Aa
Treatment options
Hi all,
I was diagnosed with Hepatitis B over 10 years ago and was confirmed to have chronic Hep B. During the same test I also found out I've got very high cholesterol (almost 2 x ULN). Since then, I've monitored my LFT roughly every 6 months as I am taking cholesterol medication. ALT has hovered around 110%-130% ULN and AST within ULN for the past 10 years.
3 months ago, the virus became very active. My results history:
23 Apr 2011
ALT: 152
AST: 65
26 May 2011
ALT: 242
AST: 134
10 Jun 2011
ALT: 364
AST: 143
17 Jun 2011
ALT: 397
AST: 161
GGT: 69
21 Jun 2011
ALT: 482
AST: 175
GGT: 73
HBV DNA >1.70 e+8 (IU/mL), the date of this test was 10 Feb 2011 and it's the only one I've got. I will ask for this test next week.
HBV Genotype A-1
Liver biopsy performed 25 June 2011 and the results were Portal activity - 3, Lobular activity - 2, Fibrosis - 1
METAVIR activity grade A2, Fibrosis state F1 (portal fibrosis without septa)
I am 29 years old, born in Taiwan, moved to Australia 20 years ago.
My liver specialist's first option for treatment is to go on trial for BMS's Peg-Interferon Lambda test. She's told me the success rate is only 1/3 but has a finite 48 weeks treatment period. I asked her about oral treatments but she said I might have to take the tablets everyday for the rest of my life. I have not started treatment because I am still searching for the optimal option.
For the past 3 weeks, I've been taking Chinese herbal medicine twice daily plus high dose of milk thistle to protect my liver. Last week (9 July 2011) my LFT results improved:
ALT: 265
AST: 97
GGT: 67
I am booked to see another specialist in 4 weeks time. I know I should to start treatment asap.
Two weeks ago, I was learning towards combined oral (Baraclude or Viread) treatment with Peg-Interferon. But the Australian government only supports mono-treatment.
At the moment, I am leaning towards getting interferon (Peg-A) to give my body a chance to fight the virus on its own. Hopefully this will achieve seroconversion from HBVeAg+ and HBVeAb- to HBVeAg- and HBVeAb+.
I don't think I'll take the Peg-Interferon Lambda trial as it's a strict mono-treatment.
I am also intrigued to take Alinia with Interferon (Peg-A) for possible (albeit very slim) chance of eliminating HBVsAg.
Please, any suggestions would be much appreciated. Thanks in advance.
I was diagnosed with Hepatitis B over 10 years ago and was confirmed to have chronic Hep B. During the same test I also found out I've got very high cholesterol (almost 2 x ULN). Since then, I've monitored my LFT roughly every 6 months as I am taking cholesterol medication. ALT has hovered around 110%-130% ULN and AST within ULN for the past 10 years.
3 months ago, the virus became very active. My results history:
23 Apr 2011
ALT: 152
AST: 65
26 May 2011
ALT: 242
AST: 134
10 Jun 2011
ALT: 364
AST: 143
17 Jun 2011
ALT: 397
AST: 161
GGT: 69
21 Jun 2011
ALT: 482
AST: 175
GGT: 73
HBV DNA >1.70 e+8 (IU/mL), the date of this test was 10 Feb 2011 and it's the only one I've got. I will ask for this test next week.
HBV Genotype A-1
Liver biopsy performed 25 June 2011 and the results were Portal activity - 3, Lobular activity - 2, Fibrosis - 1
METAVIR activity grade A2, Fibrosis state F1 (portal fibrosis without septa)
I am 29 years old, born in Taiwan, moved to Australia 20 years ago.
My liver specialist's first option for treatment is to go on trial for BMS's Peg-Interferon Lambda test. She's told me the success rate is only 1/3 but has a finite 48 weeks treatment period. I asked her about oral treatments but she said I might have to take the tablets everyday for the rest of my life. I have not started treatment because I am still searching for the optimal option.
For the past 3 weeks, I've been taking Chinese herbal medicine twice daily plus high dose of milk thistle to protect my liver. Last week (9 July 2011) my LFT results improved:
ALT: 265
AST: 97
GGT: 67
I am booked to see another specialist in 4 weeks time. I know I should to start treatment asap.
Two weeks ago, I was learning towards combined oral (Baraclude or Viread) treatment with Peg-Interferon. But the Australian government only supports mono-treatment.
At the moment, I am leaning towards getting interferon (Peg-A) to give my body a chance to fight the virus on its own. Hopefully this will achieve seroconversion from HBVeAg+ and HBVeAb- to HBVeAg- and HBVeAb+.
I don't think I'll take the Peg-Interferon Lambda trial as it's a strict mono-treatment.
I am also intrigued to take Alinia with Interferon (Peg-A) for possible (albeit very slim) chance of eliminating HBVsAg.
Please, any suggestions would be much appreciated. Thanks in advance.
