Highly reactive HBsAg

[Mars86]

Dears;

I'm 27 years male , Chronic HBV in immune Tolerant Phase and still Immune Tolerant since I got diagnosed last year in Jan...

I was treated with ETV .5 since exactly 12 month and added TDF in the last three months .. DNA is about 240 iu/ml but HBsAg is highly reactive 130 000 iu/ml ... what is the meaning of this high value ? why it keeps increasing while DNA is going to decrease ?

base line DNA was more than 170 * 10^6 iu/ml ... Normal ALT/AST ..

[Mars86]

your input ?

[studyforhope]

After 2 weeks your vl reduction coming from very high is expected to be 100 to 1000 fold, so you had closer to a billion true vl at start.

It is harder to control a  virus that replicates uninhibited, producing hugh vl numbers.  But the full picture is more complicated.

[Mars86]

Thanks

Next Month I'm going to retest DNA again , I'll inform the forum back .. BTW when I was first treated with ETV, after 2 weeks I retest DNA again and it was 870 000 iu/ml this only in 2 weeks ... the question is, does the baseline VL is an indicator of the treatment ?

[studyforhope]

When your baseline dna was determined to be higher than 170 million, was an effort made to determine your true baseline vl by retesting the sample with an appropriate dilution of 100fold?

You could be one of these patients with a vl of eg 40 billion. Then a primary treatment with entecavir alone is wrong. Hopefully the late add on of tenofovir will bring they vl to und.

A moderate reduction of hbsag quant under intense antiviral treatment is expected. But it will not go much further down and your chances of ifn add on to clear you are very small.

[Mars86]

I forgot to say that ALT/AST are in normal range

[Mars86]

Stef ,

I examined HBsAg Quant. last month it decreased about 30000 iu/ml , it is now about 980000 iu/ml .. what do you suggest ?