My lymphocytes and hbv

[sorte]

I've made some lymphocytes tests, any comments in the context of hbv appreciated:

Leukocytes 6,07 ×103/μl [4,40 - 11,30]
% lymph 43,3 % [21,8 - 53,1]
Lymphocytes 2628 cell/μl
% CD3+ (lymph T) 76,7 % [59,7 - 82,0]
CD3+ (lymph T) 2016 cell/μl [900 - 2600]
% CD3+CD4+ (helper lymph) 52,4 % [30,4 — 51,2] H
CD3+CD4+ (helper lymph) 1378 cell/μl [500 - 1600]
% CD3+CD8+ (cytotoxic lymph) 22,4 % [19,0 - 38,9]
CD3+CD8+ (cytotoxic lymph) 589 cell/μl [300 - 1200]
CD4/CD8 2,3 [0,8 - 2,5]

I'm not on any therapy yet, starting peginf soon. Viral load fluctuated from 5600 to 650 this year. I use supplements like d3, magnesium, k2mk7. Gonna have more tests like IL-2, IL-6, IL-10, TNF-alpha in 2-3 weeks.

[stef2011]

Root canal teeth should be removed, they remain infected and spread infection/inflammation from time to time, this does not happen to all but how you know those in danger

Also amalgamas should be safely removed

[sorte]

I have some more immunological results, any comments appreciated:

INF-gamma 225 [290-1050]
TNF 1836 [320-1380]
IL10 974 [1530-3830]
IL4 21 [20-120]
IL5 < 20 [20-95]
IL2 96 [20-45]

WBC 5600 [4600-7100]
Lymphocytes 2520 [1000-2400]
CD3 1789 [700-2100]
CD4 1210 [300-1400]
CD8 529 [200-900]

CD19 378 [100-500]
NK cells 277 [90-600]

I had a biopsy and US before interferon, also AFP around 3 weeks before those tests.
And nothing related to hcc revealed, also other tests in norm. I also had some wisdom tooth root canal inflammation.
Is it possible that chronic HBV may have such strong impact on those cytokines.

[sorte]

I was just worring that hbv may change some chromosomes and trigger some health problems in the child. Sorry if it's the nonsense :) I don't know if chromosomes may change during live. I've got quite good overall knowledge in the science but not in details for such things like genetics.

[studyforhope]

Some viral dna remains even in the case of acute resolution. It is not harmful only because it is under permanent lifelong T cell control. Upon intense immunosuppressive therapy, like for cancer or some autoimmune diseases there is always a risk that the hepatitis can reactivate. Two and a half billion people worldwide have this condition. It is now standard to treat such cases upon immunosuppressive therapy with antivirals to prevent such reactivation.

The father does not transmit HBV to the baby.

[sorte]

Thanks for an answer.
So after HBV infection no matter accute or chronic, even if resolved some viral dna may stay integrated into chromosomes but it's not harmful ?
How about passing hbv to the child by father ? In case of HBsAg+ and after losing it ?

[studyforhope]

You are not using the term integration properly. Integration into the genome of a liver cell means placing all or parts of the hbv genome directly into a host chromosome. No cccDNA is needed then to reproduce virions and cccDNA elimination mechanisms will not work to clear such a cell from hbv.
Forget about Integration into non hepatocyte cells. To get rid of integrated hbv DNA,  a cell must be killed. This is much harder to achieve than non cytoplasmic cccDNA clearance.

After hbsag seroconversion there is typically some cccDNA non integrated as well as a small amount of integrated hbv left in the liver.

Elimination is thus not complete, but a resident permanent t cell response, together with an effective anti hbs antibody titer to slow respreading from infected remnants will often permit a stable maintenance of a very very reduced state of infection in the liver.

[sorte]

seems that I found some answer for the second question http://www.ijidonline.com/article/S1201-9712%2812%2901248-9/abstract

[sorte]

Got one question, not related to topic. We know that hbv dna integrates into different parts of the body, tissues, not necessary only the liver. I heard about genome integration etc ..
Is it cleaned after successful seroconversion not matter spontaneous or induced by drugs ? As I know there may stay a bit in the liver as cccdna how about other parts of the body.
Another question, if HBV infected man can pass it to the infant during insemination ? As I guess there may be some hbv dna in sperm.

[stnana123]

sorry for for stupid question..should I start medication with pegintf?? how much Time it will take to clear the virus??

