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Avatar universal

Urgent Advise for Entecavir Usage

Dear Friends,

I am a chronic Hepatitis B patient (29 male from Turkey) and I need your help for the medicine (Barclude 0.5mg) usage schedule and some suggestions (if you have).

Before you answer, I would like to share my story and my daily life.

I learned that I am a chronic Hepatitis B patient in last day of July 2013 after the Elisa test for the marriage (I got married in September). I was shocked because I have a fit body, eat quality foods, and I do not have any illness or discomfort.

Then I have done some test including HBV DNA. The results are;

HBSAG: 492
HBEAG: 882
ALT: 86 (it should be 15-60 for healties)
BILIRUBIN: Normal
ALBUMIN: Normal
HBV DNA: over 170 millions (could not be counted. It is may be over billions)
ULTRASOUND: TOTALLY NORMAL

Then after 2 months later I have been done biopsy. The results were not good:

FIBROSIS: stage 3
HAI: phase 11

My doctor is one of the leading professors on Hepatitis B in the world. He and his assistant started treatment with Baraclude 0.5mg (Entecavir) 2 days ago. I will buy the medicine and start taking today. My doctor told me that it does not differ that what time I take the medicine. The only important think is that I should take it everyday in the same time.

My main question is “ At what time should I take the medicine for the best results? ”. I need the suggestions of Hepatitis B patients using Baraclude.

I know it differs for everybody because everybody has different daily life routine. So, before write your answers please read below and see my daily life routine and the natural supplements for Hepatitis B.

MORNING
07:00 am ; eat one dessert spoon of black seed (nigella sativa) with honey and continue sleeping
08:00 am ; eat one dessert spoon of honey-royal jelly-propolis-bee pollen mix and continue sleepig
08:45 am ; wake up and breakfast (bread+white cheese+juice) plus garlic
09:30 am ; start working (by computer in my office)

NOON
12:00 am ; lunch (with vegetables and a little bit meat)
13:00 pm ; start working (by computer in my office)

AFTERNOON
16:00 pm ; a little bit junk food (such as; biscuit)
17:30 pm; stop working

EVENING
18:30 pm ; at home
18:45 pm ; dinner (with vegetables or fish ) plus garlic
19:30 pm ; fitness (15min treadmill and 7 exercises OR swimming )
21:30 pm ; stop fitness

NIGHT
22:00 pm; at home, watch TV (or internet surfing), and eat some fruit
23:00 pm; take natural turmeric (curcuma longa)
23:30 pm; eat one dessert spoon of honey-royal jelly-propolis-bee pollen mix
24:00 pm; go to bed

Above you see some natural supplements (such as; black seed, turmeric, royal jelly-propolis and etc.). All the natural supplements are for Hepatitis B and I have started taking them for 3 months (after I learned I am patient). They have anti-viral effects and renewing the liver cells (I hope).

When it comes to question: “AT WHAT TIME SHOULD I TAKE BARACLUDE FOR THE BEST RESULTS?” I need the suggestions of Hepatitis B patients using Baraclude (Entecavir). And also I am very open your suggestions and sharings about Hepatitis B to get rid of this or to be more comfortable with this.

Thank you for your reading this stupid and long writing.
43 Responses
Avatar universal
Entecavir is usually taken with an empty stomach, that is, two hours before a meal and two hours after a meal. So some patients take it before going to bed. However, this is not suitable for everyone, as some patients report that they have difficulty falling asleep.
So maybe take Entecavir two hours after breakfast or two hours after lunch?

Don't be too concerned about taking the medication at the same time, but a routine does make you remember to take it everyday.

If you are taking antiviral treatment for the first time, the empty stomach rule is not that important, according to the label information.
Avatar universal
Dear friends,

I will start taking the medicine today. I really need your advises.

Please read the above post and help me..
Avatar universal
Thank you for your advise.

I got the new report with the medicines saying that HBV DNA is 557 million.
Avatar universal
Don't be too concerned about your hbvdna numbers, they are often very very high. Just follow your doctor's instructions and be monitored by him. Your viral load should come down within a year, allowing your liver to rest and hopefully your fibrosis will reverse within a few years. No smoking, no drinking, healthy lifestyle and diet, take vitamin D if your are deficient.
Avatar universal
Is it possible to reverse fibrosis 3 ? If yes, How many years does it take?

