Stef11 help please

[SphereAj]

Hi Steff11
Sorry for reposting,  bet desperate to know more....

I am 46 (india)  my recent blood test showed up following (Done on 1st February 2016)
HBs Ag Reactive
HB E Antigen serum  Non reactive
HB Core Antibodies Total 11.340 Reactive
Viral load 6250
SGPT 140
SGOT 80
All else normal
Ultrasound normal
Upper GI normal

The doctor prescribed Entecavir 0. 5mg. I have not started taking the med yet

Just did a follow up (without any medication) for SGPT and SGOT on 12 February 2016 and results are
SGPT 69 (earlier 140)
SGOT 65 (earlier 80)

Should I wait for little longer,  repeat the tests and then decide to take entecavir treatment?

Please help me understand this,  is it chronic  or acute,  is it curable?

Thanks

[SphereAj]

Hi Jason
So did your doctor tell you?  He changed the medication or you stopped it completely?

[fernan_460]

don´t stop until at least one year. in this times the doctor not recommend stop the treatment.

[fernan_460]

If you can combine the entecavir with pegylated interferon, will be perfect. But first, make sure you do your blood tests, included blood count, quantitative of hbsag is diferent or viral load, viral quantitive is one and load viral is other.

[fernan_460]

excuse me I mean say. hbsag quantitive is one and load viral is other.

[SphereAj]

Hi Stef
Help again please
I started entecavir. Today was 3rd dose. Had some wiered headache today afternoon. Also felt strange little cold in palms. I had asked my doctor about any side effects of this drug and he said none serious. But today afternoon felt really strange,  could this be side effect of entecavir?  Can I stop this medicine till I  meet the doctor again in 4 days?  
Or is it dangerous to stop now?  

I cannot meet the doctor for 3 days as he is travelling.

Please help

[Jason_256]

Everybody is different but many people here including me had many side effects on Entecavir. Don't listen to your doctor when they say no serious side effects. It's only going to get worse...

[SphereAj]

Also I am experiencing some fatigue and muscle pain in the back and legs (not very severe,  but never had these symptoms)

[SphereAj]

Conversion factor : 1IU/ML = 1 Copy/ML

[SphereAj]

Correction in above post
Mistake : Logan Value
Correct : Log10 value is 3.88

[SphereAj]

Hi Stef

Today received HBsAg quantitative test result (is it really HBsAg quantitative?}

RESULT
Sample: Serum
Method: Real Time Polymerase Chain Reaction

Test Description
Hepatitis-B, DNA (Quantitative): 7622 IU/ML
Logan Value 3.88

All my blood test done on 1 February are....

HBs Ag Reactive
HB E Antigen serum  Non reactive
HB Core Antibodies Total 11.340
Viral load 6250
SGPT 140
SGOT 80
All else normal
Ultrasound normal
Upper GI normal

SGPT 69 SGOT 65 as on 12 February 2016.

Stef do you recommend tdf?  Doctor does not no this quantitative test (he never asked for it), based on earlier report he has prescribed Entecavir 0. 5mg for 6 months.

[SphereAj]

You mean I should start with entecavir and vitamin D3 supplement?
Thanks again

[stef2011]

Do you mean yes to Fibroscan test and vitamin D deficiency test?

yes

1.. Should I wait and not jump into Entecavir treatment (prescribed by the doctor based on above report) ?

to me waiting makes no sense and just liver damage over the years in case of active replication, since tdf will clear the infection over 1 or 2 decades i dont see why wait

2. Is this single test conclusive that I have Chronic hepatitis b?
yes

alt are not that useful now for you and since also nucs will slowly cure hbv i do for it if doctor prescribed it

[SphereAj]

Hi Steff
My vitamin D report
25 OH Vitamin D (total)  Technology C. L. I.  A  is 9.41ng/ml
<20 ng/ml is high deficiency.

