how to interpretate red labs vdr

[japonego]

hello,

does anybody know how to interpretate the vdr test from redlabs? I´ve searched it a lot yesterday and I have found differente interpretations. If anyone knows it please send me some trustable link the confirms it. (the links I found are from discussion forums)

by the way I´ve just got mine, wich is
ff/Bb (some site says ff are for bad responder, and some say it is for high responder, Bb means moderate responder according to all sites I read)
and when I made the blood extraction they were very clear that they don´t do the test interpretation.

thanks and regards

[Rome70]

You can not stop tnf after a year, dna will return again. You should test hbsAg quantity in IU/ml. The goal of the therapy is to have hbsag und and develop enough of hbsab. After a few years of tdf therapy if hbsah is below 1000 you can start interferon.

[anant_bn]

Dear Stef,                   I am HbsAg +ve donno since when. I got to know when i donated blood in 2011 december. Tested HBV DNA on Sep 2012 and it is 4540642IU/ml = 26426536 copies/ml, ALT - 66, AST - 48, rest all LFT is within normal range, i was feeling mild pain under the right lower ribs, HbeAg is Negative and Anti HbeAg is +ve. Doc advise to take tdf for six months and test again. Aug 2013 report is HBV DNA is < 6 iu/ ml = < 35 copies/ml. Alt 26 and Ast 26. Rest all reports are within normal. What is the next course of treatmant? Pls advise. I am feeling occassional mild pain under the right lower ribs.

[4est]

I have to check regarding italy covreage, becauseI want a second opinion regarding my results and italy look fine.

Fibroscan is ok also in Romania, It is pay by the national healthcare and I already done this investigation.

[4est]

thanks :)

[stef2011]

you might check if you have coverage in italy as a european community citizen, in italy you will pay less for sure at public hospitals and also fibroscan will beless expensive

[stef2011]

i suggest these tests only when totally free because paid by healthcare, insurance or a research center, if you have to pay skip them

genotype of hbv: not very useful, only predicts very little increased chances on interferon

mutants of hbsag: not very useful because you will see from hbsag and hbsab tests both positive for longer than a year if the mutants is present

mutants of polimerase: absolutely needed before starting antivirals because we have mutations before we take antivirals,hbv produces mutants viruses of any type on dily basis and only the fit ones will stay.this is the way hbv escape immune system, just making random mutants all the time

Do you know were this analysis are available ?
italy, germany, france for sure at liver centers hospitals

[4est]

At a closer look I think I found the investigation on a private laboratory and the price are quite high, 300 euro for HBV genotype and 450 euro for HBV resistance to the drugs (nucs), so my previous questions is still valid.
When is necessary for a person to do the genotype of the virus and the possible mutation ?

[4est]

when is important that a person to do the genotype of the virus and the possible mutation ?

I'm asking this because this investigation are quite expensive (I heard that genotype investigation is around 300 Euro and for other I expect at the same amount or maybe more)

Do you know were this analysis are available ? (analysis for genotype I think that I saw something of some labs, but for mutation i don't saw it - or maybe I don't look for the correct names)

[stef2011]

pisa researcher found that interferon was effective to clear hbv with mutations in the "a" determinant, they said this virus is weaker.alinia might be effective too comboed with interferon
the patient in pisa had this mutation due to lamivudine

[japonego]

I found this:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1395421/

[stef2011]

"we could not find mutations of antivirals´resistance"
method: Polimerase, gene sequences dna polimerase and protein HBsAg.

this is not important, this is used only for drugs.they should check for the hbsag mutants


My last two HBsag test I did in a different lab, they both said over 250.000 and had no unit.

if there isn t iu/ml after the number it is not quantitative so this test needs to be re-checked with result in iu/ml

hbv DNA (april 2011) 10000000.0 UI/mL - 7 log UI/mL (real time PCR)
is hbvdna still so elevated?if so you have an hbsag mutant but in any case nagalase should be high and not low....i guess if it is so the mutant hbsag have other means to escape immune system

[4est]

hi

i was not try to say that you don't know the difference between the HBV DNA and HBsAg :), it was only the fact that I'm also confused by your analyses.
I'm not so knowledge like stef2011 and i only read some classical HBV books and some study and I don't remember to found information regarding HBsAg positive and  Anti HBs positive.
I'm sure that the community will find a  explanation, I will ask also my doctor regarding this but this will be only in September when i have my 6 mouth appointment.

regards

[japonego]

hey 4est how has going?

sorry I forgot to mention but I referred to this exactly phrase from steff "your hbsab is also increasing". then I said my antihabs has flutuated.

and thoses anti HBs values were right pasted, actually each one from a different lab.

I am aware that hbv DNA and HBsAg quantitative are different things. ; )

I put my hbv dna numbers also as a reponse to steff´s phrase "you need to check hbvdna pcr "

My last two HBsag test I did in a different lab, they both said over 250.000 and had no unit. Different from the Anti HBs done in the same lab wich said UI.

