Pls Stef your HELP is highly needed

[jrobronx]

Dear Stef/Every one,

I met with the doctor (Gastro) today and her prescription for my state was LIVOLIN FORTE (PHOSPHOLIPIDS WITH VITAMINS) for 6 months. I'm really scared of the aftermath if i don't begin medication soon. Please I'm really in need of your help right now. Below are my results

June 2014
Hbv DNA viral load: 1128
HbeAg: -ive
HbeAb: +ive

July 2014             Result
Hbsag Quant.       2,214 iu/ml (elizer machine)

August 2014
Sodium                130  (130-146 mEq/L)
Potassium             3.8  (3.0-5.0 mEq/L)
Bicarbonate          22   (18-28 mEq/L)
Chloride              101  (95-110 mEq/L)
Urea                      17  (10-50 mg/dl)
Creatinine             1.0 (0.5-1.5 mg/dl)
Random Glu         85  (mg/dl)

Whole Blood Test
Wbc                       3.17x10^9/L (4.00-10.00) L
Lym#                     1.98x10^9/L (0.80-4.00)
Mid#                      0.54x10^9/L (0.10-1.00)
Gra#                       0.65x10^9/L (2.00-7.80)L-
Lym%                    62.08% (20.00-50.00)H+
Mid%                     16.94% (1.00-15.00) H
Gra%                      0.65x10^9/L (40.00-70.00)L-
Rbc                         4.45x10^12/L (4.09-5.74)
Hgb                        118g/L (131.00-172.00)L
Mchc                      297.21g/L (320.00-355.00)L
Mch                        26.50pg (27.80-33.00)L
Hct                         39.70% (38.00-50.80)
Plt                          214x10^9/L(85.00-303.00)
Mpv                       7.9fl (7.00-11.00)
Pdw                       14.07%(10.00-18.00)
Pct                         0.17% (85.00-303.00)
p-lcr                       22.50%(13.00-43.00)

LFT Test
AST                    27u/l (0-28)              
ALT                    20u/l (0-26)                      
ALK Phosph       20u/l (9-35)
Total Protein       70g/l (60-82)
Albumin              50g/l(32-55)
Total Bilrubin      2.0mg/dl (0.2-1.0)
Conjugated Bilirubin 1.2mg/dl(0-0.2)

[jrobronx]

Stef i really appreciated your strong recommendation, and i thank you for support and may the Good Lord continue to bless you.

[stef2011]

start with the vitamin d3 first and after 6months retest hbsag, only then you can think of peg or tdf

as to the costs it is best you get generics from india, it is surely cheaper to get a flight to india, a doctor prescription there and the generic peg/tdf.generic tdf is about 20 to 100usd per month and generic peg is about 100usd per vial (generic peg is made by roches under different names in india)

anyway start with the vitamin d 3 first, 10.000iu daily and test both vitd25oh and pth after 1-3 months on this

[jrobronx]

Thank you for your response. Pls what is the specification for Tenofovir (Brand & Mg)? Is Peginterferon an injection? because when i heard the rate for the it i was overwhelmed of its huge price.

Thank you.

[jrobronx]

Dear Stef,

I called a pharmacy in Lagos and they told me the have Peginterferon. I also realised the Peginterferon its an injection and the rate is on the high side while Tdf rate is fair. I was just wondering how many dose will one need in 6month since a bottle cost $300.

Moreso, i wanted to equire from you the specification for Tenofovir (Brand & Mg)? Because i need confirm with the pharmacy if they have it.

@Waschool thank you for the hint, you are most appreciated.

Stef, i sincerely apologise to intrude on you. Thank you for your unending help and support.

[waschool]

u can get tdf in Nigeria, keep going and asking at the teaching hospitals, u will surely get someone to prescribe it to, i wasnt also expecting to found one in Ghana with peg but it is only the price that is untouchable some how around 350- 400 dollars per vial. I bet u I hv started selling my belongings to enable me buy only three vials. thanks bye

[jrobronx]

A million thanks to you and i'll keep you posted on the development.

[stef2011]

Vit d improves immune response and may lower hbsag to 1000iu/ml, then you can try pegintf.the time for vit d to improve immune response is 6-7months with stable vitd25oh levels 100ng/ml and pth less than 20pg/ml

if vit d doesn twork to lower hbsag keep taking anyway and try few years on tenofovir then again peginterferon plus vit d3 plus tenofovir

this is a slow disease, do not expect results on hbsag in less than 6-12months

[jrobronx]

Dear Stef,

Thank you, i sincerely appreciated your swift responses but i'm in Nigeria and dont know where to get this drug. I try to enquiry for it at some big pharmacies. Your responses is a huge relieve to me but the challenge is where and how to get the drugs. the Hbsag Quant was completed on the 7th of August 2014.

Moreso, does Vitd25oh determines when i can proceed with Pegin/tdf?

Thank you once again

[jrobronx]

Thank you, i sincerely appreciated your swift responses but i'm in Nigeria and dont know where to get this drug. I try to enquiry for it at some big pharmacies. Your responses is a huge relieve to me but the challenge is where and how to get the drugs.

Moreso, does Vitd25oh determines when i can proceed with Pegin/tdf?

Thank you once again

[stef2011]

and then recheck hbsag quant for peg add on

[stef2011]

why vitd25oh is missing?and all those useless tests performed?
why fibroscan is missing?and all those useless tests performed?
why LIVOLIN FORTE (PHOSPHOLIPIDS WITH VITAMINS) if we dont even know if there is any liver damage?
where is the hbv cure in all this?

ignorant or useless doctor!

anyway hbsag is not high, after making vitd25oh 100ng/ml i would recheck on hbsag quant and hbvdna and then go for peginterferon if hbsag 1000iu/ml , if not tenofovir for 1-3years and then recheck hbsag