HBeAg positive to negative

[bollux]

Hi,

I have Hep B for 16 years now (im now 30 years old), receive it from blood donation... Never mind that now. From 2004-2008 i received Lamivudine therapy and my liver enzymes got down to reasonable limits. They stayed there for 5, 6 years until my last blood control. Here is chronological results;

2008: AST 33, ALT 30, ALP 70, GGT 17, UBIL 10
2010: AST 42, ALT 46, ALP 66, GGT 16, UBIL 11
         HBsAg pos.>250 IU/mL, Anti-HBs neg, Anti-Hbc total positive,
         Anti-HBc IgM neg, HBeAg pos, Anti-HBe pos, HBV-DNA 791 IU/mL
2011: AST 32, ALT 47, ALP 76, GGT 19, UBIL 11
2012: AST 35, ALT 56, ALP 66, GGT 21, UBIL 15
2013: AST 72, ALT 156, ALP 59, GGT 24, UBIL 11
         HBsAg pos.9755 IU/mL, Anti-HBs neg, Anti-Hbc total positive,
         Anti-HBc IgM neg, HBeAg neg, Anti-HBe pos, HBV-DNA 5.45e+7 IU/mL

From what you can see my HBeAg turned from positive to negative and my liver enzymes and HBV-DNA started to raise.....

I'm waiting for specialist check in a few week but want some advices or opinions from any experiences, maybe...

Thank you all in advance..

[fredz2013]

my last  wbc  is 3.24 si units
platelet is 92
neutrophils 16.70

last dose was 135mcg.
my lowest platelet count drop to 52. No meds administer yet for platelet

[stef2011]

if needed you can post on hcv community about peg sides effects and warning low plts and wbc and drugs used.pegintf has much heavier sides for hcv infection so they are more experienced on this, on hbv sides are milder

[stef2011]

use 180 dose, the lower dose dont work, response is low at 180 already

low plts are less than 20.000-25.000, if you have higher it is ok to keep the high dose.expert specialists are able to monitor you at these low plts, the bad ones are not experinced and are scared of any abnormal value

neutrophils can be as low as 0.5, what are your values?

how to keep less sides and higher wbc and plts:
melatonin
vit d3
liposomal vitamin c

if these fails instead of lowering pegintf dose there are drugs that increase plts

[fredz2013]

Thank you so much stef. Your reply is much clearer than my doctor response.

My other concern is my dose of pegintf is not consistent coz of my WBC, Neutrophils and platelet count is low. Is this okay?

[stef2011]

of course if your alt were not elevated there would have been no hbsag decline or any chance to clear hbv, just to make you understand how your alt are almost normal and make no damage at all:

i regressed cirrhosis with alt 40-50 on entecavir and now still around 30-40 on entecavir plus tenofovir which is absolutley best because i have little decrease of hbsag year per year, with alt less than 30 hbsg would not decrease

[stef2011]

dont worry about ast-alt they have no danger to normal livers for just few years treatment and absolutely not a those levels, 1000 is a level of concern to cirrhosis patients while the others on mild fibrosis have no issues even on 1500

alt reflects the killing of infected cells by immune system with such result at 24weeks you re definitely going to clear in 48-72weeks.if you see a slower decline you may think of adding vitamin d3 if lower than 40-50ng/ml in blood or alinia or simvastatin but for now since hbsag decline is fast it is best not to mix, only if you find very low vit d3 it may be useful to take it immediately (we have trials were vitd3>30ng/ml had much higher clearance on pegint)

please update on your next hbsag results