Starting IFN next month.

[mustthinkpositive]

Hi all,

I will be starting a mono IFN therapy in 5 weeks time. After deliberating about it for the last 6 months, I think I need to at least give it a try. I just missed the trial for IFN/TDF in FEB this year because my viral load was too low for this trial (one of the criteria).

Lastest blood test today confirm HBV DNA has increased from 200iu/ml (2 logs) to 20000iu/ml (4 logs) in 3 months. These are approx. numbers and I didn't ask for a print on the result. We don't measure HBsAg in this hospital, which is not good. HBV DNA fluctuating between these number for the last 12 months.

Latest ALT steady at 40, AST at 34, GGT 16, ALP 52 and Bilirubin at 7.

My history:
Last ETV pill was on Dec 2011. During this treatment (somewhere in between stopping), I convert from HbeAg-Positive to HBeAg-Negative, e-antibody negative to e-antibody positive. Doctor ask me to stop after approx. 18 months. It was not my choice. I think it's because my HBV DNA was UND for a few months and my ALT value was below 40.

[mustthinkpositive]

Any comment on people with IFN experience. How's the sides and is it well tolerated?

Thanks.

[Rome70]

Did you read the latest research on combo treatment?
http://www.journal-of-hepatology.eu/article/S0168-8278(12)00871-9/fulltext

Maybe you should start tnf first...

[stef2011]

i think youare followed by clowns, it is useless to use nucs and stop them, even hbeab is useless under nucs, you just go nowhere and will never clear hbv this way, plus your doctor just runined your possibility to clear hbv easier by being hbeag+ now you are probably precore or bcp mutant and only sequential treatment can cure you at very high rates

i think the best thing you can do is look for good liver specialist and start the sequential treatment which is the only one to cure hbv all the rest is just blah blah taking drugs for life and no cure at all, so i do suggest:

start tenofovir and keep it 1-2 years at least following your hbsag quantity
add on pegintf like most of us are doing here and indeed responding with some even clearing by 48weeks combo

by the way hbsag quantity was the only thing to know in advance if you could stop etv and was the only thing to tell you have to restart because:
hbsag less than 500iu/ml can be safe to stop nucs

a rise of hbsag when nucs are stopped reflects reactivation of replication and nucs can be started before hbvdna rises

[mustthinkpositive]

I want to do combo treatment but the Pharmaceutical scheme here does not sanction combo.

IFN therapy are finite 48-52 weeks. However, if I am not a responder, the docs said TDF is my next choice. I mention combo a few times during the appointment.

[mustthinkpositive]

I think so stef. I have seen 10 different doctors everytime I have an appointment. The doctors are always rotating at different hospitals.

I can't believe they told me that HBs Quant are not relevant. The way they talk is that they are not looking for a cure, but to micro manage the disease. I know we all here at the forum are looking for a cure.

The are some place here where I can get HBs Quant. I have to do some research.

[acquah]

sorry bro but this disease is such a stress.. i have it too.. many doctors seem to be giving wrong information about the tests all the time. they all have different views of tests they deem fit for my status.. in Ghana-Africa medical care is very very expensive.. consultation is just expensive so doctors here are making hell of monies without any adequate knowledge about the virus.. get a liver specialist and get some important test done.. i have no money for drugs and my status keeps degrading. i found it about a week ago that i have Urethra infection. i was asked to take tavanic  500mg but reading it online shows that that antibiotic can have a strong impact on the liver.. whether to proceed or not i dont know.. you see? the doctors have knowledge about my hepatitis b and constant detoriating of my liver but still placed me on a strong antibiotic like tavanic to cure my UTI... get a good doctor. i am ready for death because it keeps approaching

[stef2011]

you can try bluberries extract for that and probiotics, then if they dont work go for the antibiotic

also consider colloidal silver in correct doses, a study just presnted about silver conifrmed it can increase antibiotic response 1000folds even on resistance bacteria.silver is also toxic so the correct dose must be used

[mustthinkpositive]

Hi all,

After 2 shots of IFN, my blood test shows I am very low in WBC and neutrophils. My ALT has increased from 52 to 130. No measurement on viral load until the 4th week and as always, the Doc say HBsAg is not needed or available.

The Doc has suggested me decreasing the dose to 90mcg tonight and do another blood test next week before the 4th shot.

Any comment? Do any of you have such a decrease in WBC and neutrophils in the first few weeks?

