I started treatment with test results in normal ranges, because I couldn't take any unnecessary risks. You will never know what will happen.
TEST RESULTS:
-- Cholesterol usually less than 200, but sometimes above normal (219).
-- Triglycerides: sometimes elevated, but mostly just under 150
-- Vitamin D: Low until 2016 when I started to take Vit D (Thanks to a posting I read by Stef!)
-- Glucose: Normal
-- RDW: Always slightly above normal
-- HBeAb: Positive/Reactive
-- HBsAg: Positive
-- HBeAg: Negative
-- HBV Genotype: A
-- BCP Mutations: G1764A/G
-- MRI Elastrographies: Normal & unremarkable (Dr. says my size prohibits use of Fibroscan, and I do not want liver biopsy)
-- Ultrasounds: Normal & unremarkable
-- AFP: Always within normal range
-- Aside for numbers below, other results normal (e.g., albumin, ALK Phos, Bilirubin, B12 levels)
HBV
DNA HBV
Quant DNA
Year-MM (IU/mL) (log10) AFP ALT AST
2007-08 ---------- ------ ---- 23 21
2011-07 ---------- ------ ---- 20 22
2011-08 ---------- ------ ---- 23 24
2011-10 ---------- ------ ---- 21 23
2011-11 8,930 3.95 ---- 24 25
2012-06 15,000 ------ 4.9 26 21
2013-05 32,300 ------ 2.3 44 31
2013-12 --------- ------ ---- 29 30
2014-01 84,800 4.93 1.9 40 29
2014-03a 42,276 4.63 2.6 31 27
2014-03b 92,500 ------ 3.2 30 24
2014-10 --------- ------ ---- 19 17
2015-07 2,174,976 6.34 ---- 211 123
2015-10 3,444 3.54 3.6 19 25
2015-11 --------- ------ ---- 21 21
2016-04 4,030 3.61 3.0 19 20
2016-10 7,929 3.90 2.6 17 18
2017-05 39,718 4.60 3.5 23 24
Hep dr. has wanted me to start treatment for 3 yrs and wants me to start on Vemlidy (TAF). I understand the benefits that make TAF preferred over (e.g.) TDF and Entecavir.
I respect my hep doctor VERY much (though I was surprised when dr. and associate dr. ask me for reason why I take Milk Thistle, Vitamins D & E, Turmeric, Selenium).
MY CONCERNS:
-- Dr. says I would have to take anti-viral drug for life
-- I realize all drugs come w/ warnings & risk of side effects. Primarily for me are the Vemlidy/TAF side effects I've read re: weight gain around waist & back; increased bad cholesterol (up as much as 22%) noted for some; increased triglycerides for some; cough. If I start taking TAF, I don't want to have to start to take other drugs to address raised cholesterol/triglycerides levels, & it's not good for me to gain more weight.
-- I read documentation that states risk of some known TAF side effects are greater for women, and for those that are obese.
-- Perhaps least concern when one is considering health, but cost in US is $1,200 for 30 tablets. There is no news yet as to when less expensive Vemildy generic will be available.
-- Various available documentation indicates that for HBeAg Negative patients, treatment should be started if ALT>2x Upper Level of Normal (ULN) *and* HBV DNA Viral load > 20,000. (My dr. has said ALT criteria of > 2xULN is too high.)
I know that by not starting treatment, my liver may (or perhaps may not) be "rusting" even though it is not apparent -- but I keep hoping that, having lived w/ this for 60 yrs, maybe it's safe to wait few more yrs until drug that cures HepB (like Harvoni/Slovadi for HepC) is finally available.
For some reason, portions of Test Results and Concerns sections I pasted in orig above disappeared when I hit SUBMIT. I will try to post again here:
TEST RESULTS:
-- Cholesterol usually 2x Upper Level of Normal (ULN) *and* HBV DNA Viral load > 20,000. (My dr. has said ALT criteria of > 2xULN is too high.)
I know that by not starting treatment, my liver may (or perhaps may not) be "rusting" even though it is not apparent -- but I keep hoping that, having lived w/ this for 60 yrs, maybe it's safe to wait few more yrs until drug that cures HepB (like Harvoni/Slovadi for HepC) is finally available.