Should I stop Hepsera?

[viet29]

I been taken Hepsera 10mg daily for 6 years now and the virus is undetected. Today my doctor told me to stop to see my body could suppress the virus it self. Should I stop or keep taken it? will my condition get worse? what if it didnt work and I take hepsera or viread and develop resistant? Help or personal experience would be great. Thank you

[viet29]

I google it but couldn't find the 2011 guidelines fro chronic hepatitis B

[stef2011]

2009 is too old, just check 2011 if you like

also guidelines are just general guidelines for ignorant doctors, very expert doctors are able to personalize treatment and this is the news in hbv and hcv treatment (of course 90% of doctors are not good at this)

[viet29]

http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/Chronic_Hep_B_Update_2009%208_24_2009.pdf

[viet29]

i just read this guideline for chronic hep B 2009.

"Among HBeAg-negative patients, viral suppression
was sustained in only 8% of patients who stopped adefovir after 1-year of treatment. The vast majority of patients who continued treatment up to 5 years maintained their response but there was minimal incremental response after the first year. HBsAg loss was observed in 5% of patients after 4-5 years of continued treatment. 206 In addition, long-term treatment was associated with a decrease in fibrosis score. Nonetheless,
3% of patients developed HCC indicating that longterm antiviral treatment does not completely prevent HCC. A preliminary report of 33 patients who had received adefovir for 4-5 years and had been followed up to 5 years off treatment showed that all patients had virologic relapse (redetection of serum HBV DNA) initially but 18 (55%) patients subsequently had sustained biochemical/virological remission and 9 of these 18 later lost HBsAg."
So doest this mean if i stop hepsera, I have 55% not need treatment or undetected HBV DNA and about 25% of HBsAg seroconversion to negative?

[stef2011]

carrier state is something from a decade ago it doean t exsist anymore and was a totally wrong thinking.
today we have, and only off therapy of course, inactive virus, which can be confirmed only by:
hbsag<500iu/ml
hbvdna<2000iu/ml
alt<30 men 19 woman
only for genotype D

inactive virus can reactivate any moment and just means there is an immune response which can be boosted by interferon to clear hbv very fast

only genotype D has been studied on large number of patients by brunetto pisa, some studies were done on genotype B and C in asia with less patients and hbsag level was around 100iu/ml if i remember correct.no studies on genotype A

so the word carrier state was used, without any study to prove its meaning, around 2000-2004, it can tbe used today and has no meaning.
also note that in those years there was no way to monitor closely liver damage, it was pure fantasy the fact doctors used to think hbeag neg was a good prognosis it is actually the opposite

brunetto in a congress made a story of all the mistakes done in the past of hbv, hopefully these mistakes are over

[viet29]

hey i just read one of the topic online indicate my lab work is  carrier states? it confuse:
Hsbag Positive
anti-hbs Negative
anti-hbc igm Negative
anti-hbc IgG+ igm Positive
hbeag Negative*
anti- hbe Positive
Chronic infection but low risk of liver damage — carrier state
I thought carrier state no treatment needed.
I remember 6 year ago, Hvb viral DNA
hep b viral dna iu/ml           12600
hep b viral dna copies/ml    204,932
I hate my doctor, I think he dont have updated information on treatment because he is a GI not hepatology.
http://labtestsonline.org/understanding/analytes/hepatitis-b/tab/test