My Clinical Trial (TDF vs. TAF) Post Medication Resutls

[luckyman316]

Wanted to see if anyone can offer any advice. Before I started this, I did not have all these results. My viral load started a 276,000 when I first learned of Hep B, spiked up to 5 million, 12 million and now this (and last result actually was 23 million but I do not have those results in front of me).

Is this an active Chronic infection? Any chance to tell how long I've had this? Or are there any tests to determine how long I've had it?

CBC Results:
WBC - 7.0
RBC - 4,79
Hemoglobin - 14.8
Hematocrit - 45.1
MCV - 94
MCH - 30.9
MCHC - 32.8
RDW - 13.8
Platelets - 254
Neutrophils - 56
Lymphs - 32
Monoctyes - 9
Eos - 3
Basos - 0
Neutrophils (absolute) - 3.9
Lymphs (Absolute) - 2.3
Monocytes (Absolute) - 0.6
Eos (Absolute) - 0.2
Baso (Absolute) - 0.0
Immature Granulocytes - 0
Immature Grans (Abs) - 0

Comp. Metabolic Panel
Glucose - 83
BUN - 20
Creatinine, Serum - 1.16
eGFR If NonAfrican Am - 81
eGFR if African Am - 93
BUN/Creatinine Ratio - 17
Sodium, Serum - 142
Pottasium, Serum - 4.1
Chloride, Serum - 103
Carbon Dioxide, Total - 24
Calcium, Serum - 9.6
Protein, Total Serum - 6.6
Albumin, Serum - 4.3
Globulin, Total - 2.3
A/G Ratio - 1.9
Bilirubin, Total - 0.5
Alkaline Phosphatase, S - 71
AST (SGOT) - 61
ALT (SGPT) - 115

Urinanalysis Gross Exam
Specific Gravity 1.027
pH - 6.0
Urine-Color - Yellow
Appearance - Clear
WBC Esterase - Negative
Protein - Negative
Glucose - Negative
Ketones - Negative
Occult Blood - Negative
Bilirubin - Negative
Urobilinongen, Semi-Qn - 0.2
Nitrite , Urine - Negative

HBV Real-Time PCR, Quant
HBV IU/mL - 18,907,000
log10 HBV IU/mL - 7.277
HBV Copies/mL - 110,040,000
log10 HBV Copies/mL 8.042

Panel 083824
HIV 1/0/2 Abs-Index Value <1.00
HIV 1/0/2 Abs, Qual - Non Reactive

HBV Genotype/PreCore
HBV Genotype - HBV Genotype D detected
HBV PreCore Mutation - Basal Core promoter mutation at 1764 was detected. HBV PreCore Mutation 28 was detected.

Prothrombin Time (PT)
INR - 1.1

AFP, Tumor Marker (serial)
AFP, Serum, Tumor Marker - 1.7

TSH - 1.770

PTT, Activated
aPTT - 26

Hep B Surface Ab
Hep B Surface Ab, Qual - Non-Reactive

Mitochondrial (m2) Antibody - 2.8

Vitamin D, 25-Hydroxy - 59.6

HCV Ab w/Rflx to Verification
HCV Ab - 0.1

Phosphorous, Serum - 4.0

Antinuclear Antibodies Direct
ANA Direct - Negative

Ferritin, Serum - 258

HBsAg Screen - Positive Abnormal

Hep Be Ag - Negative
Hep Be Ab - Positive Abnormal
Thyroid Peroxidase (TPO) Ab - 8
Hep B Core Ab, Tot - Positive Abnormal
Hep A Ab, Total - Negative

So yes, happy my vitamin D levels went up from 14. Still feel I could use 20 more points on there. Also need Hep A vaccine. The rest is good, except for the Hep B portion which I need to clear.

[needadvicewithhep]

Good results!

Keep my fingers crossed for you my friend.

