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Avatar universal

Results after about 2 months of VitD3 5000iu and heptec

In April my viral load was 1.7 mil copies/ml.

the results now:-
Fibroscan -- 4.6 kpa
HBV DNA --  55,814 copies/ml
HBsAg (Quantitative) --  2906.99 IU/ml (cut off= 0.05 IU/ml)
25OH Vitamin D3 --  40.8 ug/l

Alt -- 54 u/l -----high (normal 0 - 44)
Ast -- 53 u/l ----high (normal 15 - 41)

Genotype, Precore Mutation, Polemerase mutation have to wait about 2 weeks.
My alt, art is always a little bit high. My doctor already wanted to treat me and she said I have about 50% chance now if I make peg interferon treatment. But I told her I wanted to wait for the time being.
I think vitD3 or heptec or both helped me in dropping so much hbv dna.

my alt and art is high like this for about 2-3 years I think.



67 Responses
1191262 tn?1366763021
Hi what were the intial values? We have no history here unless I missed something:)
Avatar universal
25OH Vitamin D3 --  40.8 ug/l

please check unit if ug/l or ng/ml.me, my sster and my father could get it higher than 50ng/ml only using more than 5000iu, anyway it may still increase by following months

Fibroscan -- 4.6 kpa
your goal should be keep fibroscan always between 4-5kpa, abnormal over 6kpa

HBV DNA --  55,814 copies/ml
i would not care much about this, of course the lower the better but this doesn tindicate anything about infection

HBsAg (Quantitative) --  2906.99 IU/ml
this is the test to keep an eye on and lower to 1000-1500iu/ml so that we have the highest chances to clear on interferon.if possible i'd use simvastatin and nitazoxanide (alinia) and see what happens to both hbsag and hbvdna and once hbsag is in the range 1500 start interferon
Avatar universal
enolia:

my last results done in (02-05-2011) are as follows:


Total Protein-------  7.8 gm/dl---- normal-----6.5 - 8.1
Albumin------------- 4.4 gm/ml ----normal----- 3.5 - 4.8
Globulin------------- 3.4 gm/dl-----normal----- 2.5 - 3.5
Direct Bilirubin----0.1  mg/dl-----normal----- 0.1 - 0.5
Total Bilirubin------0.7  mg/dl-----normal----- 0.4 - 2.0
Alk. Phosphatase--- 54 u/l -------normal----- 38 - 126
SGOT/AST-----53 u/l---- high-----15 - 41
SGPT/ALT-----50 u/l-----high-------   0 - 44
Gamma GT----13 u/l-----normal---   7 - 50
AFP 4.2 ng/ml------------ normal--- 0.0 - 9.0
ultrasound----normal
fibroscan----- 4.2 kpa

HbeAg Negative

hbv dan 1,775,100  copies/ml  (Test methodology by COBAS Ampliprep/COBAS TaqMan HBV Test)
Log equivalence 6.25 log
Viral Load (HBV DNA) =  305,000 iu/ml , Log equivalence = 5.48

I have never done hbsag ( quantitative ) and 25ohd3 test before.

stef2011:
I checked again the unit of vit d3 test. It is mentioned "ug/l" not "ng/ml".
Is something wrong?

Do you think I can try nitazoxanide (alinia) or simvastatin...together with vit d3?
my alt & ast is a little bit up almost always....you have any idea why??


Avatar universal
correct info on vit d here

http://www.vitamindsociety.org/
http://vitamindfoundation.org/

Get Your Vitamin D Levels Tested!
Have your physician administer a calcidiol test (also know as a 25-hyrdoxyvitamin D test). More important than your daily intake of vitamin D are your actual vitamin D blood levels. Optimal vitamin D blood levels are 50 ng/mL (125 nmol/L)‚ according to The Vitamin D Council.
Avatar universal
http://www.vitamindcouncil.org/about-vitamin-d/vitamin-d-deficiency/am-i-vitamin-d-deficient/

vitamin d homekit if you dont find a lab to test vit d by ng/ml unit or nmol/l unit

http://www.zrtlab.com/vitamindcouncil/
Avatar universal
mili, micro, nono ...
m,u,n
so => 1000 ng = 1ug;

40.8 ug/l = 40800ng/l = 40.8ng/ml

so, from what I still remember from the school it seams to me that ug/l is similar to ng/ml  (or ? )

Avatar universal
this are good news :)

Could you please give us the full history from when you start to made the tests, to see how HBV DNA or qHBsAG or ATL/AST or ... variation over time line?
Avatar universal

you know these tests there are so poor sensibility that i'd have the ng/ml type directly, now i dont remember the best machine but the old vit d tests were very very poor reliability

most vitamin d tests are not reliable with results, if i remember correct the ones doing ng/ml unit are those with higest sensibility, in any case if we stay well over 50ng/ml we are safely in the correct range
Avatar universal
I have collected my results as much as possible. I have been taking vitd3 and HepTec for about 8 weeks I think before I made my last test. I am also planning to take alinia after I get mutation and geno type results.  

