Aa
Need advice pls
I just received my liver biopsy results and it's shows minimal inflammation HAI score 1/18 and 0 fibrosis. My viral load is 47 000 ui/ml. My doctor asked me if I want to start treatment with Viread. Please help me decide what is best for me. Thank you
Natural clearance rate of surface antigen is 0.5% of carriers per year.
http://www.hepb.org/expforum/media-player.aspx?speakerID=drKeefe&topicID=naturalClearance&language=English&mediaType=text&topicList=Questions
You may be one of the very very lucky 0.5% of carriers per year, but it would not be wise to hold high hopes for that. Before a real cure arrives, monitoring our disease status through regular tests and start treatment when appropriate should be the way to go.
Stress does not cause ALT flares.
I would strongly suggest you seek a second opinion from a good hepatologist (not just a family physician). Since you live in US, this link may help. It's a thread from hep forum, but some of the liver specialists listed there might be good at managing hep B as well.
http://www.medhelp.org/posts/Hepatitis-C/Who-is-your-good-doctor-/show/1715783
http://www.hepb.org/expforum/media-player.aspx?speakerID=drKeefe&topicID=naturalClearance&language=English&mediaType=text&topicList=Questions
You may be one of the very very lucky 0.5% of carriers per year, but it would not be wise to hold high hopes for that. Before a real cure arrives, monitoring our disease status through regular tests and start treatment when appropriate should be the way to go.
Stress does not cause ALT flares.
I would strongly suggest you seek a second opinion from a good hepatologist (not just a family physician). Since you live in US, this link may help. It's a thread from hep forum, but some of the liver specialists listed there might be good at managing hep B as well.
http://www.medhelp.org/posts/Hepatitis-C/Who-is-your-good-doctor-/show/1715783
You were right look what I just found while searching desperately for answers:
''Patients with minimal disease or who are unlikely to achieve sustained response should not be treated with NA, especially those who are younger than 30 years."
Source is: http://www.aafp.org/afp/2009/0215/p338.html
''Patients with minimal disease or who are unlikely to achieve sustained response should not be treated with NA, especially those who are younger than 30 years."
Source is: http://www.aafp.org/afp/2009/0215/p338.html
''ALT flares are only good if they lead to surface antigen loss and seroconversion." - how do I know if I can loose it naturally or how many years it can take ? I'm so confused right now not knowing what's the best option for me. My ALT level was 3 times higher 6 years ago but at that time I was very stressed with another problem and I don't know if ALT levels can be influenced by stress. 6 years ago I only knew I'm infected with the virus (I was 18 at that time) and I didn't investigate the problem because of the lack of information I had.
"I've read that is better to have ALT higher because that means your immune system is fighting the virus, is that true ? "
This is a quote from an answer provided by our very expert member 'studyforhope': "ALT flares are only good if they lead to surface antigen loss and seroconversion. Otherwise they are stepping stones to increased fibrosis and examplary of a chronic war with episodes of destructive battles with no decisive useful but only deleterious outcome."
http://www.medhelp.org/posts/Hepatitis-B/HBV-DNA-detected-again-after-stopping-Baraclude/show/1795946#post_8279383
This is a quote from an answer provided by our very expert member 'studyforhope': "ALT flares are only good if they lead to surface antigen loss and seroconversion. Otherwise they are stepping stones to increased fibrosis and examplary of a chronic war with episodes of destructive battles with no decisive useful but only deleterious outcome."
http://www.medhelp.org/posts/Hepatitis-B/HBV-DNA-detected-again-after-stopping-Baraclude/show/1795946#post_8279383
Also, Stef told me about combo: start with Viread and then add on Interferon if I correctly understood. Please correct me if I'm wrong. If I start like this it means I won't be able to have a child only after I finish the treatment. so if it's combo this could mean 3-5 years ?
I'll propose it to my doctor to see his opinion. My question is: Can I naturally lower the HBV DNA and ALT ? My current doctor is currently involved in Hepatitis C research and I'll try to talk to him and also ask a copy of all my results. I'm meeting him in October and I will write here all the results.
I'm not pregnant but I'm planning to have a child in the nearest future (1-2 years). I'm not taking Viread anyways because most of you recommend not to and I'm scared to death after all that I've read about that drug. I wonder how much it costs monthly to pay for Interferon without going through insurance ?
I'm so thankful that I found this forum and have the opportunity to find more information about this disease because right now I'm confused and there are many things I don't understand.
I've read that is better to have ALT higher because that means your immune system is fighting the virus, is that true ?
Thank you all!
I'm not pregnant but I'm planning to have a child in the nearest future (1-2 years). I'm not taking Viread anyways because most of you recommend not to and I'm scared to death after all that I've read about that drug. I wonder how much it costs monthly to pay for Interferon without going through insurance ?
