New GI: Do you want Tenofovir or Peginterferon

[Elijah256]

New GI: Do you want Tenofovir or Peginterferon? My new GI said she will try to switch me from Entecavir and either put me on Tenofovir or Peginterferon. I ask for a combo and she told me that Tenofovir and Peginterferon does the same thing. Is that even true?

[Ram1982]

Hi Stepen,

Thanks for the info. Do you have any info or study where pegylated interferon gave goodrsults for HBeAg negative patients with undetected viral load and HBsAg count is around 4400?

[StephenCastlecrag]

Dr Lampertico is one of the authorities on treatments for HBeAg negative patients. You can read his slide presentation at the 2015 Paris Conference
http://www.aphc.info/wp-content/uploads/2014/09/Pietro_LAMPERTICO1.pdf

On the issue of combination treatment (Peg + IFN), his conclusion is that it is NOT READY FOR CLINICAL PRACTICE YET. However, in the hand of a experienced practitioner, a higher percentage of HBsAg clearance can be achieved by careful selection of patients based on:
1. HBsAg level;
2. IP10
3. HBV genotype
4. Age, etc
these predictive and stopping rules can guide combo treatment.

There is also a study that involved stopping Tenofovir treatment after a prolonged period. A very small percentage of patients may clear HBsAg, most will have viralogical (hbvdna) and biological (ALT) rebounds. Among these, some will have a decrease in qHBsAg. This leads to speculation whether a sequence of start-stop-restart of NUC may be a way to reduce qHBsAg. As you can see, this requires experience and bold experimentation by the specialists, especially whether and when to re-start NUC treatment.

[Ram1982]

Thanks for the information Stephen.

[stef2011]

also double check if sides are from etv or by nutritional deficiencies

i d switch to tdf and think about combo after 3-5 years on tdf if hbsag goes down

[Ram1982]

Thanks Stef foe the info.

[sorte]

Not sure if I understood well:

"A very small percentage of patients may clear HBsAg, most will have viralogical (hbvdna) and biological (ALT) rebounds. Among these, some will have a decrease in qHBsAg."

So some of them have hbv dna and alt going up but hbsag goes down ? It's strange.