Results on 21.11.08  

Albumin,  Bilirubin(Total),  Alpha-Foetoprotein --- Normal
Alt  55 ( Ref. 9-52 u/l ) ---- High
Ast  47 ( Ref. 14-36 u/l ) ---- High
HBsAG  6340 ( Ref. < 1.0 ) ---- Reactive
HBeAg  -------------------------Negative
Anti-HBe------------------------Positive
---------------------------------------------------------------------------------------------------
Results on 11.3.09

HBV DNA  446,574  copies/ml
Fibroscan -- 5.2 KPa
---------------------------------------------------------------------------------------------------
Results on 01.06.09

Albumin,  Bilirubin(Total),  Alpha-Foetoprotein --- Normal
Alt  62 ( Ref. 9-52 u/l ) ---- High
Ast  43 ( Ref. 14-36 u/l ) ---- High
HBsAG  5440 ( Ref. < 1.0 ) ---- Reactive
HBeAg  -------------------------Negative
Anti-HBe  0.77 ( Ref. < 1.2 )----Negative
Blood Report--------  RBC,  Platelet --- Normal
WBC -------------Monocytosis

-------------------------------------------------------------------------------------------------------

Results on 26.10.09

SGOT/AST-----53 u/l---- high-----15 - 41
SGPT/ALT-----54 u/l-----high-------0 - 44

HBV DNA   977,760  copies/ml

-------------------------------------------------------------------------------------------------------
Results on 4.1.2010

fibroscan ----- 3.7Kpa  

----------------------------------------------------------------------------------------------------
Results on (02-05-2011)

Total Protein-------  7.8 gm/dl---- normal-----( Ref.6.5 - 8.1 )
Albumin------------- 4.4 gm/ml ----normal----- ( Ref.3.5 - 4.8 )
Globulin------------- 3.4 gm/dl-----normal----- ( Ref.2.5 - 3.5 )
Direct Bilirubin----0.1  mg/dl-----normal----- ( Ref.0.1 - 0.5 )
Total Bilirubin------0.7  mg/dl-----normal----- ( Ref.0.4 - 2.0 )
Alk. Phosphatase--- 54 u/l -------normal----- ( Ref.38 - 126 )
SGOT/AST-----53 u/l---- high-----( Ref. 15 - 41 )
SGPT/ALT-----50 u/l-----high------( Ref. 0 - 44 )
Gamma GT----13 u/l-----normal--- ( Ref. 7 - 50 )
AFP 4.2 ng/ml------------ normal--- ( Ref. 0.0 - 9.0 )
ultrasound----normal
fibroscan----- 4.2 kpa

HbeAg Negative

hbv dan 1,775,100  copies/ml  (Test methodology by COBAS Ampliprep/COBAS TaqMan HBV Test)
Log equivalence 6.25 log
Viral Load (HBV DNA) =  305,000 iu/ml , Log equivalence = 5.48
-----------------------------------------------------------------------------------------------------------------------
Results on (26-09-2011) are as follows:

Fibroscan -- 4.6 kpa
HBV DNA --  55,814 copies/ml
HBsAg (Quantitative) --  2906.99 IU/ml (cut off= 0.05 IU/ml)
25OH Vitamin D3 --  40.8 ug/l

Total Protein-------  7.5 gm/dl---- normal-----( Ref.6.5 - 8.1 )
Albumin------------- 4.1 gm/ml ----normal----- ( Ref.3.5 - 4.8 )
Globulin------------- 3.4 gm/dl-----normal----- ( Ref.2.5 - 3.5 )
Direct Bilirubin----0.1  mg/dl-----normal----- ( Ref.0.1 - 0.5 )
Total Bilirubin------0.5  mg/dl-----normal----- ( Ref.0.4 - 2.0 )
Alk. Phosphatase--- 49 u/l -------normal----- ( Ref.38 - 126 )
SGOT/AST-----53 u/l---- high-----( Ref.15 - 41 )
SGPT/ALT-----54 u/l-----high-------( Ref.0 - 44 )
Gamma GT----14 u/l-----normal--- ( Ref.  7 - 50 )
Avatar universal
Thanks for the vit D sites. In-home testing kit might be very useful. I am thinking to buy one since it is also cheaper than the test in the hospital. I paid about 80 US$ for that test in the hospital.
I want to take alinia also after I know the mutation test results. Can you please give me the link of the company you order your alinia? Thanks, stef.





Avatar universal

this morning i called the virology lab at policlinico tor vergata...they do the whole hbv genome, not just the known resistant mutations

the 18th i will have the test done, all quasispecies of hbv will be detected in hbsag, core and polimerase, i was very surprised this test is available to all at that hospital
1191262 tn?1366763021
Thanks for the info!
Avatar universal
Results are out.
My genotype is C. The one with higher hcc risk.

