Tyzeka

[manl]

My testing reports are as follows:
Hipatitis B Surface Antibody QL: Non-reactive
Hipatitis B core AB Total: Reactive
Hipatitis BE Antigen: Non-reactive
Hipatitis BE Antibody: Reactive
Hipatitis B Surface Antigen: Reactive
Hipatitis B Viral DNA
HEP B Viral DNA IU/ML: 213000
HEP B Viral DNA COPIES/ML: 589632
AST: 24 U/T
ALLT: 22 U/T
Alpha-Fetoprotien tumor marker: 2.2 ng/mL
Liver function: Normal
Liver ultrasound: normal

It is my understanding that the positive Hepatitis B Surface antigen means that the individual (me) is infected with the hepatitis B virus. However, not all hepatitis B infections are the same. Some infections are active (or replicating) and some are not active (non-replicating) Patients who do not have an active, replicating form of the virus are often said to be in a “carrier” state.

To figure out if you have a replicating or non-replicating hepatitis B infection, we usually check the markers of viral replication. These are the Hepatitis B “e” antigen (HBeAg) and the hepatitis B DNA. If both these tests are positive, they would suggest an individual has an active, replicating infection and they might be a candidate for treatment. If they are negative, they suggest the hepatitis B infection is not active and should not cause liver disease. These individual do not need to be treated, they do not respond to treatment and we do not treat these individuals although they need to be screened periodically for liver cancer which can arise in some patients with a chronic hepatitis B infection. Many patients who are HBsAg positive but not replicating often lose their infection spontaneously over time. Furthermore, individuals who have a non-replicating form of infection are still infectious to others.

I have HBeAg negative; but, Hepatitis B DNA positive.  Do I have an active, replicating infection?  Should I be a candidate for treatment?  Is Tyzeka a good treatment for me?

[lexman]

Yeah you have a mutant. Most likely precore, they run low. Your viral load is high but not that high. And since your enzymes seem to hold  in the normal range it looks like your viral load is stable. But you still need to treat it. Anything over 100,000 copies/ml needs to be treated. You can take Tyzeka, in fact that was my second choice after Entecavir. it is just from what I have been told by hepatologist's  I have seen that Entecavir is the most powerful out there. But again all these drugs are me too. And I bet you that after 4 or 5 years of been in real use there will be resistance and that is bad. Because then nothing takes it. So in that regard interferon is better.. no possibility of developing a super virus. It is just hard to take, and some people have such bad side effects that they are taken of treatment and there is about 50% chance of relapse after a year of hard time. But it is better then being forever on the nukes forever.

[stevenNYer]

Your DNA is high for an "inactive carrier", you may have a HepB mutant strain.  I would ask your doctor to do a genotyping test and to monitor the DNA count for a few months to know for sure.

If indeed it's an active chronic e-antigen negative HepB, so you may benefit from treatment because the goal of treatment is to supress the DNA.

Tyzeka is a newer antiviral drug so it's certainly an option.  Baraclude and Hepsera are widely prescribed for HepB.  Lamivudine should not be taken as a monotherapy anymore since it's resistance prone.  So talk to your doctor as to which may be best for you.  

Good luck.