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Pegasys + Tenofovir (TDF) Therapy

Dear Doctor,

First of all, apologize for my poor English.
I am an Asian male 27 years old.
I was diagnosed with hep B chronic infection in early of 2008. Since then I am regularly visit specialist doctor for medical check-up. After monitoring my hep B panel and liver condition for 4 years, my doctor decided to advise me for therapy due to my ALT level was elevated for this past 3 years (around 2 twice of normal range).
The option that suggested by my Doctor at that time was TDF alone or TDF combo with Pegasys. After a though consideration, I finally agree to start a combo therapy of TDF + Pegasys on mid of March.

Here is my recent history of records:

End of February result:
Hbs Ag (Quant) : 44575.47
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 440771328

==========================================
Decided to go on Combo therapy TDF + Pegasys
==========================================

Baseline result (mid of March), after baseline, start taking on medication
Hbs Ag (Quant) : 44977.03
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 570484864

April result (week 4 after started weekly injection of Pegasys and daily dosage of TDF)
Hbs Ag (Quant) : 32384.55 (going down)
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 148485 (going down)

Now I am on week 8, just did my medical check and wait for the result to come out.
I will gladly appreciate your view and opinion on my result

Thank you and best regards,
AsianMale1985
Best Answer
Avatar universal

do check that unit is iu/ml, there are still absolete tests with the number with no unit and those tests are useless.
most labs report the method (at least those who use new machines and have nothing to hide), hbsag quantity is done by abbott architect or roches elycsys only
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Avatar universal
HI, i'm doing the same your tx.. i'm also 27yo eag+... any sides? I

'm now on week 13 my hbsag quant baseline was 5800iu/ml now I'm waitign for the hbsag quant afetr 12wks..

DNA is under detectable limit due to TDF..
Helpful - 0
Avatar universal

responding weel but to early to say, week 12 and week 24 hbsag, ast/alt and hbvdna will tell

check also your vit d and if less than 50ng/ml i tis best to supplement until you reach 80-90ng/ml, test is vit d25oh
Helpful - 0
Avatar universal
when should the eag seroconvesrsion expected in such cases as average?
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Avatar universal
Hi Grmr, I don't feel any side effect so far, i hope this condition continue till end of treatment.
Do you have any side so far?
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Avatar universal
Thanks Stef for your post.
I notice that i my vit D is slightly low, it is 55ng/ml. But my doctor mention that it is not clinical significant.
Do you know how this HbsAg (quant) works? Seems like it is going down, but i don't know how does it effect on my treatment result.
Helpful - 0
Avatar universal
Hi Guys,
Anyone know how to delete the duplicate post.
I do some mistake when posting my question, and it is duplicating now.
Apologize for that, i am new to this forum.
Helpful - 0
Avatar universal
Do you know how this HbsAg (quant) works?

if your genotype is D levels below 1500iu/ml means you achieved immune control of hbv, at very low levels like 10-20iu/ml you dont need drugs to control hbv and it gets cleared slowly by immune system or fast by pegintf
Helpful - 0
Avatar universal
HI Stef,

Thank you for your prompt reply.
My Genotype is B. Now my HbsAg (quant) is 32384.55, but i am not sure if it is in iu/ml or some other parameter, there is no explanation my medical report.

I notice that this HbsAg (quant) is going down, is it because of i am injecting Pegasys?
Apologize for so many question at the same time.
Helpful - 0
Avatar universal

genotype B needs hbsag around 100-300iu/ml to achieve immune control, geno B responds better to intf


I notice that this HbsAg (quant) is going down, is it because of i am injecting Pegasys?
of course it is pegasys
Helpful - 0
Avatar universal
Thanks Stef.
I will update to you guys once i have latest result of my medical report.

Hope that it is getting better :)
Helpful - 0
Avatar universal
Hi All,

I have received my latest blood test result.