I'm so thankful that I found this forum and have the opportunity to find more information about this disease because right now I'm confused and there are many things I don't understand.
I've read that is better to have ALT higher because that means your immune system is fighting the virus, is that true ?
Thank you all!
GS9620 - well I beat my head against the wall they only want certain people (on Tenofovir for 3 or more months) in this study. It is like beating a head against the wall. Entecavir is the same class of drugs like Tenofovir. Yet they told me no..
And again it is a randomized phase 1 study that can land one into a placebo group. Which in itself is unethical to run clinical trials this way. Not for these type of a virus. Reasoning and pleading for the medication does not work with these people. They are doing product testing sponsored by Gilead and nothing else and that is NOT research when there is so much that is available that can help us.
p.s. It would be real nice if our friends in India can make Imiquimod in a pill form and start selling it so we can test it out.
And again it is a randomized phase 1 study that can land one into a placebo group. Which in itself is unethical to run clinical trials this way. Not for these type of a virus. Reasoning and pleading for the medication does not work with these people. They are doing product testing sponsored by Gilead and nothing else and that is NOT research when there is so much that is available that can help us.
p.s. It would be real nice if our friends in India can make Imiquimod in a pill form and start selling it so we can test it out.
Try to find a doctor that is open to interferon treatment. Or that has an experience in treating patients. Because most of them here don't. You have good chance to clear hbv based on what you have wrote here.
It is impossible to live a healthy life with virus replicating and alt twice the normal values. Active HepB is a silent killer. And I am not joking. So in that sense your doctor is right that he is recommending treatment.
If you are not pregnant you can do treatment. Effects of interferon are reversible. The nuces like Tenofovir and Entecavir yes are implicated in genetic mutations, rare cancers what have you. Some of the old school physicians will have a big grin when they hear they give us anti-HIV agents these days. Looking at the data available from the HIV crowd there is a lot of alarming things about these antiviral drugs that may effect reproductive organs in both men and women. As well as being implicated in heart disease and causing high blood pressure.
Ultimately it is for you to decide what to do. But so far for us living in America with HBV the best option is interferon. Rescuing the immune system is the key to overcoming the virus.
The doctors here (most) won't do or try anything that is not approved by the FDA for HepB treatment. And it is a legal excuse for insurance companies to not pay for the drugs that work... as say Alinia. I know what I am talking about because I have walked the hard road and beat my head against the monster thick and high doors of bureaucracy and stupidity. Now with Obama Care kicking in things are getting better for people.
But truth is that they don;t want to develop cures or delay them as long as possible - to maximize profits from what is available. By 2017-2020 we will have something that can treat HBV effectively. Competition between new antiviral companies outside of US forces monopolists like Gilead here to roll out something they had in their stash.
Why do you think we don't have surface antigen quantitative test approved here for use? It is an ELISA from what I am being told. So people won't ask questions as to why they are given antivirals that don't work like they tell us. Because they measure progress here based on viral load. 0 viral load = healthy.
The fatty liver that I have developed while on Baraclude I am told - Oh well don't eat fat food, exercise more, end of story. Any discussion about interferon + something else is looked upon as nonsense.. Or they will tell you politely then go to Europe, Cuba, Russia or China and have them treat you to make you happy. This is the larger picture of this what is going.
But thanks to forums like these world wide we can at least know the truth.
But there is still very little available for us other then interferon with the highest numbers of HBV clearance. This is based upon my own research, that it is the best option for people with healthy livers.
Antivirals should be the second line of treatment for people with advance fibrosis and cirrhosis that cannot tolerate interferon - their liver can't.
It is impossible to live a healthy life with virus replicating and alt twice the normal values. Active HepB is a silent killer. And I am not joking. So in that sense your doctor is right that he is recommending treatment.
If you are not pregnant you can do treatment. Effects of interferon are reversible. The nuces like Tenofovir and Entecavir yes are implicated in genetic mutations, rare cancers what have you. Some of the old school physicians will have a big grin when they hear they give us anti-HIV agents these days. Looking at the data available from the HIV crowd there is a lot of alarming things about these antiviral drugs that may effect reproductive organs in both men and women. As well as being implicated in heart disease and causing high blood pressure.
Ultimately it is for you to decide what to do. But so far for us living in America with HBV the best option is interferon. Rescuing the immune system is the key to overcoming the virus.
The doctors here (most) won't do or try anything that is not approved by the FDA for HepB treatment. And it is a legal excuse for insurance companies to not pay for the drugs that work... as say Alinia. I know what I am talking about because I have walked the hard road and beat my head against the monster thick and high doors of bureaucracy and stupidity. Now with Obama Care kicking in things are getting better for people.
