HBsAg quantitative after 6 months on entecavir

[SphereAj]

Hi All
Started entecavir 0.5mg 6 months ago
Baseline readings were
1. Viral load 6250 Iu/ml (came down to 333 iu/ml in two months)
2. HBsAg quantitative was 1666.10iu/ml
Now 6 months after entecavir the HBsAg is gone up to 2636iu/ml

Please comment on this rise in HBsAg quantitative

3. VITAMIN D LEVEL was 19ng/ml
Now after 5 months taking 10000iu perday it has risen to 166 nmol/L
Normal range us 75-250 nmol/L
(last time same lab gave reading in ng/ml and now nmol/L,  how do I convert?)

[SphereAj]

Got the conversion 166nmol/L is 66.50ng/ml

[SphereAj]

Got LFT results today
SGPT 50 normal is 5-35
SGOT 47 normal is 8-40
Rest is normal.
My SGPT and SGOT had become normal 3 months ago (3 months on entecavir) now after 6 months it's gone up again.

Prior to entecavir readings were 140 and 80 respectively

[flyinsky]

What Is the opinion of your doc?

[StephenCastlecrag]

This rise in qHBsAg after starting treatment is a puzzle. Others in this forum had reported rise in qHBSAg after starting PegIFN. It also showed up in some clinical study data. I think this rise is transient in PegIFN treatment and should be similar in NUCs. I can't see how this rise can be associated with a rise in the cccDNA pool.

[studyforhope]

The blood level of hbsag is not only depending on the amount of cccDNA. The intensity of transcription and synthesis of hbsag is also controlled by the local level of cytokines in the liver.

When the virion output decreases after antiviral inhibition, the local immune response will lessen and cytokine levels will fall. Virions, captured by local dendritic cells and macrophages are the strongest induces of the inflammatory response to hbv.

[SphereAj]

@flyinsky my doc not interested in HBsAg quantitative. He did not even ask me do that test in the first place. It's after coming to this forum I got it done. Anyways I will be meeting him in couple of days.

@Stephen what do you think of SGPT and SGOT?  It was 140 and 80 before treatment started. Dropped to within normal range in two months and now at 6 months it's risen again.

Waiting for Viral load test result

[StephenCastlecrag]

SGPT(ALT) can fluctuate, even within the same 24-hour period. If hbvdna remains low, a rise in ALT is not usually due to HBV. Check your cholesterol level if ALT remains persistently high with hbvdna very low.
Just my opinion.

[SphereAj]

Thanks Stefen
Will check

[coolnaresh]

My wife with HBsAg that is first test value is 7010 , after 2 months it will be 483.82 iu/ml. (billrubin is nil) those tests are CMIA tests Remaining alla test are normal. But I am not suffer with that virus. My dought is it is cureble or not we dont have any childrens please help me sir. first test date is 18/04/2016 and second test date is 27/06/2016. Please help me......

[coolnaresh]

My wife with HBsAg that is first test value is 7010 , after 2 months it will be 483.82 iu/ml. (billrubin is nil) those tests are CMIA tests Remaining alla test are normal. But I am not suffer with that virus. My dought is it is cureble or not we dont have any childrens please help me sir. first test date is 18/04/2016 and second test date is 27/06/2016. Please help me......

[Nmarius]

Coolnaresh, we understood your situation. Stop creating any topics, your wife should test again for HbsAg and HbvDna, do a fibroscan, and other liver tests, like ALT, AST. Than, come back with results.

[sorte]

exectly

[SphereAj]

@studyforhope, thanks for the insight. Now what to do?  Continue with antiviral? Will HBsAg decrease eventually? Is this rise harming the liver?
Looking forward to your inputs.
Thanks again

[studyforhope]

I would continue with the antiviral and not worry about the increase of the surface antigen. Its rise will not harm the liver.
cccDNA tends to lower to a certain degree upon prolonged antiviral use, this might also decrease your hbsag levels in the future. But not to a large degree.

[SphereAj]

Thanks again Studyforhope
I wonder about Safisifa's case. He cleared the virus in one year and his HBsAg steadily decreased on entecavir 0.5mg. Could it be due to supplements like blackseed, honey,  turmeric technology that he took regularly?
Or is it age?  He was 29 when he started antiviral. I am 46.
I am starting blackseed with honey, let's see what happens

[studyforhope]

The most likely reason for safisifas success is a lucky new tcell clone and an effective epitope, not mutated,  that allowed a systematic elimination of infected cells.
The supplements that he took are additionally helping his immune cells to function well.

The younger you are the better your tcell system works.
Furthermore, a shorter time in which the virus could adapt it's epitope structure to the recognition forces of the tcell system will lead to a higher chance of finding an effective tcell clone.

[SphereAj]

Wow. Thanks, you know this stuff well Study For Hope!!!!  :-)

[coolnaresh]

I am not creating the topics this is true.my wife hand broken with accedent.when doctors told to me your wife have hbsag with high values.they told me to your also effected that virus wiyhout testing.they told to me tell the virus load but after that they dont tell any thing about that. but 2 months later checking my wife getting value.

[SphereAj]

Coolnaresh
I am guessing you are from India. I am also from India.
Best thing is to see liver doctor/hepatologist.
Do following blood tests for you and your wife
1. LFT -  liver function test
2. HBsAg quantitative test,  Viral load
The liver specialist will be able to guide and suggest a treatment if necessary.
If you hot infected recently then  you may clear it on your own

[coolnaresh]

There is no treatment in allopaty

[SphereAj]

There is antiviral therapy in allopathy that can keep the check on the virus and protect liver damage. Ayurveda also does not have prove cure for hepatitis b, neither has homeopathy.

[coolnaresh]

already i told all test are normal

[SphereAj]

Then what are you worried about coolnaresh?

[coolnaresh]

Except Hbsag thats way iam worried

[SphereAj]

Hi All
The Viral DNA result came in today, it's undetectable.
In two months it was 333iu/ml from 6250iu/ml. Nearing 6 months it's undetectable. However HBsAg quantitative has gone up to 2656 from 1666.10iu/ml

[chimpz]

SPhereAj: my mom 56 yo had treatment and hbvdna became und. But hbsag increased.

[SphereAj]

Thanks Chimpz for the input. Want to know why that happens though

[chimpz]

Oxidative stress. Her hbvdna increased when she got stressful and exhausted. During treatment she was not in good mood too.

[SphereAj]

Yes,  stress does play a role...