Result of 3 months treatment using tenofovir

[afif120]

Dear all,
My son (23 y.o.) starts treatment using tdf 3 months ago.

Baseline (before taking Tdf):
SGOT 47 (range for normal: 5 - 34)
SGPT 102 (range for normal: 4-36)
HBV DNA 2.43 X 10^8
HBSag Quantitative: 43,205.18 IU/ML

Result after 3 months:
SGOT 89
SGPT 244
HBV DNA 3.19 X 10^5
HBSag Quantitative: 11,570.50 IU/ML
HBeAG  reactive
Anti HBe  non reactive

While HBV DNA and HBSag Quantitative decline, his SGOT and SGPT increase. Can any one give insight whether it is still okay to have SGOT and SGPT at the above levels. His doctor provides vitamin HP Pro to help lower the SGOT and SGPT but I am a bit worried whether this vitamin will be good for the treatment process.

Also the HBSag Quantitative drops significantly. I wonder whether this drop is merely fluctuation of HBSag or it is a real decline.

I would appreciate your view on this. Thanks so much.

Afif

[stef2011]

hbvdna undetactable and hbsag less than 1000iu/ml when hbeag will be negative is best to prevent liver cancer

of course it is also mandatory to have a diet full of organic fresh vegetables, little fats from milk/cheese and white meat (red meat very little), lots of fish (possibly with no mercury but looks like most fish has some metals in it)

[stef2011]

With regards to hbv genotype, it seems the test is not available here in Indonesia. I have asked such test for my son to a leading lab here but they said that genotype test is only for hepatitis C and they never heard of HBV genotype.

oh my.....

you may consider sending blood sample to india if you dont find a lab for it in indonesia.genotypes for asians in your area are B and C.the C is very hard on pegintf and has a very high rate of HCC so it is best to treat hbv by antivirals and try to keep hbsag less than 1000iu/ml to lower HCC risk

[stef2011]

Thanks very much Stef for your insights. Yes, vit D, 25-OH,total of my son is only 21. Will discuss the need to increase vit D level with the doctor.

if the liver specialist is not updated you better act yourself, 21ng/ml is too low for any human being...be aware that vit d ipmacts so many diseases and so drug makers financial profits in a very big loss, so there is a fraud about vitamin d being toxic or beng able to increase calcium levels to damage kidneys or the fraud of a vitamin d dose.....any human being can have different kinetics according to body wheight and chronic diseases.
so you d best read about trials and studies here and know how to deal with it:
vitamindwiki.com

this way you have a clear idea if the doctor is updated and prepared or ignorant or just a drug seller prescribing some drugs to any hbver.

there are also many threads with our experience here, the target is 80-100ng/ml, calcium increase can be seen only for values superior 165ng/ml

[afif120]

Thanks very much Stef for your insights. Yes, vit D, 25-OH,total of my son is only 21. Will discuss the need to increase vit D level with the doctor.

With regards to hbv genotype, it seems the test is not available here in Indonesia. I have asked such test for my son to a leading lab here but they said that genotype test is only for hepatitis C and they never heard of HBV genotype. Do you, or any one, know whether hbv genotype test is available in Singapore or Malaysia?

Thanks again.

[stef2011]

by the way hbv lowers vitamin d so you ll find your son deficent, this is done to lower immune response to the virus

it also acts producing nagalase to block vitamin d to reach immune cells and may be it uses other unknown pathways

the chances to cure hbv for your son are very high since he started as hbeag positive, do not stop tenofovir until hbsag is negative and hbsab antibody>200miu/ml or higher.if tenofovir is not enough to clear hbsag (this is in most cases) add pegintf to tenofovir when hbsag reaches 1000-1500iu/ml, also test hbv genotype before hbvdna is und otherwise there is no way to know it in the future, genotype is very important to understand pegintf response kinetics

[stef2011]

we will never end to be surprised about doctor's ignorance

you are having one of the best response that tenofovir can have, in particular your son immune system is killing infected cells, this obviously increases ast-alt but this of no clinical significance as long as alt is not superior to 1000 and not for years....

this said pray for alt to stay that way because without killing infected cells hbv will stay forver, the result of this active immune response that few chronic hbv infected have is lowering of hbsag and hbvdna, hbeag seroconversion (which is meaningless to the hbv infection) and over the years possible clearance of hbsag (which is clearance of the infection)

the only vitamin needed to boost immune response and avoid liver damage is vitamin d3, start to take 5000iu daily possibly of the best brand that combo k2 vitamin and test serum levels, the target to have an effect on immune system and prevention of liver damage is 80-100ng/ml

while taking vitamin d lower calcium sources which are not good for health like milk, cheese and bananas and monitor calcium levels from time to time.if you want to learn more browse older post about the studies of vitamin d level and hbsag/hbvdna clearance, balance of vitamin d with vitamin k2 (vitamin d absorbs more calcium and k2 takes it out of blood to fix in bones and cells, d3 without k2 is not healthy and calcium is useless if on this balance)