But truth is that they don;t want to develop cures or delay them as long as possible - to maximize profits from what is available. By 2017-2020 we will have something that can treat HBV effectively. Competition between new antiviral companies outside of US forces monopolists like Gilead here to roll out something they had in their stash.
Why do you think we don't have surface antigen quantitative test approved here for use? It is an ELISA from what I am being told. So people won't ask questions as to why they are given antivirals that don't work like they tell us. Because they measure progress here based on viral load. 0 viral load = healthy.
The fatty liver that I have developed while on Baraclude I am told - Oh well don't eat fat food, exercise more, end of story. Any discussion about interferon + something else is looked upon as nonsense.. Or they will tell you politely then go to Europe, Cuba, Russia or China and have them treat you to make you happy. This is the larger picture of this what is going.
But thanks to forums like these world wide we can at least know the truth.
But there is still very little available for us other then interferon with the highest numbers of HBV clearance. This is based upon my own research, that it is the best option for people with healthy livers.
Antivirals should be the second line of treatment for people with advance fibrosis and cirrhosis that cannot tolerate interferon - their liver can't.
Thanks for your advice. Next time I'm seeing my doctor I'll ask him to give me a copy with all the results (what I've read here: hbsag quantity, genotype, etc). Also, I'm planning to have a child in the nearest future so I don't want any drug to affect my baby. I'll follow Stef2011 advice to take vitamins and live a healthy life.
If you want to start treating it i suggest you go with interferon. That is our best bet so far.
If you had hbv since birth and there is no liver damage then obviously your immune system has some control of the virus. Might as well help it with interferon.
If you had hbv since birth and there is no liver damage then obviously your immune system has some control of the virus. Might as well help it with interferon.
Can my Hepatitis B blood test (I mean Alt, viral load etc) be influenced by the Helicobacter Pylori bacteria I have at my stomach ? Thanks, I called the doctor's office to cancel my Viread prescription. I see my doctor in October and I'll ask him alot of questions. Thanks
Thank you for your very useful answers. I'm a newbie in US so I don't know how things work here. I called him telling I don't want to start medication yet.
i d change doctor, suggesting drugs that dont cure hbv, at your age, with no liver damage.... is not a doctor accetable way of acting but a business men acting trying to sell drugs
you are too young for antivirals, long term sides effect are unknown so it is not safe for a young person to take them unless sevre damaged liver
My TGP was double than normal range in February. I'm 24 and I have the virus since bith. Next time I'll see my docotor I'll ask him to give me a copy of all the results. Thank you
Never heard of rep9ac until now. Very effective and promising indeed. I live in US and they don't use fibroscan but the docoor recommended an ultrasound evey 6 month. Thank u
hbv is benigne for most hbv carriers so this is your case and since tenofovir cant clear hbv you d have no benifit from it
just live a healthy life, take vit d to make serum levels normal and cofee, fish oil, natural vitamin e to prevent liver cancer and you ll probably never need any antiviral, choose to take a drug only if:
it clears hbv definitively
your liver develops severe fibrosis (fibroscan every year or every 6 months will tell you how your liver is much long before you develop any fibrosis allowing to make correct choices only then)
you have mutants and genotype at high risk for liver cancer (bcp/precore mutants, genotype C)
Gilead 7977 is a hep C drug. Dee1956 probably clicked the wrong button and thought this was hep C forum.
It's good you don't have liver damage now, but viral load alone is not enough to decide if you need treatment. Liver enzymes, age, family history, tumor markers, genotype, mutations, etc should all be considered.
Since you don't have liver damage now, there is no real urgency to treat right now. But my advice would be to find a good hepatologist and get a second opinion. At the same time, keep monitoring your hep B status regularly.
It's good you don't have liver damage now, but viral load alone is not enough to decide if you need treatment. Liver enzymes, age, family history, tumor markers, genotype, mutations, etc should all be considered.
Since you don't have liver damage now, there is no real urgency to treat right now. But my advice would be to find a good hepatologist and get a second opinion. At the same time, keep monitoring your hep B status regularly.
Hi. Thank you so much for your answer. Since I went back from the doc's office I started reading about Viread and I'm scared of it's possible side effects. I'll definitely wait I have the virus since birth and my liver still works good so there's no rush I guess.
Hi only you and your doctor can decide, however..if you have minimal inflammation and you think your doc thinks you can wait; I would wait for the new all orals that are being tested now and looking good. I think it is Gilead 7977 however someone more knowledgeable will be along soon
I am more of the cheering section.
Good luck
I am more of the cheering section.
Good luck
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the drugs that clear hbv are:
rep9ac, proved on human trials
maybe gs9620, still to be proved on human trials
long term viread and then interferon add on