Entecavir + Interferon combo

[cyrus131]

Dear all,

     I have been on Entecavir 0.5mg for over 6 years and my HBV DNA is nearly undetectable.  I will see my doctor tomorrow and what tests should I perform so as to assess whether I will benefit from the Entecavir + Interferon combo treatment (i.e. higher chance to achieve Hbsag seroconversion.)  Many thanks.

Regards,

Cyrus

[studyforhope]

let us wait intil your quant hbsag comes back. if your dr does not want to give you more interferon then there is very little that you can do to change the course. taking antivirals will slow the regrowth of the infected cell number.

i think if you retreat later with ifn you will have a response again. It is the lack of the proper epitope tcell clone combination and an insufficient cytokine milieu to keep the tcell clone in an effective state that limits the permanent internal control.

[andrey19]

My opinion is that your hbsag titer went below cut off level (<0.05) while paris2013 was 0.09 iu/ml almost below. Both yours and her immune system should establish permanent control of hbv but for some reasons that did not happen. Meanwhile you both continued taking entecavir after pegasys but it did not help to keep hbsag cleared.

See page 18 of below presentation: http://www.aphc.info/pdf/2014/Luncheons_13012014/S-251/Jorg_PETERSEN.pdf  

Some people clear hbsag with Baraclude mono without any relapse in the future, this is really possible while we have two members here that cleared hbs and relapsed. I already start thinking that hbsag relapse is irreversible.

[cyrus131]

Dear Andrey,

Thanks for drawing my attention to Paris2013 case.  The only difference between me and Paris2013 is that I achieved HBsAg undectable (I don't know whether it is equivalent to clearance) and then attained the Anti-HBs at 22mIU level (I know it is low but my doctor would not prescribe further interferon and I was too stupid to think I had already won the battle of HBV).  Now I was tested positive for both HBsAg and HBeAg.

I haven't checked the HBsAg quantity but will do so these few days.  What do you think about Paris2013's doctor about it is useless to repeat interferon as it appears that we (me and Paris2013) have no permanent control on the HBV.

Would studyforhope please kindly advise.  Many thanks.

This disease is indeed very frustrating!!!

Regards,

Cyrus

[andrey19]

did you check your hbsag in quantity again? By the way Paris2013 also relapsed after extremely low hbsag achieved by interferon and anti-hbsag development as well.

[stef2011]

another thing i dont have time to read the full post now but if you had only 48weeks of pegintf i strongly suggest to restart it.the most potent effect of peg on immune system is between first and second year (not shorter or longer), so this might be the best choice togheter with vit d or simvastatin as some of us are trying

[stef2011]

first of all check the level of hbsag and hbsab, after we have this result i would go for hbv vaccines, zadaxin or gcmaf if low.if high another round of pegintf

is your vitd25oh kept at optimum levels around 100ng/ml?of course this is mandatory for immune function and if low must be corrected as soon as possible

as to the use of entecavir or tenofovir i would wait for the expert opinion of studyforhope.i personally prefer tdf because more potent