The best place for treatment of Hepatitis is India

[brij116]

Hi,

If anyone can suggest me the best place for treatment of Hepatitis B in India? I have tried hard but could not find a hospital is specialised for such treatment.

[vijik]

no doctors seems to be well updated. Very updated hepatologist or medical gastroenterologist. try to find a doctor who attends all liver meetings or having friends attending lives congresses. And it is better the hospital which conduct clinical trials. Above all, keep follow the forum keenly and try to discuss with your doctor. Most prbably they wont hear you. You better discuss your tests here. If you are in delhi area go to the ILBS hospital. Fibro scan is available there.
Take care..

[brij116]

Thanks. Indeed, doctors do not hear. I have a feeling that there are no experts available in India for Hep B treatment. They have some idea but it seems there is no treatment protocol available with them.

I am 45 years old and Hep B +ve since last 10 years (at least). I visited CMC vellore 3 times and recently visiting Asian Institute of Gastroenterology, Hyderabad from last 1.5 years. But so far no medication has been started.

My test results are as follows:
HBVDNA Quantitative: 6603(IU/mL), 38429 copies/ml,
Total Biluribin             1.3 mg/dL (Normal 0.3-1.2)
SGPT (ALT)               47 U/L (Normal 0-40)
SGOST (AST)            35 U/L (Normal UPTO 40)

Can you suggest something based on my report.

[vijik]

you should check the hbsag quantification to know about the chances of eradicate the virus. The test is available in hitech labs chennai. And in ramakrishna hospital coimbatore. If it's low around 1500 iu/ml, you can try alinia (nitazoxanide). Also check vitamin d and cholesterol levels. See other posts here to understand how vitamin d and cholesterol interfere hbsag. Take care.

[vijik]

And considering your age, stefano would suggest you to go for antivirals. The reason for suggesting antivirals is it's better being undetectable to avoid HCC   and other consequences. Anyway before start them take hbsag first and post it here, stefano ll guide you. Asian Institute of
Gastroenterology, Hyderabad.
Do they have fibroscan there?

[stef2011]

in your case if fibroscan shows no relevat damage just monitor and see if our tries with alinia, gcmaf, interferon combos work.
as suggested hbsag quantity in iu/ml and fibroscan are necessary to know chances and if therapy is needed

nucs are suggested if:
liver fibrosis >7.1kpa or >f3
hbv mutations and genotypes with high risk hcc or family history hcc (see old posts for all mutations and genotypes)

interferon, alinia and possibly a nuc combo if:
hbsg less than 1500iu/ml
low or undetactable hbvdna
normal or high alt

nucs: only tenofovir and entecavir are safe after resistance test is done to be 100% safe even on these drugs.these drugs are useless on virus and can only stop liver damage or decrease hcc risk so a perfectly heathy liver has no need of these drugs

[brij116]

Thanks. I am not sure  whether Asian Institute of Gastroenterology, Hyderabad  has fibroscan, but they have Elastography test for liver (I do not know if it is the same test).

However, I will get the hbsag and fibroscan done and post you the results for your further views.

[brij116]

Thanks,

I will get the tests done and post the reports for your further views.

[LilHope2010]

Dr.Nageshwar Reddy of Asian Institute of gastroentology  is an expert in liver ailments...he should surely help you regarding the disease

[brij116]

But he is heading Medical Gastroenterology department

[brij116]

Can you suggest me some place in eastern region where fibroscan can be done.

[brij116]

Hi stef2011,

You are suggesting to start interferon, alinia and possibly a nuc combo if:
hbsg less than 1500iu/ml. (is it hbsg or hbsag?)

What if it is more than 1500iu/ml

[vijik]

sorry. I dont know about eastern region. If i come to know, ll inform you in the forum.

[anil789]

You NEED treatment for sure start with ENTECAVIR .....Consult Dr PN RAO in asian ..or Dr Mahesh goenka in Calcutta.



Regards

[brij116]

Thanks.
Dr. P N Rao is a hepatologist at AIG, I will consult him.

Simultaneously, I will get the tests done as suggest by vijik & stef2011 and post it for your further views.

[brij116]

Dear Stef, vijik,

I have booked an appointed on 5th of Sep for Fibroscan & Other tests at ILBS Delhi as suggested by you.
However, my recent report about HBVDNA Quantitative PCR has come which is showing, 10625(IU/mL).

Based on this report my doc is suggesting me to start BARACLUDE 0.5 mg once daily for one year.

Is it O.k. or shall I get the tests done before starting any medicine.

[stef2011]

hbvdna alone means nothing, that's not a good doctor at all if possible change with a more expert one

my sister had hbvdna over the detactable range (billions...) between jan and march after a stomach infection, researchers/doctors here suggested no therapy (i agreed too).hbvdna from march to june returned to 2 millions and now probably even lower.hbsag stayed about the same taking alinia.

this is to show you how your doctor is ignorant, there is no need to be a researcher to know hbvdna alone is meaningless, hbsag quant and liver damage are a must before chosing therapy

and even if so entecavir is not the best choice, tenofovir is more potent and safe

[stef2011]

by the way ask the doctor directly why are you pushing me on entecavir since it is useless on virus if we dont know if i have any damage.....

also your hbvdna is not that high

[brij116]

MANY THANKS.

I will get the Fibroscan & hbsag tests done and see a Hepatologist at ILBS, Delhi.

I will post you the results and his prescription before starting the medication.

Regards

[vijik]

If you see no liver damage in fibroscan you can stay away from entecavir for sure. Dont waste money for things that deteriorate your health.
What about ilbs.? How much they charge for fibroscan and other tests?
Thanks.

[raja1972]

please post the amount charged for fibroscan at ILBS

[brij116]

Dear vijik

Thanks a lot. You & Stef are a big help.

They will charge Rs.1000/- for Fibroscan, as they have told me over phone.

I have got an appointment at ILBS on 5th of September.  After my visit I will let you know the charges and all the other relevant details.


Regards and Thanks

[vijik]

Thank you. Post all results here in the forum. So other members, especially members from India in general and from north India in particular can use it.
Take care..

[brij116]

Dear stef, vijik

I have got the tests done at ILBS, New Delhi. They charged Rs. 1000/- each for Fibroscan & HBsAg Quantification.

The result of Fibroscan is as follows: Stiffness 4.0 KPa, Success rate - 61%.

The other blood test reports are yet to come. Once, I get these reports, I will post them for your views and advice.

I found many patients at ILBS, who are getting treatment for Hepatitis B. I also talked to a few them. They are getting better results and contented. The treatment protocol is similar to what you (Stef) has been advising. I will visit ILBS again on 16th Sept. to collect remaining reports.

Any comment on my Fibroscan report.

[stef2011]

The result of Fibroscan is as follows: Stiffness 4.0 KPa, Success rate - 61%.

perfectly healthy liver so treatment is not necessary but according to hbsag quant it is good to try to clear hbv by interferon combos