Aa
Just got my genotype result back...
See photo attached.
Can someone explain what does BCP mutations mean?
Also, is this genotype considered better to treat or more chances to seroconvert?
Where is the origin of D in the world?
Thanks!
Can someone explain what does BCP mutations mean?
Also, is this genotype considered better to treat or more chances to seroconvert?
Where is the origin of D in the world?
Thanks!
Stephen, dr lok when i told her about my qhbsag result last year she noted that and she didn't disregard it. However she told me that fda for some reason they dont't want to approve qhbsag and we have to work without it but she wouldnt be unhappy if i do it in germany
I dont know about studies, as the way he told me was from personal patients. Also, in the US there are mostly HCV, which I have heard sides seem worse for them. I wonder if US doctors relate Interferon HCV sides to HBV, even though they are clearly different.
I do not have an issue with Interferon, I am just reiterating what I have been told by specialists here. Believe me, if I could find out what my Ag quant is I would push harder for it if mine was not super high.
I have a great repect for those of you that are trying it, knowing your Ag quant, and wish you much luck!
I do not have an issue with Interferon, I am just reiterating what I have been told by specialists here. Believe me, if I could find out what my Ag quant is I would push harder for it if mine was not super high.
I have a great repect for those of you that are trying it, knowing your Ag quant, and wish you much luck!
I am aware Dr. Gish has been advocating for quant HbsAg, I was referring to Interferon only. Sorry if there was confusion.
It is about the cost-benefit analysis (in addition to some countries being corrupt) in which we are trapped sadly, like many others with different diseases.
When they go ahead and make guidelines, what they do is create guidelines according to the cost-benefit analysis. They off course do take into account population health in general but this is put in the larger picture of the "cost-benefit" analysis. They create the guidelines which are not obligatory per say, but which large majority of doctors follow, guidelines which are not benefiting the patients to the fullest but benefit them to the extent which is not too expensive for the government.
The guidelines are created for the 2 reasons:
1) to guide doctors how to treat the patients with the certain disease,
2) to guide treatments to be cost-effective.
The large majority of doctors in the highly medical legislated countries such as USA follow the guidelines even if they don't sometimes agree with them,
as by following guidelines they are protected. If they don't follow the guidelines and something goes wrong (like for example someone develops a major side on interferon) then they could be in troubles. So for them going off the guidelines is a risky behaviour. However, the doc from the Mayo clinic is a good doc, one with morals. He is aware of those risks, but yet after explaining the patient possible risks (and documenting his explanation and his stance on it - to protect himself to some extent), he still is going to treat the patient as it would be advisable to treat her (because he would treat himself the same way if he would be in the same position).
For example:
"HBV carriers at high risk for HCC such as Asian men over 40 years and Asian women over 50 years of age, persons with cirrhosis, persons with a family his- tory of HCC, Africans over 20 years of age, and any carrier over 40 years with persistent or intermittent ALT elevation and/or high HBV DNA level >2,000 IU/mL should be screened with US examination every 6-12 months."
AASLD Guidelines
They wrote this guideline like all others in line with "their" "cost-benefit" analysis. According to this guideline most of us would never be screened, and many lives would be wasted.
Same with all other guidelines...
When they go ahead and make guidelines, what they do is create guidelines according to the cost-benefit analysis. They off course do take into account population health in general but this is put in the larger picture of the "cost-benefit" analysis. They create the guidelines which are not obligatory per say, but which large majority of doctors follow, guidelines which are not benefiting the patients to the fullest but benefit them to the extent which is not too expensive for the government.
The guidelines are created for the 2 reasons:
1) to guide doctors how to treat the patients with the certain disease,
2) to guide treatments to be cost-effective.
