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My HBV Story - (Will be Updating)
Hello all!
Long time lurker here and wanted to first say what a great resource this place is. Thanks to all and hopefully I can contribute.
*******
Brief History:
I am an adopted male from an Asian country. I was adopted prior to being 1-yr old. Suspected vertical transmission of HBV from my birth mother - but no medical information is known. I was largely asymptomatic for most of my childhood but some liver enzymes began to rise along with HBV DNA when I was in middle school. At that point, I went on treatment with adefovir. I was able to clear e-antigen and bring HBV DNA to undetectable levels. I went off treatment after many years.
At that point my number and DNA began to rise again and came back up to around their pre-treatment levels. HBV DNA was around 170 million copies. I was transferred into a trial at NIH in 2011 to be treated on Tenofovir. After beginning the TDF, I quickly cleared e-antigen again and my HBV DNA came back to undetectable.
Continued to take TDF to maintain low/undetectable DNA levels as well as negative e-antigen state. No symptoms during this time. At the conclusion of my 4-yr trial I transferred into a new trial and had peg-inteferon 180mcg introduced.
Which will bring me to my current state.
Note: I have had several liver biopsies as a part of my treatments so far.
********
Current Information:
As stated above, I am currently on TDF combo with 180mcg peg-interferon alfa 2a weekly. My current labs are below
HBeAg = negative
HBsAg = positive (No value given since quant assay not available in the USA)
HBV DNA = 184 copies/ml (up from undetectable after beginning INF therapy)
HBV DNA = 31.6 IU/ML
ALP = 143 (elevated from prior to beginning INF)
ALT = 64 (same as above note)
AST = 45 (same as above note)
Of other note is that my WBC has gotten down to 1.9 due to the interferon. My Vitamin D is also a bit low but I am on supplements for that now.
I have had some depression from the interferon that is being treated with Celexa 10mg with potential increase to 20mg. This is currently my 8th week of the combo therapy. I will be done in mid to late December and will then go back to just TDF.
Beyond just sharing my story and answering any questions that people may have - I also have some questions of my own -
1) Is there ANY reliable way to get my HBsAg tested for QUANTITATIVE? I know some labs may allow me to ship samples overseas but the cost risk is high I assume (lost or damaged in transit, test being done wrong etc).
2) Is there anything in particular I should be doing other than staying as healthy as possible to encourage the loss of my sAg?
BONUS QUESTION:
How excited are you folks about the potential of Arrowhead's ARC-520 candidate making it to market? They have analyst day on September 24th that should reveal some interesting data. Making it to Phase IIa is a good accomplishment but I'm hoping they can make it to market. Being able to kick this virus would be wonderful. While I am not symptomatic it's been a pain being on interferon so far.
Long time lurker here and wanted to first say what a great resource this place is. Thanks to all and hopefully I can contribute.
*******
Brief History:
I am an adopted male from an Asian country. I was adopted prior to being 1-yr old. Suspected vertical transmission of HBV from my birth mother - but no medical information is known. I was largely asymptomatic for most of my childhood but some liver enzymes began to rise along with HBV DNA when I was in middle school. At that point, I went on treatment with adefovir. I was able to clear e-antigen and bring HBV DNA to undetectable levels. I went off treatment after many years.
At that point my number and DNA began to rise again and came back up to around their pre-treatment levels. HBV DNA was around 170 million copies. I was transferred into a trial at NIH in 2011 to be treated on Tenofovir. After beginning the TDF, I quickly cleared e-antigen again and my HBV DNA came back to undetectable.
Continued to take TDF to maintain low/undetectable DNA levels as well as negative e-antigen state. No symptoms during this time. At the conclusion of my 4-yr trial I transferred into a new trial and had peg-inteferon 180mcg introduced.
Which will bring me to my current state.
Note: I have had several liver biopsies as a part of my treatments so far.
********
Current Information:
As stated above, I am currently on TDF combo with 180mcg peg-interferon alfa 2a weekly. My current labs are below
HBeAg = negative
HBsAg = positive (No value given since quant assay not available in the USA)
HBV DNA = 184 copies/ml (up from undetectable after beginning INF therapy)
HBV DNA = 31.6 IU/ML
ALP = 143 (elevated from prior to beginning INF)
ALT = 64 (same as above note)
AST = 45 (same as above note)
Of other note is that my WBC has gotten down to 1.9 due to the interferon. My Vitamin D is also a bit low but I am on supplements for that now.