The genotype test different from the last HbsAg were made at very respected and reliable hospital. of course, sometimes there´s lab imprecisions and mistakes.

but actually I´m quite confused too...


regards

[4est]

for your sister and your wife it seams to me that they had a HBV and they clear infection (they had the acute phase and not chronic) and now are immune.

[4est]

personalty I'm confused regarding your post that states:
"HBSAG over 250.000
Anti HBS 49.3 UI (may 2011 71.8  /oct 2010 34 /sept 2010 0,09) "

because:
HbsAG over 250000 - means that you have the HBs Antigen
Anti HBS 49.3 UI - means that you have also the antibody (Anticorpes)

this is very rare, and from your post "genotype A1/a
"we could not find mutations of antivirals´resistance" " is improbable, so this is a reason to have another look on the names of your analyses.

[4est]

stef2011 is referring to the HBsAg quantitative and in you last post you say:

"actually my hbsab has been flutuating, it has reached higher values than now.
just for the record:
HbeAg positive
Anti-HbeAg negative
hbv DNA (april 2011) 10000000.0 UI/mL - 7 log UI/mL (real time PCR)
hbv DNA (oct 2010) 9650000.0 UI/mL - 6.98 log UI/mL (real time PCR) "

hbv DNA is not the HBsAg quantitative

In one of your first you say:

"HBSAG over 250.000
Anti HBS 49.3 UI (may 2011 71.8  /oct 2010 34 /sept 2010 0,09) "

Are you sure that you paste the correct names for you analyses ?

[japonego]

I´ve got also the  tests from my wife and sister, if this can help to find ou it is recent or not.
My older sister did the test and was all negative. My younger sister, she lives with me, did the test and got this: feb 2011
HbsAg - negative 0,01
Anti HBs - positive higher than 1000mUI/mL
Anti HBc - positive 9,42 (abbot architet)

my wife´s result: sep 2010
HBsAg - negative 0,39
Anti HBS - positive higher than 1000 mUI/mL
Anti Hbc - positive 0,13 (abbott Axsym method)

[japonego]

actually my hbsab has been flutuating, it has reached higher values than now.
just for the record:
HbeAg positive
Anti-HbeAg negative
hbv DNA (april 2011) 10000000.0 UI/mL - 7 log UI/mL (real time PCR)
hbv DNA (oct 2010) 9650000.0 UI/mL - 6.98 log UI/mL (real time PCR)

about virus genotype:

genotype A1/a
"we could not find mutations of antivirals´resistance"
method: Polimerase, gene sequences dna polimerase and protein HBsAg.

[stef2011]

also check if abbott architect has a range til 250.000, i think it cant detect more than 99000.it is also extremely unusual to have such high levels of hbsag

[stef2011]

looking at your labs and assuming you have no hbsag mutant, i think you have immune control of hbv since:

nagalase is normal so your immune system sould be able to detect the virus, and according to your hbsab it is so.your hbsab is also increasing

alt are almost normal

you need to check hbvdna pcr

please do check if hbsag 250000 is iu/ml unit and is done by abbot architect, such a level is common on immune tollerant or acute hbv

check hbcab igm quantitative by s/co unit, this might help to understnd your immune status too

on the contrary if you have hbsag mutants all i said above probably doesn t apply to you, there are little studies on this form and very little i can say

[stef2011]

just rechecking all your data but it is needed an update close to the nagalase test about hbvdna pcr and hbsag quant in iu/ml so we may link the nagalase to the immune status of your hbv

another special test required is hbsag mutants test but i have seen it available in a few hospitals in italy (the ones who make hbv research)
test about polierase mutations and precore/bcp mutant and genotype may be useful for HCC risk and response to conventional therapies

[stef2011]

a test of your hbsag quantity would be very helpfull for the community for many reasons

- correlate hbsag level with nagalse
- confirm if all hbv carriers have high nagalase or if it is just my case to have very high nagalase

[stef2011]

got this: nagalase 0,69. I´m in the regular levels.

i guess that gcmaf is of no benefit in your case

it would be interesting to see if with this low nagalase there is immune control over hbv which is equal to a hbsag level 1500iu/ml or less

as to vitamin d3 order it from puritans.com, i am using the one with 5000iu perls

I´m thinking in ask for a full blood test.....
hbsag quantity is the most useful to understand your immune response, phase and chances of clearance

[japonego]

hey stef,

I just received the nagalase results, wich is very weird for me. I expected a high value, but I´ve got this: 0,69. I´m in the regular levels.
immediatly some thoughts come to my mind. too soon to write them down.

I still couldn´t find the vit d without calcium, instead of pharmacies I´ll try supplements stores, like those ones for muscle people.

I´ve got an appoiment with the doctor at september 5th. in this hospital I can take more accurated quantity tests for hbsag, I´m thinking in ask for a full blood test, what should I test, I mean what interesting markers like the cd4, cd8 cells, blood count ( it´s been a year almost since the last one).

thanks and regards