V 173 ---------wild type--- weakly intensity--- low
L180/A181---wild type--- strongly intensity--- high
N236 ---------wild type--- strongly intensity--- high
N236 ---------wild type--- strongly intensity--- high
T184  ---------wild type--- strongly intensity--- high
A194   ---------wild type--- strongly intensity--- high
S202  ---------wild type--- moderate intensity--- moderate
M250 ---------wild type--- moderate intensity--- moderate

Innolipa HBV Pre core Report

Conjugate control ------strongly intensity ---Interpretable Assay
Amp Control -------------high amplicons ------DNA Amplication successs
BCP (T1762/A1764)/ Mu ----------BCP mutant strongly intensity ----high
PC Codon 28 Mu----------------------PC mutant strongly intensity ----high

Stef, can you comment on my results?

Avatar universal

i'd strongly suggest to treat it and keep hbvdna und and alt normal.do you have family history of hcc?
i'd ask studyforhope opinion treat/not treat he is immensely more expert than me

BCP (T1762/A1764) this definitely requires treatment with genotype C, too increased liver cancer


Avatar universal

http://onlinelibrary.wiley.com/doi/10.1002/jmv.20175/abstract

Keywords:
HBV in Vietnam;HBV variant;corepromoter and precore mutant of HBV;HBV genotype
Abstract
In Asia, genotypes B and C are the most common genotypes of hepatitis B virus (HBV); and genotype C causes more severe liver disease. Core promoter/precore (CP/PC) mutants, known to be linked to these genotypes, could have an impact on the progression and severity of liver disease. Sera of 115 patients, including 39 acute and 76 chronic Vietnamese HBV infected patients, were tested for their liver profile, HBeAg, HBV genotypes, and HBV DNA level. Fragments of 282 nucleotides covering CP/PC were amplified, sequenced, and analysed. In the acute group, CP/PC mutants accounted for 38.4 and 25.6%, respectively. Genotype B was found to be predominant (74.3%, P < 0.05) and linked to the PC mutant (A1896) (P < 0.05). In the chronic group, CP/PC mutants accounted for 61.7 and 32.8%. CP mutants, especially the T1762/A1764 double mutant, were found to correlate with genotype C (81%, P < 0.001), liver cirrhosis, and hepatocellular carcinoma (P < 0.05). Therefore, genotype C in Vietnam, which carried high rate of C-1858 (70%), could play an important role in causing severe chronic liver disease. J. Med. Virol. 74:228–236, 2004. © 2004 Wiley-Liss, Inc.
Avatar universal
http://jvi.asm.org/cgi/reprint/78/16/8524.pdf


Basal Core Promoter and Precore Mutations in the Hepatitis B Virus
Genome Enhance Replication Efficacy of
Lamivudine-Resistant Mutant
Avatar universal
is this core or polimerase?

this looks polimerase mutants but they are too many, please ask studyforhope because i have these mutants reported differently at my hospital and i dont want to say uncorrect things.if all these are polimerase mutants i think it is best to use tenofovir+entecavir to be absolutely sure against any resistance or therapy failure

V 173 ---------wild type--- weakly intensity--- low
L180/A181---wild type--- strongly intensity--- high
N236 ---------wild type--- strongly intensity--- high
N236 ---------wild type--- strongly intensity--- high
T184  ---------wild type--- strongly intensity--- high
A194   ---------wild type--- strongly intensity--- high
S202  ---------wild type--- moderate intensity--- moderate
M250 ---------wild type--- moderate intensity--- moderate
Avatar universal

this is the way i usually see reports for polimerase:
rt q215q/s
rt N236
rt M250V

please report exactly all you have in the test report and ask studyforhope so that the best nuc can be chosen without any possibility of resistance
Avatar universal
Is there anyway that I can post a pdf file?
Avatar universal

email it to me then i check the polimerase positions or we ask studyforhope
Avatar universal
Avatar universal
4est
Thanks for the information.

stef2011
Thanks for your advice.
What's about peginterferon+etv+alinia+vitd3+heptec instead of tnf+heptec?
tnf reduces the bone density, right?   I have osteoporosis so this one might not be good for me. I know about side effects of peginterferon but may be I might have higher chance of cure???


Avatar universal

if you want to control hbv replication and no clearance, use only tnf+heptech
vitd3 and calcium can prevent osteoporosis and gcmaf might even cure it if your vdr is not ff/BB

if you want to clear hbsag, and i d try this one because you have about 2000iu/ml:
peginterferon+tnf+alinia+vitd3+simvastatin+heptec without fibroguard or no heptech

fibroguard lowers inflammation and in case you want to activate immune response by interferon it is better to keep inflammation too

entecavir may be used instead of tnf if you get sides on kidneys.as regards the combo of interferon+etv no clearance has been reported on the little clinical cases or trials available while interferon+tnf has many clinical cases and trials with hbsag clearance

Avatar universal
Thank , stef.
I'll discuss with my doctor here in my home country for peginterferon + tnf tx.
I'll post on different thread to let the other members know the higher risk genotype c has with bcp/cp mutants. May be studyforhope can comment on my results also for the knowledge of other members.
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