to those who have chronic hepatitis b who cleared the virus, please i need advice...

[aderts]

what should i do to clear the virus??
my hbv-dna is 200,000 copies/ml..

right now im taking revovir.. is it enough?

[MikeWest1089]

Good luck with your test. Make sure to take your medications as prescribed by your doctor. :)

[MikeWest1089]

I know a friend who also has hepa b. Not sure what medication she took, but her doctor gave her a treatment that she is following religiously. She is coping with her condition just fine. While getting the insights of other hepa b patients online can help with your research, you need to take their comments with a grain of salt. You cannot blindly follow what people on the Internet tell you because they cannot be held accountable if their advice makes things worse for you. it's better to consult your doctor and share your sentiments with him or her. A doctor would know what medications will work best for your symptoms and medical history. Revovir is a drug that is commonly prescribed for the treatment of hepatitis B. It is manufactured and clinically tested in South Korea to be safe for hepatitis B patients. Ask your doctor if you have any concerns about its potential side effects.

[stef2011]

revovir is a banned drug in all world and development has been stopped becuase of fatal sides effect and useless on hbv.i guess a very high level of corruption in the phillipines made possible the use of a banned, dangerous and useless drug there

it doesn t cure or affect hbv, it can have fatal sides effect, stop it as soon as possible and use tenofovir or entecavir instead

[jagado]

hi im mark bn using revovr 4 9months ds mnths i wl dne a test 4 hvb dna...

[aderts]

since my alt is low at 8... i assumed that the virus is not actively damaging my liver..

[aderts]

since i seroconverted hbeag without having therapy and develop anti hbe, does it prove that my immune system is still fighting the virus??

[aderts]

is it okay for me to take godex?

since i dont have money yet for the therapy, ill just take godex... my doctor prescribed me this 2 times a day... he said that its for liver protection...

[stef2011]

since i have high viral load even with hbeag negative and hbeab positive.. does that mean that i have hbv mutations???
no, there is no correlation.we all have mutations but only some are classified and we know they are dangerous, the BCP and precore muattions are the prevalent form of cronic hbe neg and very common on hbe pos too

if i have mutations, does the chances of clearing the virus is very low???
no they are the same for BCP and precore mutation
only mutations for entecavir or tenofovir resistance lower your chances of making hbvdna und.
All type of mutations have been found naturally in people that never took drugs only tenofovir is free for resistance both naturally before therapy or under therapy, i guess this is by far the most potent antiviral for hbv probably totally free of resistance, we are almost at the 4th year of hbv trials without detection of any mutants even in those with detectable hbv

[aderts]

since i have high viral load even with hbeag negative and hbeab positive.. does that mean that i have hbv mutations??? if i have mutations, does the chances of clearing the virus is very low???

[stef2011]

since you have family history of liver cancer (which is not curable) and even resection has bery poor life expectancy if hbvdna/precor and bcp mutation are detactable, you are not pointing at a hbv cure but you are trying to avoid liver cancer death if it will ever happen

it can be possible you will never develop liver cancer like you uncle but if you do chances of survaival with hbvdna detectable are very very poor.research showed that hbvdna und lower liver cancer rates to almost zero so this is your point.

precore and bcp mutations are very very common especially on hbe negative, so check for these mutations if you can because they are closely connected with liver cancer development, if one or both positive your hbvdna must be und

so in the end the first doctor was ok if it was you to ask for less expensive oral therapy, but if you can afford interferon go to the previous doctor and discuss interferon with her, it is the best choice as first therapy

is it okay to take the therapy even if my alt is low?
since you have high liver cancer risk it is, my sister was inactive carrier and did interferon with normal alt when about 19yo, she didn t make hbsag negative but seroconverted hbe negative/hbeab pos and hbvdna und.it was a very good choice and she prevented cirrhosis

are there any side effects?
ntz no sides, interferon yes but since you are young maybe you'll only have some flu synthoms at start, discuss interferon sides with your doctor

[aderts]

my other doctor prescribed me revovir, but you said that its dangerous so stopped taking it.. actually she prescribed me two choices... ORAL and INJECTABLEs( interferon)... she said that interferon is very expensive so i choose oral..

is it okay to take the therapy even if my alt is low? are there any side effects?

[aderts]

i did find another doctor, and he said that i am not a candidate for treatment since my alt is low.... and he said also that ill begin my therapy once my liver is already damage and that means that my alt should be twice the normal range...

wtf? so i have to wait for my liver to be damage and do nothing? why is that so?

i also had my liver ultrasound and alfafetoprotein results, and the doctor said that they're normal...

it says the liver is not enlarged. it is homogeneous in echotexture with no focal lesion. the intrahepatic ducts are not dilated. the portal veins are unremarkable.

conclusion:
normal liver sonogram..