The large majority of doctors in the highly medical legislated countries such as USA follow the guidelines even if they don't sometimes agree with them,
as by following guidelines they are protected. If they don't follow the guidelines and something goes wrong (like for example someone develops a major side on interferon) then they could be in troubles. So for them going off the guidelines is a risky behaviour. However, the doc from the Mayo clinic is a good doc, one with morals. He is aware of those risks, but yet after explaining the patient possible risks (and documenting his explanation and his stance on it - to protect himself to some extent), he still is going to treat the patient as it would be advisable to treat her (because he would treat himself the same way if he would be in the same position).
For example:
"HBV carriers at high risk for HCC such as Asian men over 40 years and Asian women over 50 years of age, persons with cirrhosis, persons with a family his- tory of HCC, Africans over 20 years of age, and any carrier over 40 years with persistent or intermittent ALT elevation and/or high HBV DNA level >2,000 IU/mL should be screened with US examination every 6-12 months."
AASLD Guidelines
They wrote this guideline like all others in line with "their" "cost-benefit" analysis. According to this guideline most of us would never be screened, and many lives would be wasted.
Same with all other guidelines...
I am not defending the unavailability of qHBsAg assay in the USA.
I read some of Dr Gish's lectures on HBV. He is certainly very aware and in favor of knowing a patient's qHBsAg because most of his Chinese patients know their qHBsAg. Gish is also the consultant to Arrowhead(ARC520) and the objective of ARC520 is to reduce qHBsAg through RNAi.
Dr Anna Lok is also a very hands on researcher. She would most certainly be aware of qHBsAg. Have a look at the following clinical trial:
https://clinicaltrials.gov/ct2/show/NCT01263587
"To verify whether a baseline HBsAg below 1,000 IU/mL and HBV DNA below 1,000 IU/mL is an accurate predictor of people who are, or who will become, inactive carriers, defined as people who are HBsAg positive, hepatitis B "e" antigen (HBeAg) negative, have normal Alanine transaminase (ALT) and HBV DNA under 1,000 IU/mL on at least two occasions over a period of at least 6 months"
United States, Michigan
University of Michigan Health System Recruiting
Ann Arbor, Michigan, United States, 48109
Contact: Anna Lok, MD 734-936-7511 ***@****
I also read here that someone claimed that they do not do qualitative HBsAg in the USA anymore, the result is actually based on qHBsAg?!
Finally, a doctor wrote sometime ago that qHBsAg is not yet ready for prime time. So maybe the US doctors consider the evidence for the use of qHBsAg to start, stop Interferon treatment is not yet strong enough to be standard clinical practice?
I read some of Dr Gish's lectures on HBV. He is certainly very aware and in favor of knowing a patient's qHBsAg because most of his Chinese patients know their qHBsAg. Gish is also the consultant to Arrowhead(ARC520) and the objective of ARC520 is to reduce qHBsAg through RNAi.
Dr Anna Lok is also a very hands on researcher. She would most certainly be aware of qHBsAg. Have a look at the following clinical trial:
https://clinicaltrials.gov/ct2/show/NCT01263587
"To verify whether a baseline HBsAg below 1,000 IU/mL and HBV DNA below 1,000 IU/mL is an accurate predictor of people who are, or who will become, inactive carriers, defined as people who are HBsAg positive, hepatitis B "e" antigen (HBeAg) negative, have normal Alanine transaminase (ALT) and HBV DNA under 1,000 IU/mL on at least two occasions over a period of at least 6 months"
United States, Michigan
University of Michigan Health System Recruiting
Ann Arbor, Michigan, United States, 48109
Contact: Anna Lok, MD 734-936-7511 ***@****
I also read here that someone claimed that they do not do qualitative HBsAg in the USA anymore, the result is actually based on qHBsAg?!
Finally, a doctor wrote sometime ago that qHBsAg is not yet ready for prime time. So maybe the US doctors consider the evidence for the use of qHBsAg to start, stop Interferon treatment is not yet strong enough to be standard clinical practice?
"He said most go on SSDI (disability insurance) before INF because they cannot work or after the INF has long lasting immunological effects after that changes their lives." - can he provide any studies about it ?
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