Aa
Is any treatmene needed? hbs+ hbe+ dna+
Hi everyone,
first of all I’d like to introduce myself to this community: I’m 23 years old, male – Italian (so sorry for my poor English)!!!
I’ve been having HBV since my birth (my mother is a Hbsag+ carrier) but I’m very healthy and I’ve never had digestion problem or anything else. I’m used to have a bier (0.4) during the weekend twice a month and I’m not a smoker nor a drinker.
Here is my current situation:
Hbsag + / Hbeag + / HBVDNA >100.000.000
These values never changed from my birth. Transaminasis have been always in the range ALT sometimes during the last 2 years reached up to 74 (range 0-55), AST and GGT have been always ok.
I had a liver biopsy in 2007. Everything was good, they found F1 (Metavir) but doctors said there’s nothing to be worried about. I had also ultrasound test once a year and no liver damages were detected.
I saw my doctors in May and they forewarned they would treat the disease despite the values are not so high. The suggestible drug should be Peg-IFN (up to now I do not know if in mono or combo mode).
I was pushing on antiviral treatment but they told I’m so young and I should not take drugs which I may continue to take for my whole life.
Why was I pushing on AV? I’m really scared about IFN side effects, I move every month out of Europe for job and I’m not sure I’ll manage to do it again if I’ll take it!
What do you think? Am I in the immune-tolerance or immune clearance stage?
Should I be treated? May I seroconvert the eAG without drugs, I read it may take up to 3-4 decades? Should I wait some years again and then evaluate what to do?
When you convert the eag form positive to negative do the VL be low for the rest of the life or it can also flare up again?
In case I went for IFN and it didn’t work, would I have another possibility of cure? I’m also scared about disease flares during treatment..
What about if the same happened with Antiviral?
Is there anyone who can share experiences with IFN side effect and job activity? Is there a relation between my age and such effect (may I easily tolerate them?)
As you see I’ve a lot of question which are running around in my mind… I’d be very pleased if somebody answers me or cans share his experience…
Ciao ciao from Italy
first of all I’d like to introduce myself to this community: I’m 23 years old, male – Italian (so sorry for my poor English)!!!
I’ve been having HBV since my birth (my mother is a Hbsag+ carrier) but I’m very healthy and I’ve never had digestion problem or anything else. I’m used to have a bier (0.4) during the weekend twice a month and I’m not a smoker nor a drinker.
Here is my current situation:
Hbsag + / Hbeag + / HBVDNA >100.000.000
These values never changed from my birth. Transaminasis have been always in the range ALT sometimes during the last 2 years reached up to 74 (range 0-55), AST and GGT have been always ok.
I had a liver biopsy in 2007. Everything was good, they found F1 (Metavir) but doctors said there’s nothing to be worried about. I had also ultrasound test once a year and no liver damages were detected.
I saw my doctors in May and they forewarned they would treat the disease despite the values are not so high. The suggestible drug should be Peg-IFN (up to now I do not know if in mono or combo mode).
I was pushing on antiviral treatment but they told I’m so young and I should not take drugs which I may continue to take for my whole life.
Why was I pushing on AV? I’m really scared about IFN side effects, I move every month out of Europe for job and I’m not sure I’ll manage to do it again if I’ll take it!
What do you think? Am I in the immune-tolerance or immune clearance stage?
Should I be treated? May I seroconvert the eAG without drugs, I read it may take up to 3-4 decades? Should I wait some years again and then evaluate what to do?
When you convert the eag form positive to negative do the VL be low for the rest of the life or it can also flare up again?
In case I went for IFN and it didn’t work, would I have another possibility of cure? I’m also scared about disease flares during treatment..
What about if the same happened with Antiviral?
Is there anyone who can share experiences with IFN side effect and job activity? Is there a relation between my age and such effect (may I easily tolerate them?)
As you see I’ve a lot of question which are running around in my mind… I’d be very pleased if somebody answers me or cans share his experience…
Ciao ciao from Italy
So to recap:
You are 23 year old, chronic HepB, eAntigen +, and high DNA in the hundred millions, normal ALT until recently with one or two snapshot in the 70s.
You are very likely still in the immuno-tolerant stage, or very very early immuno-clearance stage. I would chart the ALTs closely, like every 2-3 months (for about year) before treatment. If ALTs (trend) goes back down to in range and stays that way, I would hold off on treatment. If it goes back and forth from in range to the 70s or higher, I would treat. I would treat either with combo, TDF and ETV. Or INF to reach a low DNA, then mono with TDF or ETV. The goal is to lower DNA to UND as quickly as possible to minimize risk to antiviral resistance. Important since the eSeroconversion process could take years and for some they may need treatment for life. I wish you good discussions with your doctor.
You are 23 year old, chronic HepB, eAntigen +, and high DNA in the hundred millions, normal ALT until recently with one or two snapshot in the 70s.
You are very likely still in the immuno-tolerant stage, or very very early immuno-clearance stage. I would chart the ALTs closely, like every 2-3 months (for about year) before treatment. If ALTs (trend) goes back down to in range and stays that way, I would hold off on treatment. If it goes back and forth from in range to the 70s or higher, I would treat. I would treat either with combo, TDF and ETV. Or INF to reach a low DNA, then mono with TDF or ETV. The goal is to lower DNA to UND as quickly as possible to minimize risk to antiviral resistance. Important since the eSeroconversion process could take years and for some they may need treatment for life. I wish you good discussions with your doctor.
I really don’t know as much about when is the best time to start tx as others on this forum do. I have only known about my HBV for less than a year so I don’t really feel qualified to give much advice other than my own personal experiences.