[luckyman316]

Wanted to share the latest labs with comments:

HBV DNA IU/mL: < 29 IU/mL HBV DNA Detected
Total Bili: 0.3mg/dL
Dir Bili :   < 0.1 mg/dL  
Ind Bili :<  0.3 mg/dL  
AST (SGOT) - 29 (down 4 points)
ALT (SGPT) - 13 (down 13 points and now NORMAL)
Creatine - 1.15 mg/dL
Uric Acid - 7.5 mg/dL  
Calcium - 9.8 mg/dL  
Phosphorus - 4.9 mg/dL
pH - 5.5  
CK - 247 U/L (huge jump.. wonder why?)
Parathyroid Hormone - 32 pg/mL (Back down again! 17pts less)
HBsAg: None done this lab, next lab it will be

Generally happy about the huge decrease in ALT. It's been always fluctuating at just above high cut off and now it's normal. Whatever I'm doing, seems to be working. Mainly dietary changes tbh. Concerned about CK levels but this is not first time it's high so let's see what next test reveals. They want me to go for DEXA, Ultrasound and MRI before next one. I swear, I was there less than 6 months ago. I suspect they are speeding up the trial for some reason. In February, I officially start TAF only.

[luckyman316]

Correction on ALT, it's 38 not 13. But still a huge drop!

[luckyman316]

This format is weird. The new format, the original post shows up on the top of the page, on page 1. The old format, this post is never bumped!

[studyforhope]

It is still  better to have a more sensitive dna test, the escape from liver reabsoption happens to some percentage of virions, thus lower is still better.

There is no direct test to measure in liver production of smaller  amounts of virions.

The Quant hbsag test measures the degree of surface antigen restricted gene expression and particle production. Since it can occur also from integrated non virion producing viral dna fragments, it is not as good a test for the remaining  cccDNA as we originally hoped.it looks more and more that a fairly high amount of hbsag is not produced from  cccDNA, very different from patient  to patient, likely depending on the time of virus evolution  in each case and the intensity of regeneration and consecutive integration of hbv dna fragments.

[needadvicewithhep]

Thanks for the detailed explination.

Its ashame re the hbsag quant ans ccdna correlation.

Didnt realise I had posted  my previous question twice sorry about that

[studyforhope]

Even at this extreme sensitivity it only refers to Dane particles in the v peripheral blood. It is not any indication  of the likelihood of hbsag loss or seroconversion.

Also, the low dna count in the peripheral blood is somewhat misleading, since it does not accurately  reflect the virion production in the liver, since a fairly large amount of virions are trapped and extracted in the liver right after synthesis and release, since the liver has a high affinity to absorb virions. Only when this absorption  capacity gets closer to saturation, more virions escape into the general circulation.

This is different for hbsag seroconverted patients with a high antibody.  In this case the antibody blocks the virions outside from contact and absorption to hepatocytes and almost all de novo  virions enter the general circulation as immuncomplexed Dane particles. These still register in the hbv pcr test, since they contain hbv dna.

[needadvicewithhep]

Wow.
So in reality there is no meaningful benefit of having more sensitive testing for dna unlike hbsag quantative?  

Or is there another form of testing for virion production in the liver,

[needadvicewithhep]

Thanks

Wow

So in reality it more sensitive testing of dna doesnt really offer anything meaningful? hbsag quantitive holds more meaningful info?

Or is there another way of measuring the activity of virions actually in the liver?

Thanks

[studyforhope]

With all these quant hbv pcr tests, there is a limit of the quantifiable range. Like eg less than 29 iu. But the fundamental sensitivity of the test is well below the Quant range, could be for example 10 iu. That is the qualitative limit.  Below that no signal is detected above background and it will then say dna not detected.

Different tests have different qualitative detection limits of course,  but they tend not to disclose these. All you know is that you are between the Quant and Qual limit  with your results.

if one uses an extremely sensitive test like the ngi hbv ultraqual,  the detection sensitivity is 0.3 iu. With this test  most patients und with lesser tests will still have a pos signal.

[needadvicewithhep]

Does 0.3iu or below offer any type of determination s seroconverstion?

Or is it only sign of further dane partical reduction?