[sorte]

seems that it's required to clean any infected cells, so maybe its normal to have it higher on chronic hbv

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0103008

[studyforhope]

a noninflamed person would have a tnfalpha of 1 to 2 pg/ml. But inflammatory conditions are quite common. i do not remember  the typical hbv profile for this cytokine.

[stef2011]

no problems, all good for max pegintf response

genotype A and B easier response, D and C worst

[stnana123]

srry...There is a correction that hbvdna is 8030.5 not 80305..
I dnt have idea. is there any process to find out gentype?? my doc suggestd me to wait for 3 months..
m very confused about this. what I shall I do??

[stef2011]

Hbsag..with end time dillution=1038.8 iu/l

you have a perfect result to clear by pegintf, do you know your genotype?

if you want to clear hbsag i uggest you start supplementing vitamin d3 to reach a intact pth value of lowest norm range, it should be 10-20pg/ml for most machines and a vitd25oh around 100ng/ml (vitd25oh test is valid only if there is no receptors resistance, that s to say pth goes low with vitd25oh 100ng/ml)

start supplemnting vit d3 and let us know results by 3 months, in the meantime some members are trying pegintf plus high dose d3 plus gcmaf, if it will help pegintf response it will be good to add but we have yet to see results, i am the only one until now who tried this combination.this said your low hbsag allows good results anyway even monotherapy

there are some trials showing better results if tenofovir is added too but effect of tdf add on are weak, i am not sure if this will help

[stnana123]

please interpret following result.......

Ast=21u/l
ALT= 25u/l
Hbvdna=80305 iu/ml
log value=3,92
hbeg= non reactive (o.39)
Anti-hbe-ab= reactive
Hbsag..with end time dillution=1038.8 iu/l
MRE(elastograpy) shear stiffness= 2.94kpa
please suggest what shall i do with this?

[stef2011]

i think only the new micro rna test studied in pisa can give a picture of ongoing immune response


as soon as i get news i will post but the test is probably not available for normal patients not on the studies

[sorte]

is it common that TNF-alpha may be like this in HBV ? My last ALT result was 41 so on the border of the norm.

[studyforhope]

not much can be concluded. from these circulating cytokine levels. the test sensitivity is limited, thats why some are in the below a certain value range only. only a few labs can even measure gamma interferon levels, thats why it is not part of your panel.
tnfalpha is fairly high, pointing to an ongoing proinflammatory source.

[sorte]

Sorry, the number in [] was labeled as referential range, not norm. So for example for TNF-alpha it was < 8.1
No idea how to interpret those results especialy for ILs

[sorte]

some more results:

TNF-alfa: 6.4 pg/ml [norm < 8.1]
Interleukin 6: < 2 pg/ml [norm < 3.8]
Interleukin 10: < 5 pg/ml [norm < 9.1]

I don't know why they don't give exact values for ILs. Also I think they used some different units than those ones mentioned in a study above, cuz some norms here are lower than average results in the study.

[sorte]

I always have all morphology results in norms and never felf any symphtoms, just last few months sometimes I feel my liver but its rather discomfort than pain. Maybe D3 supplementation triggered some immune response ? I've been deficient when started.
Bilirubin was 9,70 and 2 months later 6,60 [µmol/l]
Albumin 60.4 % [54,00 - 65,00] N
HBsAg is quite high, over 13000. HBV DNA was 5600 but last result was low 650 IU, but as I know for interferon lower is better. I haven't seen biopsy results yet, but if I qualified for peginf I suppose there is at least A1 or A2 inflammation.
My ALT varies around that norm 41, sometimes a bit lower sometimes a bit higher. Unfortunatelly in Poland they don't practice combo or sequential therapies, interferon is always first shoot drug if no contraindications, I know it will be hard to clear in 48 weeks but I hope hbsag will decrease a lot and will keep SVR. One doctor told me it's 50% chance for SVR. I don't know my genotype but 85% in Poland is A the rest is D.

[studyforhope]

serum albumin platelets and bilirubin are always interesting, although they tend to go out of optimum very late upon cirrhotic damage.

what were your hbsag quants?
when will you start ifn?

[sorte]

Thanks for the comment. I've made some tests before using interferon and gcmaf and just for overall knowledge. I also have:
TSH 1,51 µIU/ml [0,350 - 4,940]
FT4 1,09 ng/dl [0,70 - 1,48]
ANA1, AMA, ASMA negative
so normal results.
Need to make some other ones next week anyway so any other tests you think may be interesting in the context of HBV ?
I will post all other results when done.