Male patients are not allowed to take interferon if their partner is pregnant because they don't want to get into a situation where if the baby is lost, patient might relate it to the treatment. I didn't probe them on how silly that sounds. I don't like this as my wife and I are planning to have more kids.
I haven't told my doctors about chinese meds, I know they will disapprove it and ask me to stop using it. One can put down my recent improved LFT results down to chance or it could be from using chinese meds. Either way, it's short term until I go on western meds.
At the moment, I am monitored fortnightly just in case my LFT flares again, if so I'd have to start oral treatment asap.
I am beginning to understand more and more what each of the numbers mean. I've learned a lot more from this community than from my specialist. They are far too busy to give me the attention and not enough question time that I would like.
I haven't told my doctors about chinese meds, I know they will disapprove it and ask me to stop using it. One can put down my recent improved LFT results down to chance or it could be from using chinese meds. Either way, it's short term until I go on western meds.
At the moment, I am monitored fortnightly just in case my LFT flares again, if so I'd have to start oral treatment asap.
I am beginning to understand more and more what each of the numbers mean. I've learned a lot more from this community than from my specialist. They are far too busy to give me the attention and not enough question time that I would like.
I find it weird that you are not eligible for any Interferon treatments whilst your wife is pregnant. It is like you are not allowed to have a cold whilst she is having a baby. I am sure it is for non-medical reason, would appreciate if you ask your specialists why.
Once you are on a clinical trial, you are not allowed to take any other medications without approval, otherwise it will simply destroy the validity of your result in the trial.
I am not sure that it has been clinically proven that the herbs protect your liver. It is widely used in China, so I can't comment. You should inform your doctors what you are taking before starting treatment or going on a trial.
I am not sure why you need to test every two weeks. At you say in your biopsy report, your liver is in stage 1, which is pretty good. If you want to experiment with various combinations, make sure you know how to monitor your progress. Currently HBsAg quantity assay is not available in Australia and you need a prescription to do all the testings. So make sure you have a GP that will work with you. I don't think any specialists will.
Sorry to be such a pain, but you must ask questions. Stef2011 is different, he knows more than your average doctors about Hepatitis B and he knows what all the numbers mean.
Once you are on a clinical trial, you are not allowed to take any other medications without approval, otherwise it will simply destroy the validity of your result in the trial.
I am not sure that it has been clinically proven that the herbs protect your liver. It is widely used in China, so I can't comment. You should inform your doctors what you are taking before starting treatment or going on a trial.
I am not sure why you need to test every two weeks. At you say in your biopsy report, your liver is in stage 1, which is pretty good. If you want to experiment with various combinations, make sure you know how to monitor your progress. Currently HBsAg quantity assay is not available in Australia and you need a prescription to do all the testings. So make sure you have a GP that will work with you. I don't think any specialists will.
Sorry to be such a pain, but you must ask questions. Stef2011 is different, he knows more than your average doctors about Hepatitis B and he knows what all the numbers mean.
Just found out that I am not eligible to receive any form of interferon treatment (lambda or alpha) whilst my wife is pregnant. I am not sure if the same rules apply outside Australia.
She is due in two months, during which I must continue to test ALT and AST and start oral treatment if figures go up.
I was told there is going to be a new trial which will probably open in 3 months. The trial is combined tenofovir and interferon. I will probably wait for that.
She is due in two months, during which I must continue to test ALT and AST and start oral treatment if figures go up.
I was told there is going to be a new trial which will probably open in 3 months. The trial is combined tenofovir and interferon. I will probably wait for that.
Thanks for your suggested pre-treatment, it seems so obvious to prepare my body to get it into a condition that favours interferon. I wonder why medical professionals here haven't suggested cholesterol and vitamin D levels in the fight against HBV.
I will try and get fortnightly blood tests on LFT, lipids, vitamin D, HBVDNA, HBVsAg qty, HBVeAg qty and IgM HBcAb during treatment. And also report back to this community.
I will try and get fortnightly blood tests on LFT, lipids, vitamin D, HBVDNA, HBVsAg qty, HBVeAg qty and IgM HBcAb during treatment. And also report back to this community.
I am currently using chinese meds and milk thistle to protect the liver from further damage. Like you said, it's short term until I go on western treatment.
I'll ask my GP if she will actively monitor my progress through fortnightly blood tests.
At the moment, I am still thinking of not taking Lambda trial so I am open to co-treatment.
I don't want to be selfish to go on trial to receiver the newer drug and cheat by getting additional treatment. This will not help the study and Hep B community.
I'll ask my GP if she will actively monitor my progress through fortnightly blood tests.
At the moment, I am still thinking of not taking Lambda trial so I am open to co-treatment.
I don't want to be selfish to go on trial to receiver the newer drug and cheat by getting additional treatment. This will not help the study and Hep B community.
he started with the worst situation for interferon, such high hbvdna and hbsag have no hope on interferon mono anyway addition of alinia reversed anything
i think that as shown on hcv trials alinia is able to restore interferon response and improve it, this is something we do need on hbv treatments because hbv can stop both our body natural interferon and the injected interferon and make it totally useless
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