Here is the complete list:

Baseline result (mid of March)
Hbs Ag (Quant) : 44977.03
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 570484864
AST : 37
ALT : 84

April result (week 4)
Hbs Ag (Quant) : 32384.55 (going down)
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 148485 (going down)
AST : 43
ALT : 99

May result (week 8)
Hbs Ag (Quant) : 18709.00 (going down)
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 11338 (going down)
AST : 85
ALT : 190


May i know what is your opionion on my result?
I notice my ALT was up and down, does it normal to expect ALT increasing when we are on Pegasys?

Also what is the normal period to reach viral load Undetected? Looks like my first 4 weeks result was very good because the viral load was dropping so drastically. But on my week 8, it does not show the same.

Kindly help me to share your view on my latest result.

Best Regards,
AsianMale1985
Helpful - 0
Avatar universal
I am not a doctor. I would say your levels of hbvdna and HbsAg are trending down and is a good sign. As for your ALT,  a rise in ALT, followed by a drop in hbvdna is also a good sign. 8 weeks of treatment is too early to predict, especially for non-expert like myself. Since you have minimal side effect, you should go on to complete your course of treatment.

BTW, in which country are you being treated?
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Avatar universal
Hi Stephen,

Thanks for your feedback. It made me determined to finish the course :)
Currently, I am being treated in Singapore, but i am not a citizen there, just a regular medical visit.
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Avatar universal
Hi Stef,
I checked with my doctor, the HbsAg (Quant) is in iu/ml.
Helpful - 0
Avatar universal

good results, hbsag is still to high but as long as it declines it is good.losing hbeag by 24 weeks is a strong predictor of hbsag clearance

is your therapy tdf+intf?(sorry i dont remember the whole thread)
Helpful - 0
Avatar universal
TDF + Pegasys from mid of March
Helpful - 0
Avatar universal
it seems good.. by the way how was the hbsag decline from

32384.55 (going down)

to

18709.00 (going down)

expressed in terms of log? Is there anyone doing the conversion?


Helpful - 0
Avatar universal
i'm also eag+ on TDF+IFN and am colleting in the next days hbsag qquant after 12wks..
Helpful - 0
Avatar universal
Hi Stef,

I am on Pegasys combo tdf since mid of march. Next month will be my week 12 blood test.
I am glad that the HbsAg is declining, but i am little bit confuse on how this HbsAg decline in that figure. Will it keep decline 12k+ iu/ml a month? seems like my HbsAg is declining that way from 44k to 32k and latest to 18k. Does it shows a good decline figure? or it is just normal to have that.

In other side, my HBV DNAlooks like slowed down in declining from 500M to 100k and then 10k.
How long normally for people that taking TDF to reach UND from the baseline time?
Helpful - 0
Avatar universal
I am not that good in math, but i guess if we want to know in term log declining, i think first we have to convert both to log.
For example on my result:

Baseline: 44977.03 = 4.65299 log

Week 8: 18709.00 = 4.27205 log

So if we want to see how much it decline, then it will be:
Total decline = 4.65299 - 4.27205
Total decline = 0.38 log iu/ml

Please someone correct me if it is not a good way to calculate
Helpful - 0
Avatar universal

dont look hbvdna too much, when it reaches low numbers 100-2000iu/ml it is not so important, just look at hbsag only.

i think these are good results
Helpful - 0
Avatar universal
so what is the conversion coefficienf from iu to log???? really not good in math...
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Avatar universal
http://forum.corriere.it/fegato/31-05-2012/news-dal-congresso-europeo-di-epatologia-2012-riguardanti-lepatite-b-e-d-2071866.html

INTERFERONE PEGHILATO + TENOFOVIR
-In soggetti affetti da epatite cronica B trattati con Interferone Peghilato e Tenofovir per 48 settimane è stata osservata una risposta virologica sostenuta del 30% e una perdita dell’HBsAg nell’11%. Il livello basale di HBsAg inferiore a 2000 UI/ml predice un’alta percentuale di risposta. Una mancanza di riduzione superiore al 10% di HBsAg quantitativo alla settimana 12 e 24, identifica i soggetti non responsivi. (Marcellin P et al., S209).
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