Aa
HCC in HBeAg negative genotype D under nucs
*TITLE: *Impact of liver fibrosis in development of hepatocellular
carcinoma in HBeAg negative genotype D patients with chronic hepatitis B
treated with nucleos(t)ide analogues.
*ABSTRACT BODY: *Background: Chronic hepatitis B (CHB) patients are at
increased risk for hepatocellular carcinoma (HCC). The effect of medium
and long term nucleos(t)ide analogue therapy (NUCs) on HCC incidence is
unclear.
Objective: To evaluate the predictors of HCC in HBeAg negative genotype
D CHB patients who received a long term treatment with NUCs.
Design: Retrospective and prospective analysis of HCC incidence in CHB
patients starting with NUCs for a duration >18 months.
Methods: Between January 1998 and December 2011 a total of 235 patients
with CHB were treated with NUCs for more than 18 months. The incidence
for HCC was examined after the start of NUCs and risk factors for liver
carcinogenesis were analyzed. The mean follow up period was 6.8 years.
Results: During a median follow up of 6.8+3.4 years HCC developed in 32
patients (13.6%). Hepatocellular carcinoma was disclosed in 15 over 120
patients treated with entecavir (12.5%), in 7 over 27 treated with
tenofovir (13.4%), in 6 over 7 treated with lamivudine (85.7%) in 4 over
18 (22.2%) treated with adefovir plus lamivudine and in no patients
treated with telbivudine (2 patients). The cumulative incidence of HCC
was higher in patients with cirrhosis than in those with CHB (35% vs.
2.5%). At univariate analysis the probability of developing HCC was
higher for: patients with compensated and decompensated cirrhosis
(p 60 (p<0.000001) and without a
virological response (p 60
years old treated with a long term NUCs therapy are at high risk of HCC
despite a virological response.
carcinoma in HBeAg negative genotype D patients with chronic hepatitis B
treated with nucleos(t)ide analogues.
*ABSTRACT BODY: *Background: Chronic hepatitis B (CHB) patients are at
increased risk for hepatocellular carcinoma (HCC). The effect of medium
and long term nucleos(t)ide analogue therapy (NUCs) on HCC incidence is
unclear.
Objective: To evaluate the predictors of HCC in HBeAg negative genotype
D CHB patients who received a long term treatment with NUCs.
Design: Retrospective and prospective analysis of HCC incidence in CHB
patients starting with NUCs for a duration >18 months.
Methods: Between January 1998 and December 2011 a total of 235 patients
with CHB were treated with NUCs for more than 18 months. The incidence
for HCC was examined after the start of NUCs and risk factors for liver
carcinogenesis were analyzed. The mean follow up period was 6.8 years.
Results: During a median follow up of 6.8+3.4 years HCC developed in 32
patients (13.6%). Hepatocellular carcinoma was disclosed in 15 over 120
patients treated with entecavir (12.5%), in 7 over 27 treated with
tenofovir (13.4%), in 6 over 7 treated with lamivudine (85.7%) in 4 over
18 (22.2%) treated with adefovir plus lamivudine and in no patients
treated with telbivudine (2 patients). The cumulative incidence of HCC
was higher in patients with cirrhosis than in those with CHB (35% vs.
2.5%). At univariate analysis the probability of developing HCC was
higher for: patients with compensated and decompensated cirrhosis
(p 60 (p<0.000001) and without a
virological response (p 60
years old treated with a long term NUCs therapy are at high risk of HCC
despite a virological response.
exactly we want the development of anti-hbs antibodies. And so far with what is available only Interferon gives us this option at about 50% rate for most people in 6-12 months.
As for what is desirable in CHB it e+ or e- the answer is not that straight forward. E- negative HBV with viral load (mutant) infection is considered bad and very tough to treat. Dual therapy of nucs + interferon followed by Zadaxin to boost interferon is recommended by some. Also 96 weeks of interferon therapy seems to do it. The goals is here to silence a mutant and clear surface antigen.
Somebody with e-negative antigen with 0 viral load is considered a carrier, and if these people have low surface antigen quantity they may never need treatment and can have and live a normal life.