I have had some depression from the interferon that is being treated with Celexa 10mg with potential increase to 20mg. This is currently my 8th week of the combo therapy. I will be done in mid to late December and will then go back to just TDF.
Beyond just sharing my story and answering any questions that people may have - I also have some questions of my own -
1) Is there ANY reliable way to get my HBsAg tested for QUANTITATIVE? I know some labs may allow me to ship samples overseas but the cost risk is high I assume (lost or damaged in transit, test being done wrong etc).
2) Is there anything in particular I should be doing other than staying as healthy as possible to encourage the loss of my sAg?
BONUS QUESTION:
How excited are you folks about the potential of Arrowhead's ARC-520 candidate making it to market? They have analyst day on September 24th that should reveal some interesting data. Making it to Phase IIa is a good accomplishment but I'm hoping they can make it to market. Being able to kick this virus would be wonderful. While I am not symptomatic it's been a pain being on interferon so far.
For neutrophils increase you may get neupogen but it's for doctors' prescription only. I'm on interferon as well (8th shoot) and my doctor told that he'll give me this if they continue to go down, now its 1000.
More results back -
HBsAg = Positive (with a S/CO of > 5) (so no change there)
HBsAb = Negative
HBeAg = Negative
HBeAb = Reactive
So no changes on those - glad to see my eAb is steadily positive though.
On my CBC + Diff blood test some new interesting things are around -
My RBC are now showing some tear drop cells
Also for the last few times I've been testing positive for large platelets
Also for the last few times I've had giant thrombocytes.
Are any of those things related to INF treatment? Not liking the tear drop cell result but they said there weren't that many of them. But that is a new result.
Also my differential is done and my neutrophil absolute is down to 700
HBsAg = Positive (with a S/CO of > 5) (so no change there)
HBsAb = Negative
HBeAg = Negative
HBeAb = Reactive
So no changes on those - glad to see my eAb is steadily positive though.
On my CBC + Diff blood test some new interesting things are around -
My RBC are now showing some tear drop cells
Also for the last few times I've been testing positive for large platelets
Also for the last few times I've had giant thrombocytes.
Are any of those things related to INF treatment? Not liking the tear drop cell result but they said there weren't that many of them. But that is a new result.
Also my differential is done and my neutrophil absolute is down to 700
Wow - yeah I don't think I have ever (or at least recently) been that high on ALT. I know my ALT was higher than this when I was not on treatment at all - but I don't have those exact numbers in front of me right now.
The trend though has been fairly steady lately. I believe it was in the 40s before I added the INF to the TDF. Last month (as posted above) was in the 60s and now I am in the 80s. Will have to see if it keeps creeping up.
AlkPhos has been something that has been elevated for me in the past as well.
The trend though has been fairly steady lately. I believe it was in the 40s before I added the INF to the TDF. Last month (as posted above) was in the 60s and now I am in the 80s. Will have to see if it keeps creeping up.
AlkPhos has been something that has been elevated for me in the past as well.
On this past Monday I injected myself with the 9th dose (180mcg).
So just over 1/3 done with the treatment on this trial. The plan is to keep me on TDF even after the INF is done at 24 weeks, though.
So just over 1/3 done with the treatment on this trial. The plan is to keep me on TDF even after the INF is done at 24 weeks, though.
alt 1000-1500 with very low hbvdna and hbsag not too high like over 20.000iu/ml.alt less than 500 is a small flare
i had flares around 1000 many times in my life but since hbvdna was millions it just lowered hbvdna
a cirrhotic liver would have problems with such a flare especially over 1000
i had flares around 1000 many times in my life but since hbvdna was millions it just lowered hbvdna
a cirrhotic liver would have problems with such a flare especially over 1000
Which week of treatment are you on now ?
It's interesting hypothesis about why your dna become from und to detected about those dead cells, but I'd like someone here to confirm it.
Although 30 IU and undetected is a small difference, some people who lost HBsAg have small hbv dna detected anyway.
It's interesting hypothesis about why your dna become from und to detected about those dead cells, but I'd like someone here to confirm it.
Although 30 IU and undetected is a small difference, some people who lost HBsAg have small hbv dna detected anyway.
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