My lab results after 3 months taking Viread

[Ephriam]

Date: 2/27/2010
HBV AS IU/ML     Value 26560
HBV AS               Value 154600  Copies/ml
AST  71
ALT  138

Started Viread 03/11/10

Lab Result after 3 mos

06/16/2010
HBV AS IU/ML   <29
Comment HBV DNA not detected

HBV AS COPIES/ML   <168
Comment HBV DNA not detected

AST  35
ALT 63

Any chance that I'd be off  with Viread? Thanks in advance

[stef2011]

if you search in the old posts you 'll see the small human trial romark did, they tried 1years ntz at 1g daily on 5 hbe pos and 8 hbeneg
hbe pos, 1 made hbsag neg, 3 hbeag neg, and 2 hbvdna neg.
of course this means little because ntz must be used in combo with other drugs and higher doses

8 hbe neg, 2 eliminated hbsag, 7 hbvdna neg, 1 non responder, trial 1 year only

trial for 2 years
1 hbe pos, dose 500mg daily, he got hbe neg and hbvdna neg by first year and hbsag neg by second year
1 hbe pos non responder with adefovir, 1g daily ntz+adefovir, hbe neg and hbvdna neg by first year and hbsag neg by second year

i stress again ntz monotherapy is too weak, only those already hbvdna neg might use this, for all others combo with nterferon ,entecavir or tenofovir.the most potent combo is with interferon
dose minimum 1.5g daily and maximum 2,5g daily if tollerated

[hepa114]

hello stefano,

in one of your reply to "enolia", you said "nitazoxanide can eradicate virus if hbe is negative and hbeab positive" but my my case HbeAg +ve, HbeAb -ve and HbsAg +ve still you are suggesting ntz+tnf together, these two suggestion are contradicting to me? can you comment on this?

Thanks

[enolia]

Thanks.

[stef2011]

Does it mean that being und is not good for NTZ to be efficient?
we cannot tell 100% but ntz works similar to interferon and interferon doesn't work at maximum potency with hbvdna und, it looks like some low hbvdna is needed to trigger hbcab response

we have some examples in ou group but the bad is that one is hbe pos and one nega:
me, etv+ntz hbe negative, started when hbvdna about 135iu/ml, huge drop of hbsag in 4 weeks of about 2600iu/ml.ntz 1,5-2g

another patient, etv+ntz hbe positive, started ntz when und about 1 year, very small drops of hbs and hbe in 12 weeks of some hundreds.ntz 1g, he will try to switch to ntz 2 g

we have the difference between the two of hbe positive and hbe negative so we cannot tell 100%, it is just a theory because we have also a study just finished that says entecavir suppress hbcab titer when hbvdna gets und and lead to hbv persistance, tenofovir was not checked in the study but it is probably the same

[enolia]

Hi Stefano

Does it mean that being und is not good for NTZ to be efficient? I am currently und...When I will decide to start tnf + ntz should I expect a weaker result from the one you got?
Thanks.

[stef2011]

viread (tenofovir) doesn't eradicate virus, it just reduce repplication below limits of detaction and doing so liver damage but virus is not affected by it, only 8% eradicate virus so you should keep using tenofovir for life

what is hbv as, please check carefully for hbsag and hbvdna, hbv as is not correct even if lab use it

nitazoxanide can eradicate virus if hbe is negative and hbeab positive so if you are in this situation you might combo with it but good results are achieved only if you start with hbvdna detectable once hbvdna is undetactable the results are weaker
it acts as an immune modulator but once hbvdna is undetactable immune system responce gets weaker after some time so ntz is less active, on the contrary if you start 4-12 weeks of ntz and then add antiviral the results are immediate from first week

on hbe positive the results are weaker and slower 6-12months to see hbe negative/hbeab positive