If you are e+ you almost always will have a viral load, liver enzymes can be elevated in these people too. And therefore your response to interferon can even be better in terms of clearing the virus. In many cases the way I was told when the e-antigen falls, and if escape mutant does not develop, surface antibody appears shortly after and you could be done with HBV even in 6 months time. It varies based on individuals immune system, how many infections they have besides HepB all this influences your bodies ability to interferon response.
As for what is desirable in CHB it e+ or e- the answer is not that straight forward. E- negative HBV with viral load (mutant) infection is considered bad and very tough to treat. Dual therapy of nucs + interferon followed by Zadaxin to boost interferon is recommended by some. Also 96 weeks of interferon therapy seems to do it. The goals is here to silence a mutant and clear surface antigen.
Somebody with e-negative antigen with 0 viral load is considered a carrier, and if these people have low surface antigen quantity they may never need treatment and can have and live a normal life.
If you are e+ you almost always will have a viral load, liver enzymes can be elevated in these people too. And therefore your response to interferon can even be better in terms of clearing the virus. In many cases the way I was told when the e-antigen falls, and if escape mutant does not develop, surface antibody appears shortly after and you could be done with HBV even in 6 months time. It varies based on individuals immune system, how many infections they have besides HepB all this influences your bodies ability to interferon response.
OK so you have chronic HB. Is it then desirable to have the HBeAg positive or negative? I thought it is the anti-body that you want to be +, no?
Who pays for that research you mind telling me? Who sponsored that research?
p.s. You can say all you want but interferon is still more effective against HBV then ANY of these compounds. That btw were ALL developed for the treatment of HIV. These drugs do happen to suppress both viruses. But so does Alinia - and numerous independent studies back in up. So my question would be WHY Alinia is not part of HBV regiment?
Cure rates above 50% vs 1-2% on NUCS that need to be taken life time! So where do you find misinformation in that?
p.s. You can say all you want but interferon is still more effective against HBV then ANY of these compounds. That btw were ALL developed for the treatment of HIV. These drugs do happen to suppress both viruses. But so does Alinia - and numerous independent studies back in up. So my question would be WHY Alinia is not part of HBV regiment?
Cure rates above 50% vs 1-2% on NUCS that need to be taken life time! So where do you find misinformation in that?
just google it it is all there... http://www.baraclude.com/index.aspx
Some people who have taken medicines like BARACLUDE have developed serious liver problems called hepatotoxicity, with liver enlargement (hepatomegaly) and fat in the liver (steatosis). Hepatomegaly with steatosis is a serious medical emergency that can cause death.
patient reports: http://www.patientsville.com/selfreport.htm?id=7058
Some more information about ETV and blood pressure: http://www.ehealthme.com/sa/119929/hypertension
Some people who have taken medicines like BARACLUDE have developed serious liver problems called hepatotoxicity, with liver enlargement (hepatomegaly) and fat in the liver (steatosis). Hepatomegaly with steatosis is a serious medical emergency that can cause death.
patient reports: http://www.patientsville.com/selfreport.htm?id=7058
Some more information about ETV and blood pressure: http://www.ehealthme.com/sa/119929/hypertension
Journal article after journal article, doctor after doctor - they all recommend NUC treatment when certain thresholds are met (HBV DNA, ALT level, etc.).
Why do you continue to perpetuate such misinformation on these forums? You're doing more harm than good for readers who come here and aren't as well informed as some of us.
Why do you continue to perpetuate such misinformation on these forums? You're doing more harm than good for readers who come here and aren't as well informed as some of us.
Up to 50% chance to clear hbv?
Peginterferon:
Loss of hepatitis B surface antigen (HBsAg) with appearance of anti-HBs occurred in 3% to 5% of patients after 1 year of treatment and 6 months of posttreatment follow-up.[Janssen 2005; Lau 2005a]
Peginterferon:
Loss of hepatitis B surface antigen (HBsAg) with appearance of anti-HBs occurred in 3% to 5% of patients after 1 year of treatment and 6 months of posttreatment follow-up.[Janssen 2005; Lau 2005a]
With 50% chance to clear hbv vs1% on nucs I think this should be the determining factor. So far the most effective immune therapy that is approved is interferon. That happens to be an antiviral also.
