My Hep B results. Please provide treatment suggestions

[82prasad]

Hi Stef, Vijik and others,
Please provide treatment suggestions for me.

I am having HBV for the last 9 years atleast and my age is 30 years now
My latest results are as follows:
CBC - Normal
Liver funtion test - Normal
ALT - 47 (range is 30 to 65 U /Lt)
AST - 24 (range upto 35 IU/Lt)

HBeAg - Positive (29.901)
Anti ABeAb - Negative (1.53)

HBV Viral Load - 207 (Reference: Sensitivity limit: 3.8 IU/ml)
HbsAg, serum - Positive (>250)   (reference: Negative: < 0.05 IU/ml)

Thanks,
Prasad

[82prasad]

Hi Aduski, Stef,
Bad news is I am facing pain under the right ribs, now backache and right showlder ache since last 10 days. Earlier I attributed this to incorrect sleeping posture but after reading on net I know this is due to liver. I am anyaways doing a biopsy this week but do u suggest I should also get an ultrasound done? Is this pain due to liver inflamation or fibrosis. (I had a fibroscan done last year - 5.8 KpA and my doctor had said fibrosis is a slow process so it wont harm for few years atleast)

[82prasad]

"my hbsag went from 7200 to 700iu/ml by 6 years so i dont think it will last another 6 years and years go fast"

Congratz on this Stef, but I hope you dont leave this site ever even after you clear HbsAg:) May I know did u use NUC monotherapy or peg or both to achieve this?

I'll have my biopsy this friday (have done fibroscan last year - 5.8 KPA) and start NUC. Will keep you posted.

[stef2011]

Also I assume HbsAg as such is not harming to liver if viral load is in control and liver is healthy, am I right in saying this?

you even regress advanced cirrhosis by making hbvdna undetectable, hbsag is harmless and non infectious.its use is mainly suppress our immune system from attacking the virus.
so by antivirals you achieve a perfect liver like if there is no virus

hsag lowers on antivirals, just slow for majority of patients but we have time, my hbsag went from 7200 to 700iu/ml by 6 years so i dont think it will last another 6 years and years go fast, they look like few days to me when i started nucs

vitamin d3 must be taken but not together with antivirals so we are sure to avoid any  possible interference

[82prasad]

Million Thanks Adusiki,
You have been of great help to me.

I hope HbsAg drop if even for HbeAg negative persons? Im ok with smaller percentage drop as well as long as it drops :) and doesnt increase. Sorry what do you mean by 0.34 logs on 26000?

[Aduiski]

log base 10...

http://www.miniwebtool.com/log-base-10-calculator/

[82prasad]

Thanks a ton Stef,
So you say no use to supplement with Vit D medications if im taking ETV right...

I got your point on clearance rates, I agree on it however does NUC's only reverses liver condition and reduces viral load or even reduces HBsAg (in HbeAg negative). I agree it may not clear but is there a chance of lowering this? Also I assume HbsAg as such is not harming to liver if viral load is in control and liver is healthy, am I right in saying this?

[stef2011]

no vit d is better absorbed with meals, etv can t be taken close to meals

tests: vitd25oh, intact pth

genotype A has the highest levels of hbsag among all genotypes but very little studies because all the studies are made on italian genotype D and asian genotypes (no studies in US/UK and nothern europe where genotype A is common) this said it is possible response on hbsag is higher both on nucs and peg, infact genotype A has the highest clearance rates on peg and nucs (not sure if nucs is hbeag pos or neg, i guess pos)