Crazy High Help B Viral Load

[SnarkyAK]

According to my latest labs:

Hep B Virus DNA  >110000000 H   IU/mL

Hep B Virus DNA  >640200000   copies/mL

Just how bad is this exactly? I feel like my Gastro is being dodgy when I ask him. He has said it's high...

[stef2011]

be also aware of this:

all antivirals have no effect on virus infection, they only lower hbvdna which is responsible of liver damage but even when hbvdna is undetactable the infection goes on and on many cases it gets worst spreading to other cells.
so if you stop these therapies or develop resistance you have more infected cells which start producing virus so hbvdna wil be higher than before and also alt/ast

so the point is these therapies cannot be stopped and resistance cannot develop because the infection is even worst so managment of therapy is not easy

the only test that can tell you if you are getting less infected cells is hbsag quantity in the serum or even better in the biopsy

[stef2011]

as to alinia (nitazoxanide) check all the posts in the community since it is not covered by insurance companies and brand from romark is way too expensive a generic from lupin would be the best choice.it is also off label so it is not easy to find a doctor to prescribe but it has no sides and allowed even on 1yo babies so it is easy to get it even without prescription at canadian pharmacies

[stef2011]

tenofovir and alinia are active on all mutants, be aware that if you have those mutants you need a researcher or very expert doctor, no just a liver specialist, becuase wrong choices can get the situation even worst.
baraclude monotherapy was a very wrong choice, plus these antivirals can t be used without checking the resistant mutants

[stef2011]

In 2000 I was diagnosed with Chronic Hep B. I did Interfuron and Hepsera over the years as well as Epivir. In 2006 I was told that my viral load was undetectable.

my god, you got the crazy doctors to make you a mess, hbvdna has no meanning in terms of clearing infection and unfortunately ignorant doctors don t know that.
lamivudine and adefovir were taken together with interferon?without interferon you might have the very dangerous hbv mutants from those antivirals and unfortunately once you get those mutants liver cancer risk remains very high even with hbvdna undetactable, the only chance is to get hbsag negative

did you make hbv polimerase, pcp and precore mutants tests?

The doctor wants to start me on Baraclude....as to doctor if he was in italy i'd sue him for every mutant developped.go to the best doctors and liver center in the country, if you can afford it move to harvard boston or HR in LA, i can PM their names

baraclude cannot be used at this point because several mutants might be present (baraclude don t work with mutants it will develop other muatnts if used monotherapy) and hbv dna is too  high for an antiviral to work.i guess the high hbvdna is due to mutants not immune tollerant at this point.
after we know the mutants i'd start:
tenofovir+entecavir+alinia and see if they can get hbvdna down but we have to be sure about the type of mutants you have to choose entecavir or other

there was an asian guy on the forum with hbvdna in the billions and tenofovir+entecavir worked

[SnarkyAK]

Hi Stefano, thanks for answering my posts.

In 2000 I was diagnosed with Chronic Hep B. I did Interfuron and Hepsera over the years as well as Epivir. In 2006 I was told that my viral load was undetectable.

Last month after not feeling well, I went to the Doctors and lo and behold my Hep is back with a vengeance. I had a sonogram where some polyps are found in my Gall Bladder.

The doctor wants to start me on Baraclude. The last time I had a liver biopsy was in 2001. I was wondering if I should have one now given my ast/asl numbers.

[stef2011]

in this case a biopsy or fibroscan is needed to understand if it is the virus or you might have fatty liver
are you very low weight and bmi, this can rule out fatty liver

you can also check hbcab igm, if this is more than 0.02s/co immune system is active and you are not immune tollerant.in any case it is better to wait that hbvdna gets lower before starting a therapy

are you asian?on asians hbvdna are much hihger and immune response less

[SnarkyAK]

My AST and ASL are 135 and 303

[stef2011]

you have to know (ur doctor should be very aware of this so change it if it didn t tell you) that hbv is not pathogenic, it means it makes no damage to our body.it is the immune system that makes the damage killing the infected cells producing the virus

with such high viral loads the state is immune tollerant (no immune response), this means no dammage at all, so you are in the best stage of hbv infection, perfectly healthy, and hope to stay in this stage as long as possible

your liver during this stage is even healthier since the virus changes free radical protection genes of infected cells making them more strong and living longer than others

as long as hbvdna, hbsag stay at high range numbers and alt/ast stay about normal you are immune tollerant.in case alt/ast are a little abpve normal range you have to check if it is immune response starting or justfatty liver/unhealthy life to make alt a little higher than normal.a fibroscan or biopsy is ofetn needed to be 100% sure you are immune tollerant

the best time to start a therapy is when your immune system will start with interferon and alinia while entecavir/tenofovir are useless on virus
at this stage no therapy is needed and no therapy can work