I suggest you also read the hiv forums on reported antiviral sides that now we have to deal with.
Drug resistant super virus hbv that develops on these nucs that is another issue which is also important.
Drug resistant super virus hbv that develops on these nucs that is another issue which is also important.
Not all interferon's side effects are reversible. Autoimmune disorders caused by interferon use are usually not reversible. The longer we use interferon (ie. more than one year), the higher chance to develop autoimmune problems (eg. autoimmune thyroid disorder, diabetes, rheumatoid arthritis, Crohn's, autoimmune hepatitis, etc). Some of these autoimmune problems are not easy to control without taking immunosuppressants. So interferon has its own serious side effects (some permanent) and is not for everyone.
I don't necessarily like taking an antiviral. But so far the TDF+add-on 48-96-week-interferon treatment has NOT showed good cure rate for e-negative people with qHbsAg more than 1000 iu/ml (with the exception of maybe 2-3 cases, but that's 'the exception', not general). The benefit of interferon treatment (especially the 96-week one) doesn't outweigh the risk for me at this moment.
I don't necessarily like taking an antiviral. But so far the TDF+add-on 48-96-week-interferon treatment has NOT showed good cure rate for e-negative people with qHbsAg more than 1000 iu/ml (with the exception of maybe 2-3 cases, but that's 'the exception', not general). The benefit of interferon treatment (especially the 96-week one) doesn't outweigh the risk for me at this moment.
you support Veteran B argue on kidney problems and mutation caused by NUC's - please read the @ studyforhope explanation and argue again with other arguments if it is the case.
as far as I understand if we are disusing Tenofovir (for example) and we use vit D and resveratrol we have a good chance not to have any kidney problem, mutation and also to have a low HVB DNA and low risk of liver problems (do to HBV)
as far as I understand if we are disusing Tenofovir (for example) and we use vit D and resveratrol we have a good chance not to have any kidney problem, mutation and also to have a low HVB DNA and low risk of liver problems (do to HBV)
I think you are a math / logic teacher / enthusiastic :).
I agree with you and your position regarding NUC's and also I support that some time, some thing should be say using tough words.
@Veteran: as I say fatty liver and high blood pressure cand be develop also without NUC's or any other relation to NUC's so be careful when you put the blame.
Also do not put all NUC's in the same basket, @ studyforhope give us some precious information regarding NUC's and mutation and I think that were easily forgot because of our small fight.
Read again what @ studyforhope post (now ant also in past) and maybe we will have other point of view.
I agree with you and your position regarding NUC's and also I support that some time, some thing should be say using tough words.
@Veteran: as I say fatty liver and high blood pressure cand be develop also without NUC's or any other relation to NUC's so be careful when you put the blame.
Also do not put all NUC's in the same basket, @ studyforhope give us some precious information regarding NUC's and mutation and I think that were easily forgot because of our small fight.
Read again what @ studyforhope post (now ant also in past) and maybe we will have other point of view.
The one who tells A False statement is not necessarily a lier.
And it is not up to anyone to be an ultimate judge here, one should just agree or disagree rather than accuse, other wise it is a quarrel but not an argument.
And it is not up to anyone to be an ultimate judge here, one should just agree or disagree rather than accuse, other wise it is a quarrel but not an argument.
Challenge in a civil manner? Does telling a lie with a smile acceptable? I don't think so.
try to challenge google bud. People can reference everything I say. And go to hiv forums and ask around about Nucs side effects. From real people that actually take this stuff like me.
