Im in 1.5 years under TDF.before treatment I am hbeag positive, elevated ALT/AST and mild fatty liver and 180miilion HBV DNA. Now everthing is normal with hbeag negative/anti-hbe positive, undetected HBV DNA. normal ALT/AST and normal liver ultrasound. I will have my hbsag count by February to see if there is any decline.
Lots to learn. Thanks for sharing your experiences guys!It's good to know not to jump right into treatment. I guess we all have to measure the risk and hope for the best. Every time I think I got a sort of grasp on this virus, I learn something new. But like my wife says, better to know it than not know it, even if it's not all good news. Thanks again guys.
the thing that worries me about long term treatment of antivirals is mitochondrial toxicity. A lot of long term hiv patients on antivirals have mitochondrial toxicity and some even with side effects such as myopathy, peripheral neuropathy, and hepatic steatosis with lactic acidosis, which can be life-threatening. this is why doctors advise not to jump to treatment unless it is necessary. the catch 22 is that w/o treatment chances of cirrhosis and hcc is higher.
Tenofovir (TDF) was approved in 2001 for HIV. It has been 14/15 years since then that many people are taking it. TAF, the new version of tenofovir will be even easier to take it with less side-effects...so it looks like it shouldn't be a problem to take it for next 20 years. 20 years from now people shall be cured from Hep B anyway...
Antivirals haven't been around that long so really we don't know. My guess is if there is no resistance and the body can handle any long term sides then it should be okay. Maybe others can take a better guess, but when I've asked my doctor she has said we don't know.
Keep in mind we've come a very long way treatment wise. Our hope is of course in the next decade we see even better treatments and functional cures. Also, with HCV cured the buzz is drug companies are turning to HBV, although HBV is a trickier virus.
How realistic is it to on treatment for the next twenty to thirty years?
There is the chance for the virus to come back worse than ever if you stop. However, they are currently doing studies (and have done studies) of stopping after 5 years on NUCs and undetectable. So far, patients are "ok"
I recommend people to follow the British/NICE (almost exactly same as Japanese and Canadian) guidelines as I believe them to be the best.
Other guidelines are written more in favor of governments (to save governments money) and not in favor of patients. British one are the most comprehensive one as well, taking into account patient age and fibroscan results as well.
I've known about my HBV for decades and so far always been stable. Last year I went to a new specialist who said to go on Viread due to lenghth of infection and over 40 to lower HCC risk, not treatment guidelines. I did so for 6 months. I changed insurance and switched to a new specialist. She works with a world renowned Hepatologist and after reviewing my records said I didn't fit the guidelines for treatment. They agreed for me to go off Viread. I was scared because once you start oral antivirals you usually don't go off for e negative. This was 4 months ago and so far labs are just like they were off treatment. My HBV may stay as in past or it may go active, and in the future if I need treatment due to guidelines and liver showing damage then I will go back on.
Just watch your labs, ultrasound, and Fibroscan and go from there. They have guidelines but doctors in the US seem to be more lenient to treat off guidelines.
I am among those who started treatment right away after i diagnosed with the disease Coz of my fibroscan & high hbvdna result plus Hbeag negative.
Found out about my hbv last September. After I did my tests, my doctor told me that I won't benefit from any treatment because the DNA is at close to undetectable level.