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Avatar universal

HBV DNA detected again after stopping Baraclude

I took Baraclude for 3 yrs 3mths and seroconverted to HBe neg/anti-HBe pos. and dna was undetected for about 2yrs. I recently stopped in March. But my recent lab results showed the dna is detected again.

March '12 - Stop baraclude
June '12 - hbv dna 1260 IU/ml
July '12 - hbv dna 966 IU/ml, ALT - 10

My dr said my levels are stable but may also cause liver damage over time. He mentioned the virus in my body belongs to the pre-core or core-promoter mutation group. And he also recommended me to take lab tests every month to monitor.

I wish to know what does "pre-core" or "core-promoter" group mean? What are the repercussions?

Does low hbv dna mean a lower risk of liver cancer?

What should i next do to improve my condition? continue to be on medication? or am I ok to stop and just monitor first. I am thinking of a natural treatment like taking phyllanthus niruri and thymus gland supplement. Anyone knows if it will help?

Appreciate your knowledge here...tks.
99 Responses
Avatar universal
another example that anti-viral drug do not work ; it is just good for the pharm compant to make $$$$!
Avatar universal
I forgot to mention that before baraclude treatment, my hbv dna was very high...probably about 8 log. So if it can be stable at less than 4 log, isn't it good? Or does hbv dna not make a difference at all in lowering risk of liver damage/cancer?
Avatar universal
this info was posted by another member orientS

Up to March 2010, The Center for Liver Health at CUHK studied nine literature reporting HCC recurrence in chronic hepatitis B patients. 551 patients were studied, of which 204 had antiviral treatment and 347 were untreated controls. The analysis reveals that antiviral treatment was associated with over 40% risk reduction for HCC recurrence as compared with the untreated controls. Furthermore, antiviral treatment was associated with more than 85% reduction in risk of liver failure and more than 70% risk reduction in death after HCC treatment.

Avatar universal
Thank you for your kind sharing. It is indeed insightful.

Qn. Does it mean if I go on anti-viral for the rest of my life, thats the best solution as it much lowers risk of liver damage/cancer?

My knowledge of hepB treatment is still not very good, and its great we have this forum to learn from one another!
Avatar universal
I don't have any ready answers for your situation. Rules that allow patients to stop antiviral treatment successfully are still being developed. So we are grateful for your effort and hope to learn from your experience. Do keep us posted.

In the old days, seroconversion from HbeAg positive to HBeAg negative was considered the end point of treatment as HBeAg negative was taken to indicate a low replication phase, accompanied by very low hbvdna and normal ALT. But few years ago, they discovered mutant forms of the virus - pre-core or core promoter HBV variants - that prevent or decrease the production of HBeAg. So even though a patient is HBeAg negative, the virus is still actively replicating, as indicated by increased level of hbvdna. This is now called HBeAg negative chronic hepatitis (as distinct from HBeAg positive chronic hepatitis) and usually requires treatment.

So your doctor thinks that you may have the pre-core or core-promotor variant form of the virus. I am not a doctor, but I don't necessary agree with your doctor on this. The reasons are complicated but basically I believe there are differences between spontaneous HBeAg seroconversion and drug-induced seroconversion, as in your case.

I think it is a good idea to keep monitoring your hbvdna and ALT closely, as you may still have stopped successfully. HBV is tricky and there is a lot to discover.

Just my opinion.
Avatar universal

there are no reports about stopping baraclude and clearing the virus but there are reports on tenofovir and adefovir taken for long periods like 3-5 years and then stopping it, i dont remember exact numbers now but something like 40% cleared hbv definitively

since adefovir is similar to tenofovir but so weak that is not firstline drug anymore it is best to use tenofovir for this
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