Smoking and drinking

[Peteshine]

Hey guys,

How has everyone been? Sorry i haven't been commenting recently but once again my new role at J P and my other duties are taking a toll on my timetable. I have been doing and feeling very well... I have managed to read most of the threads from my last read, some very interesting articles and nice to see some new and 'younger members' on this forum as well. Welcome Sylvanat (think i have spelt that right)...

There has been a regular question buzzing in my head which is the title above. So obviously alcohol hurts the liver as the liver breaks down both food and drink in our bodies right... Alcohol agrevates the liver enzymes which in turn causes a wekaness in our virus fighters.... Have i got this bit right? All i know is alcohol isn't good for the liver regardless of whether one has HBV or not..... It leads to liver problems in the future etc....

Ok... so how comes we are also advised not to smoke either? Right i know Smoking causes lung cancer and other forms of cancer but how is it directly as bad as acohol to the liver?

Right i lied: I have one more question for the vets here: I was told my v/load from my liver biopsy showed 1,337,000U/L
when i originally found out i had HBV.... Went onto Interferon and unfotunately did not find out what my VL was when i stopped a year later... I am now on combo treatment :- adevori + Lumuvudine.... I recently had another blood test showing my ALT was down to 47 (90+ before) and my VL was actuallyonly 638U/L.... My question is: Obviously this shows the treatment is gradually reducing the virus replicating..... but is it normal for such a jump down when going combo treating? I mean to jump from million to thousands already is a feat right? How bout from mill to literally hundreds? I just don't get it....

Steven, Zelly and Caj.... Hope you lot are well too.

Thanks once again for all your inputs...

[zellyf]

Due to the unpredictable nature of HBV there are no studies or numbers that can answer these questions for you.  You can live a perfectly healthy lifestyle and still get liver cancer with HBV.  That's the stark reality.  I don't think you need to be very well-versed in the biology of cancer to understand the impact that drinking and smoking could have.  You're the only one who can decide if the risk is worth it.  You're the only one who can know if you'll be at peace with your decisions given the possibilities.

[cajim]

Are you relaxed more if drinking consistently has a higher risk of liver damage than smoking consistently?

Maybe your quest should be for the answer to how to stop hurting your liver intentionally when you know it is trying so hard dealing with HBV and giving you your good life.

[Peteshine]

So is there a higher risk of liver damage to those who only smoke (consistently) compared to those who only drink (copnsisently)?

[zellyf]

Cigarette smoking deliver toxins (carcinogenic ones) to the bloodstream which have to filtered out by, guess who?  That's right, me, your liver.  

[Ann8]

Yr 1-year interferon treatment should help to decrease the VL to a low level and then you continue with the combo which continue to push down the VL to your current level. If you look back, you have been on medication for 1year+ which I think it's normal and you have to continue to monitor your VL to probably UND vs current detectable level. Mono has been very effective in reducing the VL to UND level. Combo will give you extra assurance on the drug resistance......no so much on reducing the VL.  

[cajim]

This study "Hepatitis B virus DNA levels at week 4 of lamivudine treatment predict the 5-year ideal response," Yuen MF et al, Hepatology. 2007 Nov 20;46(6):1695-1703 concluded that if your VL can achieve the ideal response [HBV DNA level < 2000 copies/mL (400 IU/mL)] at week 4, then your chance of HBeAg seroconversion, normal alanine aminotransferase levels, and absence of tyrosine-methionine-aspartate-aspartate (YMDD) mutations] at year 5 is best.

Also, part of your combo treatment, lamivudine, is known to be very effective in quickly bring down VL.

[Peteshine]

Hello,

Actually, Adevifor + Lamuvudine were the only options given to me at that time... In the UK, i don't think entecavir + tenofovir is frequently used....I only recently got a posting in regards to what combo-treatments were the most effective and was gonna mention (ask) my hepitologist the reason why i wasn't put on the latter.... The main question here tho was whether it is normal for one to decrease so much in VL in the spate of a few months....

[cajim]

May I ask the reason for Adevori + Lumuvudine combo treatment?  Is it correct entecavir + tenofovir are stronger in potency against resistance?

[cajim]

The faster the suppression of the viral load to UND, the better the prognosis of your treatment.  After you have reached UND or <105U/L, you need to monitor regularly your VL.  If it stays UND, you are fine; otherwise your doctor needs to consider adding or switching to deal with the resistance.

Glad to see your posting again.