I am a 36 years old female and have chronic hepatitis B for 20 years. Have been feeling fine. Had a liver biopsy due to an elevated alt (100) and ast (49). The virus DNA is 3860. The biopsy results show mildly active (grade 2 of 4 ) with focal portal fibrosis (stage 0-1 of 4). My doctor wants to put me on Viread. Read about the side effects and seems like if I stop taking it at some point, it will make the hepatitis worse.
I am contacting another doctor for a second opinion, just curious if anyone have any suggestions or comments. Thanks,
also keep in mind that we have only one hbv cure which is sequential treatment by tenofovir for 1-3years and then pegintf add on but to monitor this cure we need hbsag quantity which reflects number of infected cells in the liver and your immune response towards hbv.
when hbsag is around 1000-1500iu/ml there is little suppression of your immune system by hbv so pegintf has the highest chances to clear hbv definitively
the basis of sequential treatment is that human trial showed:
50% hbsag clearance by 48weeks of peg add on after 3 years of antivral monotherapy
90% response with hbsag lowering to less than 300iu/ml by 72weeks of combo.hbsag at less than 300iu/ml is usually inactive and drugs can even be stopped with no infection reactivating
10% no response but this patient used weak antivirals not used today
tenofovir monotherapy is able rescue specific hbv cd8 immune response and pegintf killer cells, both arms are needed to clear hbv....search this study by search box it has been posted recently