Aa
Finally got the first "full picture" of my results... Should I start treatment?
ast 18 (ref range: 10-30 u/l)
alt 19 (ref range: 6-29 u/l)
vit d, 25-oh, total: 28 (ref range: 30-100 ng/ml)
pth intact 35 (ref range: 14-64 pg/ml)
hbsag positive
hbsab negative
hbcab positive
hbeag negative
hbeab positive
hbv dna 1311 ui/ml
hbsag count ??? ui/ml (can't do the test in the US, but I'm guessing it's going to be more than hbv dna?)
alpha fetoprotein tumor marker 2.0 (ref range: <6.1 ng/ml)
liver fibrotest score: 0.29 (F1) minimal fibrosis
acti test (assesses activity (inflammation in chb)): score 0.05 (A0) no activity.
hep a ab negative (should I get vaccinated?)
hep d co-infection negative
Ultrasound: No significant abnormality is identified.
tests pending: hbv genotype
What do you think guys am I a good candidate to start treatment? If so, what treatment plan would you advise? Is peg-Intf an option? How likely will my fibrosis progress to F2? What phase do I belong to (e.g. immunte tolrent, clearance, inactive, etc)? How often should I monitor myself? Also, would it be beneficial to get a FibroScan in addition to the FibroTest I already got?
I'm going to discuss with my gi about my treatment options this Tuesday, and also going to have a second opinion appt with a hepatologist specialist next month. I would also appreciate if you could recommend good docs in LA area.
Thanks for your help!
alt 19 (ref range: 6-29 u/l)
vit d, 25-oh, total: 28 (ref range: 30-100 ng/ml)
pth intact 35 (ref range: 14-64 pg/ml)
hbsag positive
hbsab negative
hbcab positive
hbeag negative
hbeab positive
hbv dna 1311 ui/ml
hbsag count ??? ui/ml (can't do the test in the US, but I'm guessing it's going to be more than hbv dna?)
alpha fetoprotein tumor marker 2.0 (ref range: <6.1 ng/ml)
liver fibrotest score: 0.29 (F1) minimal fibrosis
acti test (assesses activity (inflammation in chb)): score 0.05 (A0) no activity.
hep a ab negative (should I get vaccinated?)
hep d co-infection negative
Ultrasound: No significant abnormality is identified.
tests pending: hbv genotype
What do you think guys am I a good candidate to start treatment? If so, what treatment plan would you advise? Is peg-Intf an option? How likely will my fibrosis progress to F2? What phase do I belong to (e.g. immunte tolrent, clearance, inactive, etc)? How often should I monitor myself? Also, would it be beneficial to get a FibroScan in addition to the FibroTest I already got?
I'm going to discuss with my gi about my treatment options this Tuesday, and also going to have a second opinion appt with a hepatologist specialist next month. I would also appreciate if you could recommend good docs in LA area.
Thanks for your help!
Best Answer
Of course there is a risk. If something is expected to work it may also harm. That's why you monitor urine calc, serum calc and PTH to adjust supplementation.
The question is not only what is the benefit, but what is the risk of taking big doses of vitamin d that can cause to your kidneys...
I guess you refer to this article:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692974/
"Normal vitamin D levels are associated with spontaneous hepatitis B surface antigen seroclearance"
"Our study contains some limitations. The link between vitamin D levels and HBsAg seroclearance was not shown to be causal but associative. The retrospective pattern of this study was unable to determine the cause effect of vitamin D levels to HBsAg seroclearance. More studies with a larger number of patients and with a prospective and controlled design are needed to confirm this hypothesis. Furthermore, this study did show that a very high percentage of spontaneous converters do have high levels of vitamin D but this percentage was not compared to a similar group of patients with hepatitis B without a spontaneous seroclearance."
In other words, it doesn't prove that vitamin d is the reason for serocleareance, it could be the people who had normal vitamin d levels was caused by some other reasons in their body.. it doesn't mean if you get normal vitamin d levels by taking supplements will get you the same result (seroclearance) as those group of people. Without more studies, it cannot be determined.
This is what they used to consider below normal levels:
Below normal levels of 25 (OH) vitamin D ≤ 30 ng/mL
Laboratory, demographic and clinical data of the two groups n (%) or (mean ± SD)
Normal levels of 25 (OH) vitamin D (n = 44): 31 ± 4
Below normal levels of 25 (OH) vitamin D (n = 9): 13.5 ± 7.2
Even those who had normal levels of vitamin D around 27-35
that seroconverted didn't have their vitamin D levels at the max like Stef tries to say that is needed...
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692974/
"Normal vitamin D levels are associated with spontaneous hepatitis B surface antigen seroclearance"
"Our study contains some limitations. The link between vitamin D levels and HBsAg seroclearance was not shown to be causal but associative. The retrospective pattern of this study was unable to determine the cause effect of vitamin D levels to HBsAg seroclearance. More studies with a larger number of patients and with a prospective and controlled design are needed to confirm this hypothesis. Furthermore, this study did show that a very high percentage of spontaneous converters do have high levels of vitamin D but this percentage was not compared to a similar group of patients with hepatitis B without a spontaneous seroclearance."
In other words, it doesn't prove that vitamin d is the reason for serocleareance, it could be the people who had normal vitamin d levels was caused by some other reasons in their body.. it doesn't mean if you get normal vitamin d levels by taking supplements will get you the same result (seroclearance) as those group of people. Without more studies, it cannot be determined.
This is what they used to consider below normal levels:
Below normal levels of 25 (OH) vitamin D ≤ 30 ng/mL
Laboratory, demographic and clinical data of the two groups n (%) or (mean ± SD)
Normal levels of 25 (OH) vitamin D (n = 44): 31 ± 4
Below normal levels of 25 (OH) vitamin D (n = 9): 13.5 ± 7.2
Even those who had normal levels of vitamin D around 27-35
that seroconverted didn't have their vitamin D levels at the max like Stef tries to say that is needed...
I am not saying it plays a role of anti viral but any thing helps our immune system sure assure prevention of reactivation of virus and liver damage.not just vit d.not go far on any study just read on google what is the role and benifit of vit d.or on drug notice.
But in one study i read it has an effect in order to seroconvert i can't provide the source though because it has been a while now.
"to do not give virus chance to do damagedto our liver" - it's not proven that taking vitamin d will prevent liver damage, are you saying it's effective as the anti-viral drug? Also you are you saying it's helping the immune system but to what extent, is it effective as interferon? I doubt if, unless you can provide evidence. Yes different body react differently, but without clinical studies and getting significant statistical conclusion you can't guess how effective it is, sorry.
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Bringing PTH to minimum is not your target it's just signal that you have obtained your max safe vit d level when vit D has the best immunoregulation effect.