I haven't been smoking for 2 years and I had never drunk more than 1-2 times in a mounth since I am young. Finally I have stopped drinking  for 3 months.

What kind of diet?
Avatar universal
Yes, it is possible to reverse fibrosis, a surprise but most happy discovery. How long it takes depends on how quickly and how persistently you can reduce your viral load to undetectable. This is just my opinion.

What diet? A balanced diet.
Avatar universal
Just cut out junk food, alcohol and cigarettes and start researching food that are good for liver health.
Avatar universal
I got the new report with the medicines saying that HBV DNA is 557 million.

My HBV DNA was 840 mil before I start ETV and it went UNDETECTABLE in 14 months. I stayed on it for another 8 months before stopping. So hopefully you will do the same, albeit faster. Because during those time (I was stupid and ignorance/uneducated), I was still smoking and drinking soda/alcohol/eating junk food and unhealthy lifestyle.

I have just changed to a healthy lifestyle March this year.

Avatar universal
My ALT was 112 before ETV in 2009. Biopsy indicate F2.

When I start IFN this late July, I had a piece of paper that state Fibroscan 4.3kpa - F1 on my name. The thing is, I did not even know I did a Fibroscan.

Avatar universal
thank you for your sharing. This is my 4th week that I take Entecavir. 8 weeks later I will have a test to see the results.
Avatar universal
you are hbeag pos and very high hbvdna, entecavir is not the best choice and most potent antiviral for this status and hbvdna might take too long to become undetectable.
tenofovir is the most potent hbv drug and has over 16% hbsag clearance over 3 years use so if your liver specialist is so expert i really dont see this stupid choice of using entecavir

another very bad and annoying point on entecavir is that it is on strict surveillance for cancer since on mices it made lung cancer, it looks like it is not dangerous for human until now but there is no history on its usage over 10 years so.....
it was also a pain in the.....for the 4hrs empty stomach

i suggest to discuss tenofovir plus entecavir and then stop entecavir when hbvdna undetectable if entecavir monotherapy is not able to make hbvdna und by 6 months or if you prefer a more potent antiviral without empty stomach request

also keep in mind that hbsag clearance on entecavir is about 5% only
Avatar universal
above all tenofovir is also cheaper and soon out of patent (this is the reason of prescrbing i beleive), generic tenofovir is about 20usd per month in india.in case you pay for the drug tenofovir is a better choice on all aspects
Avatar universal
this is the real reason of prescribing entecavir when not the best choice i believe
Avatar universal
Thank for your sharing Stef2011. I am not an expert so I do not know why my doctor started Entecavir instead of Tenefovir. But I will keep in mind what you say.

What I want to ask that my fibrosis is 3/4 and I have a health life style (see above). Is it really possible to regress the fibrosis?
Avatar universal
I do not pay for the pills.
Avatar universal
I would also suggest TDF. My viral load came back after I went off ETV. Probably should never be taken off it. Good luck with your treatment with ETV and I think it's probably too late for you to switch to TDF.

As with the fibrosis, the anti-viral should regress it along with healthy diet, supplements (Vit D3 a must) and no/little alcohol/junk food/soda drinks and cigarettes. Just don't do things that can hurt the liver.



Avatar universal
Just saw your HbsAg value. Maybe IFN would be a better option for you. But with your biopsy result, maybe your Doc decide a safer option.
Avatar universal
Your HbsAg quite low and your immune system seems to be active (because of the high ALT) and you are HbeAg positive. IFN would be ideal now.

Anyone else thinks so? Maybe a combo with ETV.
Avatar universal
it wasn t hbsag quantity, no unit after the number and impossible to be so low on hbeag pos with such high hbvdna
Avatar universal
the best way to clear hbv is:
entecavir 3 years or etv+tdf 3 years or tdf 3 years, then pegintf add on until hbsag is cleared (response to antiviral better be hbvdna und by 6 months)

Avatar universal
stef: does it seem strange? still EAG +ve and F3 fibrosis???
Avatar universal
are you on f3?do you have firbsocan number?
Avatar universal
in your case it is inflammation i think unless it is a biopsy result

in any case you better start tenofovir, it doesn t make sense to let the virus free of replication in your status
Avatar universal
no no I mean how SafiSifa can be on F3... it is so young and EAG+..
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