Aa
HBV
My VL was 100000000 IU/ml & HBe antigen level was 948.33.I was taking lamivedin for the last 12 years.
now Ihave developed YMDD MUTATION so I have been put on Entacavir for the last 1month.How long will it take to bring down the VL to normal level?
now Ihave developed YMDD MUTATION so I have been put on Entacavir for the last 1month.How long will it take to bring down the VL to normal level?
I was taking lamivedin for the last 12 years.
sorry i did not notice this so i guess you were not immune tollerant
the hbvdna so high is a problem now, during antiviral treatment hbvdna must be checked every 3-6 months maximum and lam and adv must not be used.if you catch hbvdna while 20-50iu/ml you can easily get it doown but now even tenofovir might not be able to decrease so much replication
add tenofovir as soon as possible to entecavir because entecavir doesnt work if there are lam mutants, use entecavir 1mg.this should work.if hbvdna is not und by 1 year and very low in 6-8 months you may also add interferon on them
you may try to increase vit d3 to >50ng/ml and lower cholesterol by simvastatin at the same time but these things dont work on virus directly, might only weaken it a little
sorry i did not notice this so i guess you were not immune tollerant
the hbvdna so high is a problem now, during antiviral treatment hbvdna must be checked every 3-6 months maximum and lam and adv must not be used.if you catch hbvdna while 20-50iu/ml you can easily get it doown but now even tenofovir might not be able to decrease so much replication
add tenofovir as soon as possible to entecavir because entecavir doesnt work if there are lam mutants, use entecavir 1mg.this should work.if hbvdna is not und by 1 year and very low in 6-8 months you may also add interferon on them
you may try to increase vit d3 to >50ng/ml and lower cholesterol by simvastatin at the same time but these things dont work on virus directly, might only weaken it a little
with lam mutants no drug works, entecavir especially, stop it immediately or add tenofovir to it but only if you know you are not immuen tollerant because if you are so and add tenofovir you may get a monster mutant which is not treatable by any drug in the future
i think you are immune tollerant and you MUST NOT treat if so, you just develop mutants and resistance to all drugs
the virus makes no damage so until there is no immune response you must not treat because you get worst if you treat
what is ast/alt and fibroscan or biopsy?do you have a doctors who knows what he is doing?you can get in a no way out situation once immune system makes a response
"Entecavir should not be used in patients with previous lamivudine resistance, yet it may still be an option in lamivudine-experienced patients in case lamivudine resistance never developed," - http://www.hivandhepatitis.com/hep_b/news/2010/0402_2010_a.html
have another option regarding Entecavir and discuss with you doctor Tenofovir.
Maybe Entecavir is more potent on HBe + and Tenofovir in HBe-, but if you have Lamivudine resistance already the chance to become Entecavir resistance incerease, so maybe Tenofovir will be a good option, or maybe a combo Tenofovir / Entecavir
Maybe Entecavir is more potent on HBe + and Tenofovir in HBe-, but if you have Lamivudine resistance already the chance to become Entecavir resistance incerease, so maybe Tenofovir will be a good option, or maybe a combo Tenofovir / Entecavir
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