HBV DNA drop 5 months post tx

[grmr]

Mates,

really strange what's happening to my HBV.. Stopped combo TX (IFN+TDF) 5 months ago after almost 60wks as I still was eag+ and no drop in HBS.

2 months later the DNA increased from UND to 60.000 iu/ml and ALT AST increasd also aourn 70iu/ml .. very weak flare

Latest lab 2 wks ago show HBV DNA 300iu/ml.. while ALT are inside the range (40 range 5 - 50).. I'd hope but i relaly do not believe in any EAG seronconversion.. :(

Stef: have you read this?
http://forum.corriere.it/fegato/17-09-2013/news-dal-congresso-europeo-di-epatologia-2013-epatiti-b-e-d-delta-2401294.html


God bless u all

[grmr]

should i be treated again accordin to guidelines? do not think so as ALT are normal...

[grmr]

hi all..

last update..
AST 16 ALT 30 ---- > decreasing
DNA 4000iu -----> increasing..

[grmr]

my liver, accordin to ULTRASOUND is abosultely ok... seems like i'm back to immune tolerant phase...

TDF for me was not a trial... it was a combo therapy with IFN... but i'll believe in 2/3 months there will put me back on antivirals..

[mustthinkpositive]

What are you taking complimentary G? Vitamins, herbs, tea....etc?

I understand these have no effects on the virus but some may improve liver condition and boost immune system.

Since you still have not seroconvert, the doc should kept you on TDF. Why were you taken off it. Was it a trial?

[grmr]

--. Dec:  DNA 715iu/ml... increasing..

EAG +ve - HBEAB -ve.... no seroconversion yet...

[grmr]

---Novemeber... DNA=270iu/ml... starting increasing..

[grmr]

@ newtr.. check my posts to find out treatment i had undergone to..

@ stef.. next month i'll also have vitd25oh.. i keep on intaking 5000iu dailiy.. so I expecti it is in the 80/100 range....

[newtr]

please tell us your treatment history and results in details.thnks

[stef2011]

please also report all the vitd25oh tests you have, we are trying to check correlation d3 to hbsag/hbvdna when vitd25oh>100ng/ml

[stef2011]

wow 100iu/ml is definitely a strong immune response i hope this reflects on hbsag too, if it keeps dropping use of antivirals is useless and you may just monitor and keep d3 supplements or try another round of pegintf when hbsag/hbvdna stop the decline

[grmr]

still dropping.. now is 100iu/ml with normal ALT AST.. but monocites started increasing.. I'll have EAG test next month..keep u posted

[newtr]

similar was my viral load before 3 years before baraclude now undo dna but very high hbsag quantative.i dont know whether i could be benefitted from discontinuation.

[grmr]

let's hope...
@new tr: my DNA has always been >100 000 000 copies/ml since birth to date..

[stef2011]

also keep in mind the max strenght of immune system on pegintf is after 48weeks and it keeps working even when stopping pegintf, it is very probable you are having some response to the pegintf therapy

the relapse usually happens at the end of the second year so it is best to follow changes with no therapy and when you see a relapse restart tdf

[newtr]

what was ur vius count before starting  tenofovir+intf at the begining.

[grmr]

i'll have them done soon... do really know whether this is a sign of EAG serocnversion or not... I read the better is to have a high flare before EAG serconversions... not my case

[stef2011]

if possible keep serum levels around 100ng/ml like me and my sister are doing so we get more data on this

as regards calcium we have seen same trend as you with lowering calcium when increasing vitd25oh around 100ng/ml,we re both at 9.2mg/dl

[stef2011]

I do not think my immune system senses the HBV as ALT are normal and monocytes too.. will have hbs quant done soon as wee as eag..

this doesn t matter you are not at the stge of infected cells killing but probably only making intf gamma to block replication

[grmr]

@ stef: I refer to the study saying 50% of asians and caucasians has DNA drop withn 6 months afetr tx

I do not think my immune system senses the HBV as ALT are normal and monocytes too.. will have hbs quant done soon as wee as eag..

@mtp. My BMI is identical to yours.. I was on 135ng dose during the first course 5 ys ago as well..

I keep on 5000iu VIT D daily...

[mustthinkpositive]

How long were you on 135mcg G? Also, what are you on right now in term of supplement/diet?

Also, when you were on your first IFN Tx, were you on 180mcg?

I am currently on 90mcg because of the low platelets count.

Not sure when the Dr will allow me to up the dose. My ALT elevate from 50 to 131 max on the first 2 180mcg dose. Last weekly check up, it went down to 91. I will let nature take it's course. Maybe it's our BMI that dictate lower doses. I am 168cm/63kg. So we are both quite small.

[stef2011]

which article do you refer to "in forum corriere fegato"?

[stef2011]

intf effect will continue for at least another year and in sustained responders for 5 years and more, one thing is certain your immune cells are starting to sense hbv and producing cytokines to abolish replication

do you also have hbsag quant and hbeag quant or will do soon?in bergamo hbsag is about 7€ no need of prescription to make tests if you pay

[grmr]

to me it seems quite strange that's due to ifn effect..as I stopped in March and i was on 135ng shots... not full does.

@MTP... i do not bet i have serconverted.. possibilties rates are too low...

doc decided to have me on TDF for 1 year only.. then quit TDF 3/4 months before stopping IFN..

[mustthinkpositive]

Good to hear. Maybe you did sero-convert to E-Antigen negative because of your normal ALT and low rebound in HBV DNA.

Was it your decision to not continuing with TDF after the combo?

God Bless.