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Wife saw spontaneous HBeAg seroconversion in <1 month, HBsAg lowers
Guys, I hope to get some ideas from you on my wife's situation. She's not on any treatment now.
As I mentioned in an earlier post my wife was diagnosed to have activated her Hepatitis B after she gave birth to our daughter in Jan 2014. The new news is that in latest checkup we found out that she has quickly seroconverted HBeAg within one month. ALT & AST are both very close to normal ranges now but still slightly above. HBV DNA undetectable (<1,000 copies/mL).
Another thing is that her HBsAg dropped from 1128 IU/mL one month ago to 505 IU/mL. I kinda feel this is all positive movements, but not knowledgeable enough to tell:
1. Why did the HBeAg seroconversion happen so quickly in 30 days? Any chance of a bounce-back?
2. ALT/AST is still not normal yet although DNA is already und, but shall I consider this as a good sign since this might indicate a chance of a HBsAg further drop?
3. What options do I have now? to wait for another month or start interferons?
4. Am I crazy to imagine that she would clear HBsAg all by herself and develop HBsAb without any drugs/interferons? What all happened was just a bit dramatic and beyond expectation to me.
Thank you everyone for your opinions!
=====Her Data=====
On Jan 6, 2014:
HBsAg: 1128 IU/ml
HBsAb: <6.4 mIU/ml
HBeAg: 224 CI
HBeAb: <30 INH%
HBcAb: 99.9 INH%
ALT: 116 @ Jan 4; 195 @ Jan 6; 173 @ Jan 8
AST: 130 @ Jan 4; 130 @ Jan 6; 98 @ Jan 8
HBV DNA: 5.4x10^5 copies/ml
On Feb 5, 2014:
HBsAg: 505 IU/ml
HBsAb: <6.4 mIU/ml
HBeAg: <1.0 CI
HBeAb: <76.8 INH%
HBcAb: 99.2 INH%
ALT: 51 IU/L
AST: 38 IU/L
HBV DNA: <1,000 copies/ml
She's Asian, 27 years old, genotype unknown
We believe she got infected before 10 years old, but not when she's born.
My post when we first discovered her activation
http://www.medhelp.org/posts/Hepatitis-B/Need-advice-before-seeing-doctor-again/show/2078206#post_9844997
As I mentioned in an earlier post my wife was diagnosed to have activated her Hepatitis B after she gave birth to our daughter in Jan 2014. The new news is that in latest checkup we found out that she has quickly seroconverted HBeAg within one month. ALT & AST are both very close to normal ranges now but still slightly above. HBV DNA undetectable (<1,000 copies/mL).
Another thing is that her HBsAg dropped from 1128 IU/mL one month ago to 505 IU/mL. I kinda feel this is all positive movements, but not knowledgeable enough to tell:
1. Why did the HBeAg seroconversion happen so quickly in 30 days? Any chance of a bounce-back?
2. ALT/AST is still not normal yet although DNA is already und, but shall I consider this as a good sign since this might indicate a chance of a HBsAg further drop?
3. What options do I have now? to wait for another month or start interferons?
4. Am I crazy to imagine that she would clear HBsAg all by herself and develop HBsAb without any drugs/interferons? What all happened was just a bit dramatic and beyond expectation to me.
Thank you everyone for your opinions!
=====Her Data=====
On Jan 6, 2014:
HBsAg: 1128 IU/ml
HBsAb: <6.4 mIU/ml
HBeAg: 224 CI
HBeAb: <30 INH%
HBcAb: 99.9 INH%
ALT: 116 @ Jan 4; 195 @ Jan 6; 173 @ Jan 8
AST: 130 @ Jan 4; 130 @ Jan 6; 98 @ Jan 8
HBV DNA: 5.4x10^5 copies/ml
On Feb 5, 2014:
HBsAg: 505 IU/ml
HBsAb: <6.4 mIU/ml
HBeAg: <1.0 CI
HBeAb: <76.8 INH%
HBcAb: 99.2 INH%
ALT: 51 IU/L
AST: 38 IU/L
HBV DNA: <1,000 copies/ml
She's Asian, 27 years old, genotype unknown
We believe she got infected before 10 years old, but not when she's born.
My post when we first discovered her activation
http://www.medhelp.org/posts/Hepatitis-B/Need-advice-before-seeing-doctor-again/show/2078206#post_9844997
Best Answer
just follow hbsag monthly so you are on time to catch if the decline stops, i guess genotype is asian, so B or C.just another though on genotypes
in case of genotype C maybe peg add on canbe justify with the high liver cancer risk and the less predictive role of low hbsag, while geno B is safe enough to wait for spontaneous clearance
in case of genotype C maybe peg add on canbe justify with the high liver cancer risk and the less predictive role of low hbsag, while geno B is safe enough to wait for spontaneous clearance
Thanks Stef. I guess my hope is that my wife's HBsAg was low at 1100 when upon first check and quickly dropped to 500 one month later, so I am hoping that she could spontaneously clear HBsAg in months (tell me if this is crazy thoughts).
