Coming off treatment

[Peteshine]

Guys,

I had this reply back from my hepitologist:-


Your Consultant wants you to stay on the Lamivudine and Adefovir until July 09 as this will be a year from when you sero-converted from being E antigen positive to E antigen negative and developed E antibodies.

We cannot determine whether you will become an inactive carrier of Hepatitis B until you have stopped the medication and we have followed you up for a while to see what happens. Unfortunately sometimes the virus becomes active again after treatment is stopped and inactivity is not achieved.

Is this good or bad?

[stevenNYer]

If your eSeroconversion is a successful one, your eAntibody (+) will hold viral activity down on its own.  Hopefully this "inactive" phase will last many years.  As HR pointed out "retreatment is best initiated when the VL is still low".  This means you still have to do DNA regularly.  If your DNA starts climbing right after you stop antivirals, it's retreatment.  If your DNA stay low and after some years starts to climb, it's retreatment.  Point is don't let the DNA creep up to the millions until you do retreatment.  If you need retreatment in the future, Adevoir & Lumivudine should still work.  But you are now eAntigen - so you likely need treatment for a lifetime.  So I would ask for Entecavir and Tenofovir combo.

Also, you could take Tenofovir after your take Adefovir. It's a question of how well it will work.  If you didn't develop resistance to Adefovir, Tenofovir will work great.  If you already developed resistance to Adefovir, you will have a hard time going UND on Tenofovir alone.

[grmr]

It could be the same combo again or maybe ETV.. I do not think It could be TFV aince I read it cannot be used by patients who took adefovir..

[Peteshine]

Right,

If i was to stop treatment in July.... and it is found my VL has shot up and become more active I would have to then go back onto the combo treatment of Adevoir & lumivudine etc.... Could there be a chance the VL would be too strong for the tablets to suppress it? I mean with the current treatment i am on, it is beneficial from my recent results, however that was because the tablets are holding the VL nicely (and in control), if i was to go off these tablets (even for a couple weeks), would the virus find a way to over-ride the treatment, which we often hear happens after a couple years on the same tablet treatment. If so, what does that mean for tx in the future....?

[Hepatitis Researcher]

The critical key aspect is tight monitoring of VL after stopping treatment. Because you could get a flare after stopping and if the the virus resurfaces, retreatment is best initiated when the VL is still low...

[zellyf]

Its good.  Standard even.  No problems here.

[cajim]

Agree.

The result is pretty good.

[grmr]

I can agree with them... If for you is not a big physal effort staying on combeo till JULY you could do it..

then you must be monitored to check VL... anyhow I read that patiens who seroconvert  on tx (either ifn as combo) have a greater chance to stay inactive...

Can anyone agree with this assumption?