[grmr]

yes I did... first shots have stronger impact on WBC then they will stabilize.. I had to reduce dose to 135mcg... what about platelets count?

[stef2011]

Any comment? Do any of you have such a decrease in WBC and neutrophils in the first few weeks?

fist of all the lowering dose is 130 and not 90, pegintf doesn t work already at 130, 90 may be totally useless

what are the numbers?they must be extremely low to change dose and before changing doses it is best to go for supplements and if they dont work go for drugs

without hbsag quant you will not know if you are responding and if it is best to stop at 24 weeks for non response....have you planned to sip blood sample to europe or india for hbsag testing?

[mustthinkpositive]

Not yet Stef. Because it will be costly and time consuming, I did not want to send blood sample overseas. Also, these sample will need to be done quite a few times over the course of treatment.

To grmr, I wasn't given any figures, just by word of mouth. I heard that neutrophils has decrease to a third of something. Also that it's quite common for this to happen so as I don't panic.

To Stef, I think the WBC and neutrophils were quite low. My ALT has increased quite a lot. Before that, it was between 40 and 67 for about 2 years.

All in all, I am just going to pray and hope everything is business as usual.

[stef2011]

Not yet Stef. Because it will be costly and time consuming, I did not want to send blood sample overseas. Also, these sample will need to be done quite a few times over the course of treatment.

hbsag quant is extremely cheap, it is 7euros here and i guess india is even cheaper, as to courier tnt is about 60-70€ from here to asia, you can use slow/economy because hbsag is very stable.it should not be expensive

I think the WBC and neutrophils were quite low.

WBC can get very low and no worries, even 3 or 2.5 is ok.neutrophiles are more important and as long as they are >0.5 you don t need to worry.platlets are also the most important you can keep full dose as long as they are not less than 25.000
of course expert doctor on pegintf therapy are needed because these numbers are quite lower than normal range but liver specialist very experienced on pegintf therapy know what is the range and the drugs to use in case neutrophils or plts get too low, the ignorant messed up....doctors/butchers make mess as soon as they see lowering numbers which is normal on pegintf or having an immune response...the lowering of plts, wbc and neutrophils mean these cells are gathering in the liver where the battle is

i do hope they will manage everything ok so that you ll clear, are you combo with etv?

[mustthinkpositive]

Thanks for the advise Stef.

No, this is a IFN mono. The hospital here don't do combo unless it's a trial. I just took the 90mcg (as my 3rd shots) as advised by the nurse this evening. Another blood test next week.

All in all, flu-like symptom the first week (the first 2 nights). Second week, didn't notice too much other than a badly executed injection and darker bruising. Still got bruise mark on the first 2 injection.

I guess all the signs are there for the immune response. High ALT and low WBC and neutrophils.

[Jeff912000]

There is no benefit to a combo.  Better to do sequential.  Save money too.  

[Jeff912000]

Best overlap 3 month though.  it takes IFN 3 month to start working.  you can fund your own treatment if you can afford it.  Though IFN is expensive.  tenofovir is cheaper.

[mustthinkpositive]

Hi all.....

Another blood test this week saw neutrophils gone up slightly (I think from the phone 0.33 to 0.48). Dr and Nurse has advise another 90mcg for the 4th shot.

[stef2011]

again i suggest to talk to them about the drugs to increase neutrophils instead of lowering pegintf because you ll have the same problem during the whole treatment

[veteranB]

Hi I wonder if 90mcg is a suffucient dose for us?

Why do 180? Isnt this hep c dose?.

[newtr]

pegintr-2b 80mcg for 60 kg.

[stef2011]

there have been trials with low dose even prolonged, failure....

[stef2011]

i should actually say they did trials with low dose prolong for 2 years or more and it was such a failure they will never try such a thing again.

i think it is ok to lower dose only if drugs to boost neutrophils or plts fail

[mustthinkpositive]

BTW, my weight is 64kg and height 170cm.

[calebz]

Good luck with your treatment.
Why won't those idiots just ship your blood sample along with those from clinical trials for the HBsAg quantity, they send it anyway for other trial people so whats the big deal ?

[mustthinkpositive]

Thanks Calebz.

Seems like they don't want to give you this false hope of clearing the virus. It's not their goal. Our goal is to clear it but their's is to control it.

We just have to pray that one day a cure is available with the likes of REP 9AC, GS 9620 and IFN.