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How to know if Entecavir stopped working
Dear all,
First I have to really thank for all of you who are giving us lots of good information.
I am 33 years old man and I think I have Hep B from birth, because of our family history.
I started taking Entecavir 2 years ago and the reason to start treatment was having 640 milion copy/ml of DNA and ALT more than normal range (almost two times of normal ). So Doctor decided to treat. Almost after a year of taking Entecavir my DNA dropped to 20 copy/ml, but still ALT more than the normal range. Then 6 months later DNA increased to 70 with abnormal ALT and 6 month after that DNA went up to 137 with ALT 70. When I started treatment my Hbeag was positive but after a year it turned to be negative and Hbab get positive.
Now I am a little worried about Entecavir suspecting that maybe virus gets resistance to it because of my DNA increase but doctor telling me that these variations in DNA are ok since it is not too much variations and the most important is that your e-antigen is negative. Yesterday I again tested for DNA test but really I am worried.
Any comments and suggestions will be much appreciated.
Aydin
First I have to really thank for all of you who are giving us lots of good information.
I am 33 years old man and I think I have Hep B from birth, because of our family history.
I started taking Entecavir 2 years ago and the reason to start treatment was having 640 milion copy/ml of DNA and ALT more than normal range (almost two times of normal ). So Doctor decided to treat. Almost after a year of taking Entecavir my DNA dropped to 20 copy/ml, but still ALT more than the normal range. Then 6 months later DNA increased to 70 with abnormal ALT and 6 month after that DNA went up to 137 with ALT 70. When I started treatment my Hbeag was positive but after a year it turned to be negative and Hbab get positive.
Now I am a little worried about Entecavir suspecting that maybe virus gets resistance to it because of my DNA increase but doctor telling me that these variations in DNA are ok since it is not too much variations and the most important is that your e-antigen is negative. Yesterday I again tested for DNA test but really I am worried.
Any comments and suggestions will be much appreciated.
Aydin
Finally I got my DNA HBV result of 106 week being on Baraclude. I have asked my doctor to have an early meeting to discuss about adding tdf .
Week DNA ALT AST
1 19301802 103 48
12 3994 30 22
30 192 63 34
45 60 63 44
74 21 148 59
77 41 85 40
91 137 101 47
107 85 75 32
Do you think I have already developed resistance based on my last results which shows decrease in DNA value ( iu/ml). I saw some studies and my doctor told me also on phone that some people are very slow to response and it may not necessary to switch or add another drug.
http://www.ncbi.nlm.nih.gov/pubmed/21563196
But the question is that am I partial response? Or what if I develop resistance (or may already developed). It is very tough and I really do not want to make a risk and continue on ETV.
Thanks
Week DNA ALT AST
1 19301802 103 48
12 3994 30 22
30 192 63 34
45 60 63 44
74 21 148 59
77 41 85 40
91 137 101 47
107 85 75 32
Do you think I have already developed resistance based on my last results which shows decrease in DNA value ( iu/ml). I saw some studies and my doctor told me also on phone that some people are very slow to response and it may not necessary to switch or add another drug.
http://www.ncbi.nlm.nih.gov/pubmed/21563196
But the question is that am I partial response? Or what if I develop resistance (or may already developed). It is very tough and I really do not want to make a risk and continue on ETV.
Thanks
vitamins are food, you are taking them already when you eat.
there is no interaction with antivirals at all, just remember to take etv on empty stomach 2 hrs before and 2 hrs after
I was also reading your other very useful comments in other threads regarding Vitamin D and E. What I am afraid of is the interaction between drugs? Should I also take vitamin D while on ETV or ETV+TDF and later Pegint.
How about vitamin E?
Thanks
How about vitamin E?
Thanks
Can you please explain what is your plan after being on ETV+TDF combo?
keep it as long as hbsag is detected, i cannot stop antivirals since my liver was severely damaged, maybe we will stop etv when intf is added
How long after being in this combo, you are going to have Pegint?
2,8 years on etv and about 9 months on tdf
Are you going to discontinue ETV+TDF while being on Pegint?
absolutely not, maybe etv if hbsag goes down fast
Then how long you will be on Pegint?
it depends on hbsag response but not less than 2 years
keep it as long as hbsag is detected, i cannot stop antivirals since my liver was severely damaged, maybe we will stop etv when intf is added
How long after being in this combo, you are going to have Pegint?
2,8 years on etv and about 9 months on tdf
Are you going to discontinue ETV+TDF while being on Pegint?
absolutely not, maybe etv if hbsag goes down fast
Then how long you will be on Pegint?
it depends on hbsag response but not less than 2 years
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the facts are:
etv failure and partial response in ur case
resistance can be confimed by test only and even if negative it is not sure you have no resistance, test sensibility is poor
why keep entecavir if:
tenofovir is more potent
tenofovir is safer on cancerogenesis
tenofovir has no resistnce
tenofovir costs 50% less than etv or more
this is not to promote tdf use but it is definitely better especially in ur case, i d make add on 6 months and then stop etv