IFN course

[calebz]

Hi

Was sharing my status and though I should maybe share my current experience with IFN.
I'm currently 29. First diagnosed 2012 January. First HBV DNA June2012 was about 214000 IU.
I was HBeAg Negative then. For some reason at baseline I became HBeAg Positive.

My baseline
DNA ~170000 IU
qHBsAg 4500 IU
ASP/ALT 40/60
Fibroscan 6,6 Kpa

Week 4
DNA 67000 IU
qHBsAg 4700 IU
ASP/ALT 35/55

Week 8
DNA 6000 IU
qHBsAg 3900 IU
ASP/ALT 35/55

Week 12
DNA 3000 IU
qHBsAg 4700 IU
ASP/ALT 36/54


My ALT/ASP is generally unchanged, DNA keeps dropping but HBSaG is really scaring me. Doc says we need to wait for a pattern to take out any conclusions and consider stopping treatment.
One thing I can think of is before that Week 12 visit I went to a gym a few times and skiing where I got tired like crazy.

[stef2011]

really stupid study indeed, we do know antivirals take 5-6 years use for cd cells rescue....

why put money where it fails when we already know the strategy that works?

[calebz]

My treatment was a part of control arm for TDF+IFN but it was a stupid made study in my opinion as it only made 2 months of drugs together and monotheraphy after that.

I don't think there are published results for a few years of nucs + IFN addon but its worth a try if you are still young and can take IFN.

[stef2011]

buy pegintf yourself if you can afford and let a doctor monitor treatment, of course add it after 3-5years when hbsag lowers

if you can afford you can also get peg in india which is very cheap and get it prescribed there, they also have very good liver specialists like in europe

[SafiSifa]

my doctor also said we will never try interferon after entecavir treatment.

[stef2011]

you have all the trials posted already in the community and all the members who tried it after 3-6 years of nucs cleared, there s nothing else left to say

[FlyingHippo]

Stef, here we have a lot of discussion on the therapy you advocate (A few years NUCs then combo IFN). To be honest, we still have concerns on that, not about the negative effect, but about current situation. We know it's a wonderful way to cure the patient, but so far no doctors know about that, no wide publish of that, and no medicine journals talk about that. Can you give us more info about the therapy? We need more positive power.

[stef2011]

get tenofovir and retry peg in 3-5years time when hbsag will be low at around 1500iu/ml

for the baby you can have etv or tdf it makes no difference and no effect on baby

[calebz]

Hey

Just had my week 72 visit, my DNA completely rebound to 110000iu/ml and hbsag increased from 3300 to 4000 so I'm back where I was at start. At least my Fibroscan stays at 6.8Kpa.

I think I will go on NUC's. My public health care changed treatment guides and I think it opened up Baraclude (and I think tenofovir too) for Hbe-.
Haven't seen the program details cause its fresh news.

Too bad its almost a permanent medicine and I'm still trying for a child.
Anybody had any experience in Tenofovir in men trying to conceive ? Label says it had no issues with rats...

[stef2011]

You can try staggered pegintf like stop 1 to 3 months, make hbvdna und and then restart pegintf or just add on nucs to pegintf mono before going to few years nucs mono

[grmr]

hi cale.. same situattion here..  NUC's will not be a choice due to the young age (same of mine!)... in any case I beliver you'll do agaign modno ifn in some months (at least 10/12 months since the end of the tx)..

[calebz]

Hey

Just had my week 64 visit.
At week 60 my dna raised to 7000 IU and my HBsAg stopped at 3300IU levels. ALT/ASP 45,40.

Fibroscan results F0-F1 6.8Kpa.

I envy you folks with IFN response :( Time too look at NUC's for me.

[mustthinkpositive]

Your HBsAg looks good on a downward trend. Hope it continues.

[stef2011]

tenofovir must be given to infected mothers to prevent reinfection and this is done since 2000 on hiv too so just imagine how well and safe the thing is....i dont think the doctor is so stupid and ignorant, they surely have a budget per patient because fo insurance

insurances should be outlaw on healthcare, it just can t work, hopefully europe will keep public healthcare and one day maybe patents and insurances will be outlaw, making money on people's life is just disgusting

[stef2011]

if you can afford you can buy generic tenofovir online, there are no fakes because you see immediately the effect on hbvdna plus the chemicals are so cheap that the fakes might be even more expensive

[calebz]

I don't know about the child thing - I searched the web and it only says there are no studies regarding the subject so I guess they say no out of the box.

Regarding treatment options no other country will cover your treatment for HBV just like that and this is not his choice of treatment but ****** insurance health program for treatment of HBV/HCV. There are organizations that try to force it on government to change this outdated program.

[stef2011]

better go to a real doctor or to another country, healthcare should be free in all EU countries, at least for italy, germany, france and uk is

[stef2011]

my god is he a real doctor?i d sue him for saying such bunch of lies

[calebz]

hello

lastest fallow up for week 56
DNA stopped at 2400 IU (exactly the same as week 54)
HBsAg down to 3400 IU
ALT at 49
hbe-

week 54 update as fallows:
DNA still raising now at 2000 IU
HBsAg down to 3700 IU
ALT stays at 45  
hbe-

Baseline was
DNA ~170000 IU
qHBsAg 4500 IU
ASP/ALT 40/60
hbe+

stef my doc told me that its a NO GO for TDF + trying to conceive a child.
Since my current result don't indicate a flare they won't give me free TDF anyway.
I think I will postpone my fight with HBV untill this is resolved for me.
Im thinking to get TDF generic abroad and try to take it for some time and add IFN but the insurance program for HBV treatment requires my HBV DNA to be detectable before start of treatment and certain drop in DNA within 24 weeks - they discontinue treatment otherwise or not qualify me for it (DNA UND). I'm thinking how to bypass this. Second insurance option is lamivudine for HBE- as I already mentioned.

[stef2011]

your hbvdna>2000iu/ml and alt>30 on most guidelines requires therapy, european guidelines do, tdf best choice

[calebz]

Hello, my week 54 update as fallows:
DNA still raising now at 2000 IU
HBsAg down to 3700 IU
ALT stays at 45

I guess this means a relapse to baseline levels soon but at least i didn't flare up after stopping the TX. Interesting thing is that trial sponsor has an additional program for relapses that consists of 2 years of Tenofovir for free but you need to meet some special scenarios of hepatitis flare up after TX.
Another thing i found out by sitting and chatting at lobby is that some sort of three pill trial for hepatitis C works very well - info from three different participants.

[stef2011]

lamivudine is to avoid like plague

[calebz]

Sorry can you spell this correctly ?

lam is to avoidmlike plague, it would ruin you definitively if used

[stef2011]

Hell to ******* uselss insurances......words to be polite

you should buy generic tenofovir in india or vietnam, supply for few years, that ll be about 20usd per month, no need of insurance and even if you go there by flight you still save
sorry but you dont have results to stay off drugs and the effort of pegintf go wasted

lam is to avoidmlike plague, it would ruin you definitively if used

[calebz]

Thanks for feedback. I'm currently off interferon treatment - stopped at 48w -  and these are fallow up results.

Currently there is no option for TNF for me. My insurance doesn't give last gen drugs for HBE- just for HBE+. For - there is just IFN and LAM. :/

I'm considering Vit D.