I am new: Interferon Treatment vs. Entecavir????

[ambiance3021]

I am 26 yrs old and contracted HBV vertically.  I am new to this site, but am due to start the pegylated interferon alfa-2a treatment (Pegasys) this Friday and am terrified of the side effects.  This treatment is usually used to treat HCV, but I have chosen it over the antiviral pills b/c of the lack of risk of viral tolerance and the dangers connected to skipping doses or quitting an antiviral pill treatment.

As I have read the forums related to HBV, I have not seen any posts regarding others who have chosen to go on this Pegasys treatment as I have.  I was wondering if any of you could please respond to my post in regards of whether or not you were ever offered Pegasys (interferon), and if you were offered, how you decided on the treatment option that you did.

I am a 3rd year full-time student doing a double major in Biology and Radiation Therapy.  Can anyone out there provide me with your personal experiences on Pegasys and whether or not you were able to continue with a busy schedule?  Am I being too optimistic to continue with even a 15 credit hr load?

[stef2011]

your doctor is a killer, change it right away or sue him if possible:

using adefovir he made you resistant to both adefovir and reduced response to tenofovir

using entecavir monotherapy you risk resistance to entecavir low but possible, lamivudine, telbivudine

to be safe you should be on entecavir plus tenofovir, entecavir will be active on the adefovir mutation and the possible tenofovir resistance mutations while tenofovir will protect you from entecavir, lamivudine, telbivudine resistance mutations

interferon add on to entecavir plus tenofovir or entecavir plus interferon can be good only if your hbsag is low in the 1000iu/ml range, if hbsag is 1000 to 10.000iu/ml it is not sure to work on hbsag

[stef2011]

hbeag reversion is impossible with bcp and precore mutants but it is normal if you are wildtype
in the wildtype case the patient is hbeag negative because of antibodies hbeab but if immune system gets suppressed or the virus antigens get superior to the antibodies you get hbeag pos again

in my family:
one used to get hbeag pos again all the time when hbvdna detactable

i was hbeag neg and hbeab neg at 16-17yo but became hbeag pos at about 18-19 and then hbeag neg after 6 months of alt at 1500.hbv simply mutated to precore or bcp at that time

[StephenCastlecrag]

Thanks for the information. Reversion of HbeAg is not unheard of, but I can find very little information about its clinical significance. I wonder whether it is possible that the lab had made a mistake? In  November, did you test your hbvdna and ALT?

As for Interferon treatment, as it is finite course of treatment, with manageable side effects in most cases, I don't see any harm in trying it. But I always want to know what the treatment hopes to achieve. If available, I would suggest getting a quantitative assay of HBsAg, and a re-test of your hbvdna, ALT, and HBeAg status before starting Interferon.

I am not a doctor, these are just my opinions.

[saritahemanth]

actually when i was detected hbsag positive four yrs back i was found to be hbeag negative with high hbv dna count , so he started with adefovir n it worked well for a yr but after that dna levels started to increase again so he switched me to entecavir , it worked well my dna viral load constantly was zero for three yrs with hbeag negative and anti hbeag positive ... but recently n november when he was planning to stop the treatment my hbeag turned to be positive which he says is impossible when dna viral load is zero so decided to to go for interferon :-(

[StephenCastlecrag]

Can you tell us for how long have you been HBeAg? Did you become HBeAg negative whilst on treatment? Otherwise why were you on Entecavir?

I read of another case when a  hbver who became HBeAg negative at 12 is now HBeAg positive again at 27. This is all rather strange.

[stef2011]

some have but it is just the hair getting thinner, it is not exactly hair loss and
all the hair comes back

but recently i converted from hbeag negative to positive.....
maybe you converted hbeag negative, if you converted hbeag positive you have  wildtype virus and not mutans.
anyway hbeag pos or neg doesn t make much difference, pos is better

which he says is pretty impossible so decided to switch me from entecavir to interferon :-(
how stupid doctor combo is the only way to clear hbv, entecavir mono will never clear hbv (only 5%) and intf mono pretty much the same (7-10%) while combo can reach 50% of hbv clearance.if doctors says these are on study now ombo trials date back since 2004 and earlier