Chronic hepatitis B detected

[hepa114]

Hello Guys,
please see my reports,
HAV -ve
HEV -ve
HBeAg report need to come (+ve 2yr back)
anti-HBE -ve
anti-HCV -ve
HBsAg +ve
HBV DNA (By TAQ MAN) > 170,000,000 IU/ML
AFP 3.4
PT 1.0
SGOT/SGPT 369/526
Now after getting these reports I have consulted with two doctors. One doctor has suggested “TenoHep” and the other one has suggested “Tavin”. Both are Tenofovir medicines and I am confused which one should I start?
The first one is costing around $1 in india and the second one is around 65 cent.
I did little bit internet search about “tenofovir” and came to know once you start these medicines you can’t stop in-between otherwise it might start damaging your lever also you can’t change the medicine in-between if you are seeing any side affect. I also asked from doctors which medicine should I start taking, he told the first once in new in India and the company is also not good and the second one (which he has recommended) is quiet old and it is from known company.
Can anyone suggest me which one should I start taking? Also doe’s tenofovir has any side affect? How do I will come to know about side affect after taking these tables?
As of now I am vomiting after eating any food so I stopped taking any solid food and just taking liquid food and fruits. Also I am not feeling much hunger.
TenoHep is manufactured by : Cadila Healthcare Ltd under a license from Gilead, USA.
I can afford both the tables so money is not a concern. Also please suggest what is the best time to take these medicine and BF or AF? since I have to go office from 9:00AM-6PM).
Thanks in advance for reply.

[hepa114]

Hello Steven,
could you please help me to understand my reports and next step.

Thanks.

[hepa114]

Hello Stefano,
could you please help me as well.

Thanks,

[hepa114]

Hello Stefano,

below are my latest reports after continuing "Tenvir" for almost 1 year 2 months.
on 15/12/2012
HBeAg Positive
Test Value 4.48 cutoff rate 0.10
HBeAb Negative cutoff rate 0.40
after this i started taking the "Tenvir" tab.

on 05/02/2011
SGOT: 81   [15-37]
SGPT: 150   [30-65]

on 23/04/2011
SGOT: 37   [15-37]
SGPT: 54   [30-65]

on 23/07/2011
SGOT: 30  [15-37]
SGPT: 49   [30-65]
HBeAb - Reactive 0.264 Ref Range  1.0 Non-Reactive
HbeAg - Reactive 4.09 Ref Range  1.0 Reactive

on 17/04/2012
SGOT: 30  [15-37]
SGPT: 50   [30-65]
LFT Normal
HBeAb - Reactive 0.831 Ref Range  1.0 Non-Reactive
HbeAg - Reactive 2.07 Ref Range  1.0 Reactive
DNA LOAD - report awaited

Based on these results could you please tell me my health condition. since HBeAb is reactive (positive i hope) did i have achieved the "seroconversion" stage and not more treatment required.
from last month i have stopped taking the "Tenvir" tab and going to meet the Dr after DNA Load report.
can i start the Tenvir tab again to make HBeAg also negative.
what does 0.831 or 2.07 number mean? or 0.264 and 4.09 mean? if the number is more mean more hap B virus?
although i have some more question but waiting for your reply.
Thanks,

[stef2011]

bilirubin and PT are a little high and also platlets not very high you may be f3/cirrhosis and may be not, in any case liver damage is advanced so start both tablets as soon as possible.only fibroscan will be able to confirm cirrhosis or not, in any case even if you cannot check cirrhosis and damage will start regressing within as little as a couple of years to maximum 6 years

[hepa114]

Hello Stefano,

please see the results.
serum creatinine (mod. jaffe)      0.9 mg/dl       [0.8-1.6]
platelet count    170000 /cu.mm      [150000-450000]
bilirubin-total (mod. j groff)   1.3 mg/dl    [0.1-1.2]
bilirubin - direct (,,)      0.7 mg/dl     [0.0-0.4]
prothrombin time test   13.3  sec  [12.0-15.0]
prothrombin time control  13.0  sec
inr 1.0

also my age is 31/M - 75kg - 5'11"
which test i have to do blood/serum/urine creatinine? i have already done serum creatinie.

Thanks

[stef2011]

also since my condition is deteriorating day by day so i can't wait too long without any treatment (i am not able to eat properly also etching has started in my body and i am feeling vomiting continually).

this is bad you might already have cirrhosis, is platelts, bilirubin, PT normal?

do start both drugs as soon as possible and if you can have acess to a fibroscan do check if you have cirrhosis.
remember to check creatinine because on cirrhosis kidneys can be damaged, in case it increases there is another drug a little weaker than tenofovir but with no sides on kidneys (Actually the one i am using because my kidneys cannot stand tenofovir)

[stef2011]

because tenofovir blocks only replicating virions and replication but doesn t stop virus at all, virus template, the cccdna, might even increase

on the contrary nitazoxanide has no activity directly on virus but interferes with production of antigens inside infected cells, and by doing so it can lower hbsag which is the reason why our immune system is blocked and infection persists.
if nitazoxanide makes hbsag negative our immune system works normally again and hbsab will appear and there is no need for drugs anymore

we don tknow how many can get hbsag negative by nitazoxanide but we do know it lower hbsag, in your case it can also make hbeag negative by a shorter time compared to tenofovir only and when hbeag gets negative the virus gets weaker

[hepa114]

Hello Stefano,
Thanks for your prompt reply, i was expecting a reply from you looking at the past thread. can i ask you why you suggesting nizonide500 tablet if tavin itself will bring down the sgpt/sgot to normal level?
also since my condition is deteriorating day by day so i can't wait too long without any treatment (i am not able to eat properly also etching has started in my body and i am feeling vomiting continually). So instead of first taking nizonide500 for 4 week and then starting nizonide500+tavin can i start both the tablets from very first day or only just start tavin?
thanks.

[stef2011]

actually tavin is much more reliable company and even tenvir from cipla is

[stef2011]

which one should I start?
the cheapest between the two, they are the same drug

there are no drugs active on virus eradication they can only lower replication to stop liver damage, that's why they can t be stopped

tenofovir has any side affect?
the only sides can be on people with cirrhosis/severe liver damage which has made damage to kidneys too, or in people with hiv which damages kidneys too
so you must check creatinine before taking drug and then every week first month and every month the first year so that you are sure your kidneys were not already damaged and can accept this drug with no damage.
unfortunately there are no tests to know if your kidenys are damaged or not, you can only see if creatinine increases after taking the drug.the kidneys can be sick and damaged with all blood tests normal.there are sensitive tests being developped for the future but for now you can only do as suggested.

the alt/ast (sgpt/sgot) are elevated because of virus replication, tenofovir lowers replication very fast and make alt/ast normal.what you think is wrong, liver and alt are not ok because of the virus replication

if you take nizonide500 by lupin (nitazoxanide 500mg pills) and take 1 pill every 6-8 hours with food for a total of 1,5 or 2g daily for at least 4 weeks before starting tenofovir you will be able to have hbvdna undetactable and alt/ast normal within a month.
nitazoxanide can also increase chances to eradicate hbv so you will not be forced to take drugs for life

nitazoxanide can only make mild diarrea, if you do experience some for more than 2 days you can take probiotics to stop it

so my suggestion is:
4 weeks nizonide500 (nitazoxanide)
after 4 weeks nizonide500+tenofovir

[hepa114]

also is there are any medicine which can lower my SGOT/SGPT? since my lever is not functioning properly and these medicine only suppress the viruses or reduce their multiplications but don’t reduce SGPT/SGOT.