Please suggest good brand Vitamin D3 to buy in India

[SphereAj]

Hi Stef Thanks for replying
You said yes to both questions,  which ones?  
Do you mean yes to Fibroscan test and vitamin D deficiency test?
1.. Should I wait and not jump into Entecavir treatment (prescribed by the doctor based on above report) ?
2. Is this single test conclusive that I have Chronic hepatitis b?
3. My SGPT and SGOT dropped down from 140 to 69 and 80 to 65 respectively without any medication. Is this normal?

Thanks and Regards

[stef2011]

yes to both questions

[Aduiski]

I am actually sorry for jumping in this tread, as you originally invited steff to answer the questions.

Steff, please don't let my answers cause you not to answer :)

[SphereAj]

Thanks Aduiski
I will get it done

[Aduiski]

Ultrasound isn't very good for seeing fibrosis, yes you need a fibroscan even if you have to travel I would do it.

[SphereAj]

Hi Aduiski
My Ultrasound says liver normal,  echo texture normal, do you still recommend Fibroscan?  I do not have immediate access to Fibroscan test facility

Should I do vitamin D deficiency test?  
My diet is vegetarian, I consume homemade curd (yogurt) regularly

[Aduiski]

I don't know anything about that medicine.
If you decide to try it let us know if it worked or not.

[SphereAj]

I can see an advertisement of Dr.  N D Sharma of ND ayurveda just below the post comment button on this forum :-)    I have their medications with me (not using)

[SphereAj]

But can sgpt and sgot reduce on its own??
I also have two ayurvedic medicines with me right now,  not using (one source of these medicines ND Ayurveda has said that I can see results in a month by doing follow up tests,  they claim that many people have cleared their chronic hepB with their medication but are not sharing patient contact details, so that I can verify, the other source also does not have any testimonies)

[SphereAj]

Thanks a ton Aduiski
Will follow your suggestions

[Aduiski]

I wouldn't start with treatment right away, few months of waiting shouldn't cause you harm.
You need to do following tests:
- Fibroscan (to check whether there is any liver damage currently, if there is damage then you might decide start with treatment right away, if no significant damage you would be better to wait 3 months and test your SGPT and SGOT again)
- Hbsag Quantitative (this test needs to be done in IU/ml)
- while you are taking blood go and test your Hep B genotype as well

If your fibroscan is OK, then you can wait 3 months and retest SGPT and SGOT, to see their state. It might be that the elevation of ALT was only a temporary one, but it might be also not.

If fibroscan shows > 6 kPa then, on your place, I would start with treatment right away. In this case you would need to decide on the treatment option: entecavir, tenofovir, peg-interferon

[Aduiski]

keep up with the healthy lifestyle..that will help your liver....and get into coffee drinking if you aren't yet, as at least 2 coffee intakes per day have shown to reduce chances of liver cancer by 40%. Avoid saturated fat and eat daily fresh vegetables and fruits. Check your vitamin D levels...as most chronic hep B people are very low with it.

[Aduiski]

make sure to closely follow the virus as your ALT was recently 140 which was very high.

[SphereAj]

Hi Aduiski
Doctor says it's not very old,  maybe a year or so.
I am on medication for Hypertension since one and half year-tablet called Benitec (olmesartan) . No weight lifting. I only do cycling. I don't have any earlier SGPT and SGOT results (never done any liver function tests earlier).  I am confused about drop in SGPT and SGOT in just 12 days without any medication.  

[Aduiski]

Based on what he said it is a not very old? It usually takes number of years to become hbeag negative which you are currently. Aditionaly, virtually all healthy adults don't become chronic carriers.

[Aduiski]

Or did recently weight lifting?

[Aduiski]

Also, were u on any recent medications?

[Aduiski]

You got hep b probably as a child, at birth from your mom, or trough some earlier (not very recent like 2015) medical procedure....like most of us.

Would u happen to have any other, older sgpt and sgot results?