Thanks thanks for the cancer briefing. It is great to know. Personally I know very little about this field (even HBV, which I know little until not long ago!)
Thanks thanks for the cancer briefing. It is great to know. Personally I know very little about this field (even HBV, which I know little until not long ago!)
also the japan team of scientists from saisei clinic has published some reports, but i dont follow that too much
If say a woman has already HBsAg seroconverted, and developed HBsAb, does the immune suppression mechanism during pregnancy still post the same risk?
i guess not i ve never seen studies on this, that isn t so severe immune suppression and nagalase levels are very high around fetus for sure and not the whole body.
anyway it is easy to monitor by hbsab levels and if they fall tenofovir can be used
One question since you mentioned cancer cells - since cancer cells make nagalase to suppress immune system, could this mechanism serve as a universal treatment target for generally all cancers? Is there any research going on that targets nagalase? sorry my medical background is almost close to zero!
yes researchers in a swiss hospital using gcmaf.eu are publishing people with 3 months left to live with tumors reduction of 25% per week (when not multiple tumors), they just started in december so too eraly for the follow up publication.if reduction is less the patient dont pay the hospital, they are getting this because they inject gcmaf close to the tumors or on the veins that supply the tumors by guided high sensibility ultrasound and of course nutrition intervensions
they had front page of oncology immunology on august 2013 and i guess at end of 2014 we will have the follow-up publication and know how many of these dying persons were saved
i guess not i ve never seen studies on this, that isn t so severe immune suppression and nagalase levels are very high around fetus for sure and not the whole body.
anyway it is easy to monitor by hbsab levels and if they fall tenofovir can be used
One question since you mentioned cancer cells - since cancer cells make nagalase to suppress immune system, could this mechanism serve as a universal treatment target for generally all cancers? Is there any research going on that targets nagalase? sorry my medical background is almost close to zero!
yes researchers in a swiss hospital using gcmaf.eu are publishing people with 3 months left to live with tumors reduction of 25% per week (when not multiple tumors), they just started in december so too eraly for the follow up publication.if reduction is less the patient dont pay the hospital, they are getting this because they inject gcmaf close to the tumors or on the veins that supply the tumors by guided high sensibility ultrasound and of course nutrition intervensions
they had front page of oncology immunology on august 2013 and i guess at end of 2014 we will have the follow-up publication and know how many of these dying persons were saved
Thanks stef, I remember that post about gcmaf, I'll go back read again.
If say a woman has already HBsAg seroconverted, and developed HBsAb, does the immune suppression mechanism during pregnancy still post the same risk? thanks!
One question since you mentioned cancer cells - since cancer cells make nagalase to suppress immune system, could this mechanism serve as a universal treatment target for generally all cancers? Is there any research going on that targets nagalase? sorry my medical background is almost close to zero!
If say a woman has already HBsAg seroconverted, and developed HBsAb, does the immune suppression mechanism during pregnancy still post the same risk? thanks!
One question since you mentioned cancer cells - since cancer cells make nagalase to suppress immune system, could this mechanism serve as a universal treatment target for generally all cancers? Is there any research going on that targets nagalase? sorry my medical background is almost close to zero!
we have observations of this in posts about gcmaf.
the immune system is suppressed to protect the fetus from attack and natural abortion, immune suppresion is made by nagalase which inactivates macrophages which are the main/first sensors for invaders by our immune system
also hbv, hcv, flu virus, cancer cells, bacteria and other viruses make nagalase to suppress our immune system it.our own nagalase is little different and in healthy person is less than 0.6
after delivery our own prodcution of nagalase go down and macrophages reactivate
without immune suppression there is abortion, no way to deliver baby safely without it
the immune system is suppressed to protect the fetus from attack and natural abortion, immune suppresion is made by nagalase which inactivates macrophages which are the main/first sensors for invaders by our immune system
also hbv, hcv, flu virus, cancer cells, bacteria and other viruses make nagalase to suppress our immune system it.our own nagalase is little different and in healthy person is less than 0.6
after delivery our own prodcution of nagalase go down and macrophages reactivate
without immune suppression there is abortion, no way to deliver baby safely without it
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1 Obviously, your wife has seroconvverted her e- antigen naturally. During pregnancy, the immune system is naturally suppressed because of the fetus. So there is a rebounce in the immune system after birth. I think you will find what happened to your wife is not rare. The e-seroconversion is always a bit of a mystery. It heralds the end of immune clearance and transition to the immune control (inactive) phase. There is a chance of going back to e-antigen positive, but unlikely in my opinion because she did it naturally.
2. The qHBSAg may drop further, but unlikely because her ALT is really not that elevated, but that is just a guess.
3. I have no idea whether she should start IFN to see if it will help her to clear the virus. You may like to ask her doctor.
4. In the natural history of HBV, your wife may stay in this phase for a very long time with some chances of eventually losing her HBsAg altogether. However, in a percentage of patients, they will transition to the immune escape (re-active) phase due to mutation of the virus. If your wife' qHBSAg drops below 100 iu/ml, this would indicate she is in a truely inactive state. So an annual check-up is important.
Finally, did you find out anything about arc520 clinical trial?