Pegasys + Tenofovir (TDF) Therapy

[AsianMale1985]

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

[AsianMale1985]

Dear All,

As promised, here is my latest result up to week 52 (1 month post treatment. Stop pegasys + tenofovir).

Here is the complete history till date:

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

June result (week 12)
Hbs Ag (Quant) : 5806.99 (going down)
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 198 (going down)
AST : 64
ALT : 134

July result (week 16)
Hbs Ag (Quant) : 1195.62 (going down)
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 38 (going down)
AST : 55
ALT : 106

September result (week 24)
Hbs Ag (Quant) : 94.52 (going down)
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 22 (going down)
AST : 68
ALT : 121

November result (week 32)
Hbs Ag (Quant) : 7.83 (going down)
Hbs Ag : Reactive
Hbe Ag : Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
HBV DNA : 36 (fluctuated)
AST : 62
ALT : 118

December result (week 40)
Hbs Ag (Quant) : 4.42 (going down)
Hbs Ag : Reactive
Hbe Ag : Non-Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
Anti-Hbe: Reactive
HBV DNA : UND: Ref <15
AST : 63
ALT : 109

February 2013 result (week 48)
Hbs Ag (Quant) : 2.66 (going down)
Hbs Ag : Reactive
Hbe Ag : Non-Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
Anti-Hbe: Reactive
HBV DNA : UND: Ref <15
AST : 43
ALT : 70

==================================================
Treatment stopped.
==================================================
March 2013 result (week 50)
Hbs Ag (Quant) : 2.39 (still going down but not significant)
Hbs Ag : Reactive
Hbe Ag : Non-Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
Anti-Hbe: Reactive
HBV DNA : UND: Ref <15
AST : 30
ALT : 55

March 2013 result (week 52)
Hbs Ag (Quant) : 2.47 (uncertain)
Hbs Ag : Reactive
Hbe Ag : Non-Reactive
ANTI-Hbs (Quant): < 3.0 Non-Reactive
Anti-Hbe: Reactive
HBV DNA : UND: Ref <15
AST : 19
ALT : 31


For quick information:
AST and ALT finally become Normal (After 3 years high ALT)
HbeAg is still negative (Anti-HBe sustained)

Treatment have been stopped for 1 month, no medication right now.

Continuing monitoring action till next 2 months.

Kindly give your comment.

Best Regards,
AsianMale1985

[AsianMale1985]

Hi Stef,

I am treated in Singapore (Southeast Asia). I have posted this info in my earlier post.

Best Regards,
AsianMale1985

[stef2011]

post your country here so maybe other members may help to find reputable and updated real doctors.usually those going at conferences like easl, aapals and so on are very updated and may help you finish to clear hbv  which is 100% now with hbsag 2iu/ml

[stef2011]

just buy pegintf and have the doctor monitor you or at least buy tdf which is very safe and need less monitoring

keeping tdf you are safe from hbsag mutations which abolish any possible cure by hbsag negative/hbsab detactable, sorry the doctors acted out of any guidelines, they should have broght you to hbsab detactable not just giving drugs as dumb a.... we can do that ourselves not needed them

best thing could be at least tdf+ezetimibe now since very easy to buy, if you are in asia probably even with no prescriptions required....

[AsianMale1985]

Hi Kantaka,

Thank you for your prayer. Same to you, wish you and all the people here always healthy and happy.

Best Regards,
AsianMale1985

[AsianMale1985]

Hi Stef,

are you on tdf mono?you can add ezetimibe even if we dont know if it is able to stop reinfection, i will be able to confirm if this work in april by my second hbsag test

No, I am not on TDF mono now and it has been almost a month without medication. Now i am waiting for my latest blood test result (1 month post treatment).

as suggested eralier you should restart pegintf and keep it until hbsag is formed and if it does not reach good stable levels at hbsab 250-500miu/ml hbv vaccine and zadaxin are needed to keep response.it is also very very important to keep hbvdna undetactable so that the virus cannot mutate hbsag and make hbsab antibody useless

Yes, as per your advise,  in the monitoring status, i am still looking for a doctor that can advice me for restart of Pegasys. Seems like every doctor that i visit refuse to do so. Will keep u posted on this.

Best Regards,
AsianMale1985