Something people should think about http://www.livestrong.com/article/107979-side-effects-long-term-hiv/
http://www.livestrong.com/article/109880-side-effects-hiv-medication/
http://www.livestrong.com/article/109880-side-effects-hiv-medication/
"That is why they should not use NUCS period. These are dangerous drugs. "
verses
"I am not saying not to use nucs, but not for lifetime as they tell these doctors. In a combo with immune modulators for up to 3 years yes I think we can say young people will be OK. "
Both statements cannot be true. One of them is lying. Yes, readers are not stupid, but they can be misled. It is irresponsible not to challenge a wrong statement, no matter who said it.
verses
"I am not saying not to use nucs, but not for lifetime as they tell these doctors. In a combo with immune modulators for up to 3 years yes I think we can say young people will be OK. "
Both statements cannot be true. One of them is lying. Yes, readers are not stupid, but they can be misled. It is irresponsible not to challenge a wrong statement, no matter who said it.
Instead doctors mindlessly prescribe nucs for life to us. Without taking into an account the fact that hbv is not hiv. And totally disregarding all the info reported by patients on hiv forums regarding toxicity of these drugs and they cause high blood pressure in some patients even heart attacks and strokes. Sure they take higher dose then we do of some of these nucs.
If some.of these drugs integrate into us on the cellular levels causing mutations then this equals to like be exposed to radioactive hot particles. Thus = carcinogenesis. Beats me how can FDA still approve these drugs and not approve alinia or zadaxin that are not toxic.
All this exactly backs up my point that nucs - chemotherapy should not be used for longer then a year to be safe. Maybe even 3 years but not lifetime.
The side effects that I got from etv based on the time frame of use correspond to time lines of similar side effects reported on hiv forums.
If baraclude causes fatty liver and high blood pressure plus it is a mutogenic this is a dangerous drug.
They have always used interferon to treat hbv. For some people it works great. Some need repeated cycles. Why then use these anti HIV agents that are known to cause serious side effects that develop gradually for which no one knows even the full extent of potential damage they can cause?
If some.of these drugs integrate into us on the cellular levels causing mutations then this equals to like be exposed to radioactive hot particles. Thus = carcinogenesis. Beats me how can FDA still approve these drugs and not approve alinia or zadaxin that are not toxic.
All this exactly backs up my point that nucs - chemotherapy should not be used for longer then a year to be safe. Maybe even 3 years but not lifetime.
The side effects that I got from etv based on the time frame of use correspond to time lines of similar side effects reported on hiv forums.
If baraclude causes fatty liver and high blood pressure plus it is a mutogenic this is a dangerous drug.
They have always used interferon to treat hbv. For some people it works great. Some need repeated cycles. Why then use these anti HIV agents that are known to cause serious side effects that develop gradually for which no one knows even the full extent of potential damage they can cause?
So how can then somebody detox themselves from being polluted on the cellular level from entecavir? Is it possible.
Given everything you have just stated I still dont know why they give us these drugs. They dont cure and have the ability to make a person an invalid. At least with interferon the effects are reversible.
I have developed fatty liver. High blood pressure and my hair stopped growing after a prolonged etv use. Side effects that are now documented on the drug label. So naturally I ask what was the value of me taking it?
Etv was developed for HIV failed there miserably and so BMS lobbied their way to give it to us. Same is with Tenifovir. It is also an anti HIV drug. They give it to us because it happens to suppress hbv.
But so does Alinia can even better and combined with interferon can cure a person in a year. And yet they dont prescribe it to us.
Given everything you have just stated I still dont know why they give us these drugs. They dont cure and have the ability to make a person an invalid. At least with interferon the effects are reversible.
I have developed fatty liver. High blood pressure and my hair stopped growing after a prolonged etv use. Side effects that are now documented on the drug label. So naturally I ask what was the value of me taking it?
Etv was developed for HIV failed there miserably and so BMS lobbied their way to give it to us. Same is with Tenifovir. It is also an anti HIV drug. They give it to us because it happens to suppress hbv.
But so does Alinia can even better and combined with interferon can cure a person in a year. And yet they dont prescribe it to us.
I think that Veteran well supported his position in much more civil way.
He might be wrong but he was not lying.
People are not stupid they will read all posts and make their own judgement that is why you should concentrate on the topic rather than on the one who posted it.
He might be wrong but he was not lying.
People are not stupid they will read all posts and make their own judgement that is why you should concentrate on the topic rather than on the one who posted it.
Have an Answer?
You are reading content posted in the Hepatitis B Community
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