As far as Peg IFN goes, there are no resistance issues with this drug so it will always be an option. Also, if you read the post by Peteshine titled “No Questions”, he says that he really didn’t feel many side effects from Peg IFN mono-therapy. You may not have any side effects either but unfortunately you can never be sure unless you try it because everyone reacts differently to Peg. (Zelly, what does your magic 8 ball say? Lol)
TDV and ETV both have excellent resistant profiles so far, so if you were to get into the trial study, you would be in good hands whether or not you got mono or combo therapy (unless there is a control arm of the study were both pills are placebos) However, as your Dr said, these drugs don’t have a long history either so there may be some resistance issues develop as the drugs get a longer history of use.
It sounds like you are in good health now, so if you were to continue to monitor, you may very well convert your “e” antigen on your own and/or better drugs may come along by the time you need to tx.
I wish I could help more with your decision to tx or not to tx. Others may be able to give you a better idea about that decision.
Best of luck and keep us posted.
As far as Peg IFN goes, there are no resistance issues with this drug so it will always be an option. Also, if you read the post by Peteshine titled “No Questions”, he says that he really didn’t feel many side effects from Peg IFN mono-therapy. You may not have any side effects either but unfortunately you can never be sure unless you try it because everyone reacts differently to Peg. (Zelly, what does your magic 8 ball say? Lol)
TDV and ETV both have excellent resistant profiles so far, so if you were to get into the trial study, you would be in good hands whether or not you got mono or combo therapy (unless there is a control arm of the study were both pills are placebos) However, as your Dr said, these drugs don’t have a long history either so there may be some resistance issues develop as the drugs get a longer history of use.
It sounds like you are in good health now, so if you were to continue to monitor, you may very well convert your “e” antigen on your own and/or better drugs may come along by the time you need to tx.
I wish I could help more with your decision to tx or not to tx. Others may be able to give you a better idea about that decision.
Best of luck and keep us posted.
Hi everyone,
i’ve just met doctors who had suggested me some months ago a pegIFN tx and this morning they was on that same opinion… I told them about sx which can be very difficult to match with my job.. and I also did ask for antivirals, especially entecavir and tenofovir.
They would not suggest antivirals tx at this time, i’m 23 years old, due to resistance that may rise during thay period.. the only solutions they proposed are pegIFN or just keep on monitoring every 3 months for 5 years.. then have a biopsy and evaluate what to do afer it.
In this light I assume my liver does not need an immediate tx therefore I keep on wondering why they were hardly pushing on it..
Anyway they did propose me to take part to a sperimentation with the aim yo evaluate results in patients taking Entecavir monotx or combo tx ETV + TFV (tenofovir). I just have to put my sign on the docuemnts they gave me and then the trial should start and last 100 weeks approx…at that time I’ll know if I will be taking mono or combo tx..
Now I’m a bit concernded about this… what if antivirals did not work? Would I still have the chance to go for IFN? What may happen when I’ll stop taking them… would my HBV become stronegr than now?
I keep on hoping that I’ll gain the E seroconversion by myself…
I’m very confused…
Your comments are needed and greatly appreciated..
i’ve just met doctors who had suggested me some months ago a pegIFN tx and this morning they was on that same opinion… I told them about sx which can be very difficult to match with my job.. and I also did ask for antivirals, especially entecavir and tenofovir.
They would not suggest antivirals tx at this time, i’m 23 years old, due to resistance that may rise during thay period.. the only solutions they proposed are pegIFN or just keep on monitoring every 3 months for 5 years.. then have a biopsy and evaluate what to do afer it.
In this light I assume my liver does not need an immediate tx therefore I keep on wondering why they were hardly pushing on it..
Anyway they did propose me to take part to a sperimentation with the aim yo evaluate results in patients taking Entecavir monotx or combo tx ETV + TFV (tenofovir). I just have to put my sign on the docuemnts they gave me and then the trial should start and last 100 weeks approx…at that time I’ll know if I will be taking mono or combo tx..
Now I’m a bit concernded about this… what if antivirals did not work? Would I still have the chance to go for IFN? What may happen when I’ll stop taking them… would my HBV become stronegr than now?
I keep on hoping that I’ll gain the E seroconversion by myself…
I’m very confused…
Your comments are needed and greatly appreciated..
PC = Precore
BCP = Core Promoter
These are the common (BCP are more common) HBV mutant strains that could escape during the seroconversion process and lead to eAntigen - disease.
BCP = Core Promoter
These are the common (BCP are more common) HBV mutant strains that could escape during the seroconversion process and lead to eAntigen - disease.
It the traditional sense, yes, you start off as eAg positive. It's the wild-type (kind of like, the virus left alone in the wild to do its thing) strain that releases the eAntigen on viral replication. And if you infected with the wild-type, then it usually takes its course, and for some they get the mutation (PC, BCP) at seroconversion.
But what's interesting is that there are newer and more variations to HBV now. For example, those with PC, BCP, and antiviral resistance strains. So let's say, someone with eAntigen - disease that turns out to have a PC mutation. This person infects someone, that new infected person will be surface antigen positive but are they eAntigen - to begin with ? They could be but we need a HR type person to confirm that. So I think as they are more variations, it could get more confusing in the future.
But what's interesting is that there are newer and more variations to HBV now. For example, those with PC, BCP, and antiviral resistance strains. So let's say, someone with eAntigen - disease that turns out to have a PC mutation. This person infects someone, that new infected person will be surface antigen positive but are they eAntigen - to begin with ? They could be but we need a HR type person to confirm that. So I think as they are more variations, it could get more confusing in the future.
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