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Review with Doctor after 16 weeks on TDF
Hi HepB community,
Tomorrow I will see my doctor after 16 weeks treatment on TDF. I have also been taking Vitamin D3 10,000 IU, though my infections disease doctor do not recommend. We will review the latest blood lab results taken last week. What should I be concerned with and what are questions I should have for my doctor tomorrow?
My HepB serologies:
HBVeAG: reactive
HBVeAb: non-reactive
11/2011 HBV DNA PCR: > 8.2 log IU,
11/2011 HBV DNA IU: > 170,000,000 IU/mL, ALT: 250
04/2011 HBV DNA IU: > 110,000,000 IU/mL, ALT: 215
09/2010 HBV DNA IU: > 110,000,000 IU/mL, ALT: 245
12/2009 HBV DNA IU: > 110,000,000 IU/mL, ALT: 235
05/2009 HBV DNA IU: 1,740,000 IU/mL, ALT: 123
11/2008 HBV DNA IU: 98,400 IU/mL, ALT: 1280
Tomorrow I will see my doctor after 16 weeks treatment on TDF. I have also been taking Vitamin D3 10,000 IU, though my infections disease doctor do not recommend. We will review the latest blood lab results taken last week. What should I be concerned with and what are questions I should have for my doctor tomorrow?
My HepB serologies:
HBVeAG: reactive
HBVeAb: non-reactive
11/2011 HBV DNA PCR: > 8.2 log IU,
11/2011 HBV DNA IU: > 170,000,000 IU/mL, ALT: 250
04/2011 HBV DNA IU: > 110,000,000 IU/mL, ALT: 215
09/2010 HBV DNA IU: > 110,000,000 IU/mL, ALT: 245
12/2009 HBV DNA IU: > 110,000,000 IU/mL, ALT: 235
05/2009 HBV DNA IU: 1,740,000 IU/mL, ALT: 123
11/2008 HBV DNA IU: 98,400 IU/mL, ALT: 1280
do not look US guidelines only or avoid them directly, they are shaped on drug makers/insurance preference and obsolete on some matters
the most reliable are the european ones, then the asians and last US, anyway ultrasound is required on all guidlines
ultrasound is a must for liver cancer managment, if you do develop a liver cancer it gets non treatable by 6 months.if insurance pays for it that is a must, it is also on all guidelines to do it every 6 months
The doctor thinks that there is no purpose in doing the ultrasound and the results does not change the current tdf treatment plan. He said there is no guidelines on requiring ultrasound scan while on treatment. I'm believe ultrasound should still be good to check, I am looking for the guidelines and see if ultrasound is necessary while on treatment.
Does anyone know the USA approved guidelines on whether ultrasound is necessary while on antiviral treatment?
Does anyone know the USA approved guidelines on whether ultrasound is necessary while on antiviral treatment?
"Considering i'm already on TDF treatment, should I still try to get my HBV genotype now? Would it be useful to know it? "
You should have done your genotyping when your viral load was >8.2 log IU. It cannot be done now when your hbvdna is practically UND.
Congrats on your quick response to treatment. But I don't quite understand your dr's decision not to do ultrasound. It's a simple procedure--no radiation, no contrast agent, non-invasive. If your insurance pays for it, once a year ultrasound is not really that much to ask for, IMO. Maybe other more knowledgable members have different opinion.
You should have done your genotyping when your viral load was >8.2 log IU. It cannot be done now when your hbvdna is practically UND.
Congrats on your quick response to treatment. But I don't quite understand your dr's decision not to do ultrasound. It's a simple procedure--no radiation, no contrast agent, non-invasive. If your insurance pays for it, once a year ultrasound is not really that much to ask for, IMO. Maybe other more knowledgable members have different opinion.
that s a very fast decline from such a high hbvdna, some have to take combo etv+tdf to get results at these high ranges in 6 months
do keep vit d3 because it may be the reason but monitor serum calcium and vit d level monthly at first and then go every 3 months once you reach a balance, vitd25oh 80ng/ml would be the best level and calcium less than 10.5-11 according to tests
Here are my new results for 05/2012
HBV DNA PCR: 1.6 log IU
HBV DNA IU: 37 IU/mL
HBV DNA Intrp: Detected
AST: 38 ALT: 34
CREAT: 0.8 mg/dL
Calcium: 9.5 mg/dL
ADJ Calcium: 9.5 mg/dL
The hbvDna drop to 37 iu/ml from 170,000,000 iu/mL and AST & ALT also dropped to normal range. I learned from here these are not very accurate analysis for liver damage, but do these change mean much? What do you think?
I've requested for ultrasound but my doctor believe there is not purpose for this since I'm already on TDF treatment. He did not approve my request for ultrasound. He would recommend only do ultrasound at age older than 40 for me. What do you think, is this right?
Considering i'm already on TDF treatment, should I still try to get my HBV genotype now? Would it be useful to know it?
My doctor is following standard treatment for short term and only approve TDF mono for now, he is afraid of interferon add-on due to his previous patient died from using interferon. He thinks I will be on TDF for life until maybe the next Gilead drug comes out for cure. This is to keep HBVDNA undetectable and will prevent liver cancer/failure. I don't want to be on anti-viral drugs for life because unknown life long complications on drugs so my ultimate plan is to clear HBV for good. What should my next steps be?
Thank you in advance for the help!
HBV DNA PCR: 1.6 log IU
HBV DNA IU: 37 IU/mL
HBV DNA Intrp: Detected
AST: 38 ALT: 34
CREAT: 0.8 mg/dL
Calcium: 9.5 mg/dL
ADJ Calcium: 9.5 mg/dL
The hbvDna drop to 37 iu/ml from 170,000,000 iu/mL and AST & ALT also dropped to normal range. I learned from here these are not very accurate analysis for liver damage, but do these change mean much? What do you think?
I've requested for ultrasound but my doctor believe there is not purpose for this since I'm already on TDF treatment. He did not approve my request for ultrasound. He would recommend only do ultrasound at age older than 40 for me. What do you think, is this right?
Considering i'm already on TDF treatment, should I still try to get my HBV genotype now? Would it be useful to know it?
My doctor is following standard treatment for short term and only approve TDF mono for now, he is afraid of interferon add-on due to his previous patient died from using interferon. He thinks I will be on TDF for life until maybe the next Gilead drug comes out for cure. This is to keep HBVDNA undetectable and will prevent liver cancer/failure. I don't want to be on anti-viral drugs for life because unknown life long complications on drugs so my ultimate plan is to clear HBV for good. What should my next steps be?
Thank you in advance for the help!
I will get a copy of the results tomorrow. Though without the results and are there questions I should bring tomorrow to my doctor?
In the mean while I'm brushing up on latest on HepB in this forum.
In the mean while I'm brushing up on latest on HepB in this forum.
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