Viraferon Peg 80 mg once a week.
Ttreatment not started yet.
Please suggest the best option.
Few more test report , please note:
HBe Ab : 43.0 dated 6/12/2013 .
HBeAg : 0.15 dated 6/12/2013.
AFP: 4.38 ng/mL dated 5/12/2013.
Anti-dsDNA result : 16.6 IU/mL dated 13/11/2013.HCV,IgG 0.12 dated 9/11/2013.
Anti Nuclear Antibody ( ANA) 0.12.IgA : 279 mg/dL dated 9/11/2013.
AMA : 0.26 UI/mL dated 11/11/2013.
ASMA : 2.70 U/ml dated 13/11/2013.LKM 0.02 U/ml dated 11/11/2013.
both hbsag and hbvdna too high for pegintf to respond, you may try 24 weeks and then go for tenofovir
i myself would go for:
tenofovir plus telbivudine 1 year and then discontinue telbivudine and add on peg to tdf
or tdf 3 years
tdf+pegintf 2 years
Thank you so much Stef2011 , tomorrow i will discuss with Doctor and go for the best option . Shall up date you .
Thanks for your kind suggestion.
Hope you are doing good ,
Today I consulted my Doctor and discussed the report , he suggest me to go for TERAVIR 300 Mg one daily.
Also ask me to repeat the blood test after one month for CBC , LFT & S.creatinine.
Please guide me the treatment is okay.
Thank you so much , shall share the outcome.
Hope you are doing ,
I have one question in mind please let me know " Is there any relation with HB Virus vs.HIV1 & HIV2.
Looking forward your best opinion.
no whatsoever, also keep inmind that hiv has never been isolated and purified so all hiv tests say in the booklet of producers "you can t use this test to diagnose hiv infection".....if you don t purify you can t have a goldstandard for testing, see "house of numbers" on youtube and what scientists that won nobel prize think of this and then you can have an idea of yours
my idea is "hiv retroviruses" probably exsit but if you dont purify and isolate the virus all the tests are of very little help
Thank you for your quick reply , actually i joined new company where they asked to do the medical test and in that requirement they asked to go for HIV1 & 2 test , since I suffered with HBV little worried if HIV1 &2 comes may be they will consider me in there company..
just google online for hiv test false negative there are so many interference.