Alphafetoprotein (ECLIA) <0.500 normal

[vinprik]

please tell me higher the Hepatatis DnA viral load more are the curing chances?

[stef2011]

http://pubget.com/search?q=authors%3A%22Maura%20Dandri%22

high levels of HBV replicative activity, in the absence of
transaminase elevation, have been shown to dramatically
increase the incidence of hepatocellular carcinoma development.

as i thought low alt level with hbvdna moderate/high is a big factor of risk for HCC

[stef2011]

does that mean i am immune to future infections and will develop anti hbs??
yes you are immune, don t need durgs and cancer risk is almost zero

my suggestion:
ntz+interferon 48weeks, stop at 24 weeks if no decline of hbsag>10% and hbvdna>2 logs

after 48weeks of interferon (or 24weeks if failed) if still hbsag pos and hbvdna detectable ntz+tenofovir until you make hbsag negative hbsab positive.hbvdna will be und while you take tenofovir so you cut cancer risk to almost zero

[stef2011]

the good of interferon is that you will know if it works on you by 12-24 weeks therapy, the bad is it has sides and usually not used with normal alt but that's not a rule

[stef2011]

in that case the doctor made the right choice with the worng drug, hbvdna must be kept und to have almost zero risk of liver cancer since there is no cure for it

you might try ntz+interferon first to see if you seroconvert and after stay on tenofovir+ntz or etv+ntz, sucsess rate of interferon is about 11% maximum on hbsag seroconversion and much worst on hbvdna und

tenofovir has zero chances of seroconversion, but almost 90-100% of hbvdna und, once you keep hbvdna und for 10-15years maybe you clear hbsag, while hbvdna will be und you have almost zero risk of liver cancer
tenofovir+ntz is new so we don t know time for seroconversion but probably faster than 10-15 years

etv has 3% seroconversion of hbsag, and almost 90-100% hbvdna und, there is a risk of 1,2% resistance so tenofovir is better
you must not develop mutations since mutants have same liver cancer risk even when hbvdna und, at least this has been found about lam mutants

[aderts]

well, my uncle died because of liver cancer due to hepa...

how long should this interferon or nitazoxanide therapy??
how much is the success rate??
if ever i have cleared the virus... does that mean i am immune to future infections and will develop anti hbs??

[stef2011]

you have chances especially on ntz+interferon or ntz+etv, as regards tenofoivr combo we have people in our group but just started this combo

only low hbsag and hbe negative are good for chances on ntz but yo won't find hbsag test in iu/ml in philippins

but as regards your situation i see your are young 22yo so you have to consider many things before starting antivirals, only family story of liver cancer, genotype C and e-minus mutation suggests therapy otherwise you better try nitazoxanide or interferon, both boost immune system and can be stopped without problems

[aderts]

hi stefano,

does it mean when im hbe negative and low alt eventhough i have high hbvdna, i still have higher chance of clearing the virus??

[aderts]

yes my alt is 8, i took the test last august 5, 2010....
and also, i just got my alphafetoprotien result, and it says normal....

i will find another doctor for second opinion... thanks

[stef2011]

it is possible to have alt 8 with hbvdna even 100000iu/ml for 2 reasons, one more common in caucasian A,D genotype and one in asia B,C genotypes and where immune response is much lower than western countries:

low alt with high hbvdna, result of low hbsag and more immune control, usually in western countries with genotypes A,D

low alt with high hbvdna, no immune control so immune system cannot see virus replication and doesn t kill infected cells that s why alt is 8

in asia need of therapy is different since genptype B and C plus precore, corepromoter mutations have highest liver cancer risk, so it is maybe correct to make treatment if this is the case.only if there is no liver cancer risk and no fibrosis therapy is not required

problem is i don t think in philipins you have fibroscan and tests for e-minus mutants so it is probably better to suppress hbvdna.
E-minus mutants promote liver cancer and cirrhosis even with old alt normal range, the second happened to me

[Sharp7]

Are you sure about your ALT level? if it is really just 8, you have no reason to medicate. Check it again, in a couple of weeks, and again every 2 months. You have reason to medicate only if it exceeds 30 two or three times.

And... do get yourself another doctor.

[stef2011]

if you just took one i'd just discontinue and use tenofovir or entecavir

if possible make a resistance test because we have viral resistance to the drugs even before taking them, lamivudine and adefovir resistance happen also naturally, but if you choose tenofovir you might skip resistance test

i also see you are hbe negative, pretreatment with nitazoxanide 4 weeks minimum will help clear much of hbsag too, i am on etv+ntz and cleared 55% hbsag in 4 weeks