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Hbs+ hbeag+ --- VL after tx...


Need some thoughts here…

As you may have read going through this thread I’m still Hbeag+ ALT slightly out og range (70-80) and my VL has always beein >100000000.

I had been on Pegasys IFN180 mono tx for 8 months (2 years ago) and then I quitted as I seemed to not responding to tx… (just for you info I have not had any side effect at all but VL was almost always >100000000).

After that I just have my blood tests done every 3 or 4 months, ultrasound every 6 months  …… so I’ll keep on monitoring how this stuff is progressing..

Now.. got my latest labs last week.. and I was really surprised as my VL dropped down to 50000000… yes mate I know this is still high but I’ve never had a result like this in 26years.. Neither had I while on tx…

ALT still around 70 however….

Any ideas?????

thanks to you all guys!!!
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Avatar universal

go for none at all now if you can
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... so of course i do not mean getting drunk, for sure.. only a glass on meals...

none at all.... :(
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none, my first acute flare at 19yo was due to drinking even if once a week
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neither once weekly?
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Avatar universal

definitely poison for us, avoid absolutely

it also decreases immune system damaging dentric cells that are already non reactive to hbv
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just a further advice... what about dringkn beer/glass of wine in such conditions once a week (1 glass on meals)?
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Avatar universal

of course my hbvdna and hbsag are much lower than yours because my immune system is much more active, but in my case hbv escaped most of my response

in ur case the chances of success with therapy are higher because you dont have a good immune response yet, so hbv has not mutated yet to escape it

so tdf will make hbvdna und and make some immune response

interferon will boost that little immune response to clear hbv

having hbvdna nd will make impossible for hbv to mutate and escape your response

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Avatar universal

no vitamin d3 is protecting your liver from fibrosis and severe liver daamge as clearly shown by a poster at the liver meeting.the liver with vit d reached f1-f2 fibrosis while the others got advanced nodular cirrhosis

high cholesterol and platlets 190.000 are due to hbv, keep in mind that also cholesterol promotes fibrosis and liver damage, it is all linked with hbv and damage.making cholesterol lower you will also prevent fibrosis

by the way i also had tot chol 218 when i had  hbvdna 580.000iu/ml and alt 600, while it decreased to normal with hbvdna und
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is that harmful? may it be caused by VIT d3 i'm currenlty intaking 10000 daily?
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Avatar universal

sorry confused it because it should be 1.15

you can use biostatine, it is a red yeast rice supplement, it will ower cholesterol in about 20-30 days, this way you will weaken a little hbv and you will respond better to therapies.once you start therapy you can stop biostatine or lower it to one pill a day
biostatine can be found in farmacia, eroristeria, parafarmacie, it doens t need prescription.use that brand only because it is not sure all red yeast supplements work.i hve seen them at auchan and coop but dont know how reliable other brands are
if doctor agrees you may also use simvastatin with prescription but only updated doctors know use of sim is safe, so you using biostatine is easier

of course do not keep chol so high, there is an increased risk of arterosclerosis and chol related diseases in hbsag carriers because hbv upregulates genes
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Avatar universal
Pt was (protrombina). Platelettes are arounf 190

so should I worry for cholesterol?
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Avatar universal

cholesterol is controlled by hbv, cholesterol genes are changed by hbv to make its antigens

re check platlets 115 is extremely low, lowest normal range is 150.if so low start tenofovir as soon as possible and l carnitine.low plt means a lot of damage is being done in the liver

if plt doesn t get in normal range and hbvdna gets low fast by 6 months do ask for tdf+etv combo and then interferon add on, jus tlike i am doing, tdf+etv are very fast to make hbvdna und by 6 months even when so high.interferon with low platlets is a problem
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Avatar universal
sorry colesterol range is 120-200... :)
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Avatar universal
here i am my fellows... got latest labs.. not so good mates..

AST 85 h
ALT 308 h
GGT 78 h
Pt 115
VL >1000000000 (out of range)
Colesterol 223 h (120-20)

you see the only one inside the range is pt.. i believe this refers to liver functionality...

What surprised me is the cholesterol which for me seems a little unussal as i'm 26yo and live a healthy life style..no fatty food meals nor alcohol abuse..

any feedback is welcome..

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Avatar universal
so we're starting more or less at the same time..
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Avatar universal

start l-carnitine which will keep platlets higher and go as doctors said tdf first and then add on interferon

i will be starting around february too, i will be doing gcmaf atthe same time, the reports of gcmaf are that it even prevents chemios sides so i guess it will help me with interferon too
Helpful - 0
Avatar universal
thx again stef.

so what is reccomendable now? would it be better wait again? I do belive doctors will suggest combo tx.. starting tfv and then add on pega.. 115 or 180 as last time I got low platelettese values so I had to reduce from 180 to 115..
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Avatar universal

yes you are not totally immune tollerant but that little immune response is of n o help
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Avatar universal
thx stef for replying.. I'm in fact startin with tdf for some weeks/months and then adding ifn... anyhow you're right alt is getting lower but still really out of  range.. isnt this meaning some immune repsonse is still on?
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Avatar universal

it may also happen that tdf makes hbvdna und in 3 months but this is rare, in this case interferon+tdf can work
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Avatar universal

sorry it got even worst, you lost the little immunity you were achieveing

to me the best option would be tdf+etv 1 year and then tdf+interferon.this because hbeag and hbvdna so high destroy all hbv immune response.by lowering hbvdna to und by tdf+etv (one antiviral only is too weak on such high hbvdna) will rescue your immune response so that interferon add-on when hbvdna und will work

if you use tdf+interferon from begining you will probably have:
hbvdna and hbeag high anyway even in 6-12months
as antiviral rescue some immune response ast/alt may get elevated
interferon will make ast/alt elevated

by sequential strategy you avoid the flares and optimize interferon response
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Avatar universal
hi all,

got latest lab

AST 70
ALT 240
GGT 76
EAG +
anti-hbe -
VL >1000000000 (out of range)
PT 117 (80-120)

so far I see i'm still eag+ so he combo tx tdf+pega may have higher success rates.. I believe I can start this next month..

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Avatar universal
maybe you should put your ALT / AST / GT / PT / VIT D / VL ..in a tabel and maybe a pattern will be visible.

BTW on the Nov 15, 2011 post you maybe switch ALT value with AST value - just double check.

on the other hand I can see that a maximum was ereach in Oct and now it start to decline (I guess that you are in the last part of immune clerance phase  and maybe a e seorconevrsion can happening )
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Avatar universal
latest labs ALT 320 AST 100 GGT 103
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