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New Results & Continuing Vemlidy (TAF)

Had my 3 month follow up since my last visit in June 2022.

Good news is my insurance is now covering Vemlidy (TAF) again. They had to make a special case for me in order for insurance to cover it. Otherwise I was going back on TDF. My HBV DNA is also undected

Bad News is: My weight is in obesity stage, my blood pressure is in hypertension, my HBSAG has also increased. My ultrasound also had the lesion show up again that I had back in 2019 and back then it was a fatty  lesion and not a concern, but I do have fatty liver.

Unfortunately, I forgot to ask for them to check my Vitamin D so I don't have my results there but everything else is pretty much normal and stable. See below for the latest

Glucose - 92 mg/dL
Sodium - 137 mmol/L
Calcium - 9.5 mg/dL
Bilirubin, Total - 0.4 mg/dL
Alkaline Phosphatase - 71 IU/L
AST (SGOT) - 20 IU/L (1 pt lower than 3 months ago)
ALT (SGPT) - 35 IU/L (1 pt lower than 3 months ago)
pH - 6.0
HBV IU/mL - HBV DNA not detected
AFP, Serum, Tumor Marker - 1.8 ng/mL
Hep B Surface Ab, Qual - Non Reactive
Hep B Surface Antigen Quant  - 5616.00 IU/mL
Phosphorus- 2.9 mg/dL
HBsAg Screen - Positive

My HBsAg Quantitative keeps going UP and this is a problem for me. I suspect now it's weight related more than anything else.They are now as follows:

In March of 2020 it was at:
1318.00 IU/mL

In September 2021 it was at:
3599.00 IU/mL

June 2022 it was at:
4168.00 IU/mL

September 2022 it's now at:
5616.00

Regarding my weight, it's seemingly gone up since I stopped the clinical trial for TAF. My doctor did suggest try going back to TDF since he's heard patients saying TAF caused weight gain. My thought behind that is that I was on TAF in the clinical trial for 5 years and I weighed less and actually lost weight at some point.

I do agree my weight needs to come back down a LOT.

Regarding my blood pressure, while I do think my weight contributes to a high blood pressure, I also take into account that:

- I walked 1 mile to the doctor's office (because I am unable to sit comfortably in a car) and that causes the BP and heart rate to rise

- I have 2 failed neck surgeries in my neck and this alone can also cause BP to rise (and makes doing intense cardio exercises impossible, which is what I need to do to lose weight).

I was also offered to go on a clinical trial. The same clinical trial last year that they suggested I go on after a patient was cured from it, and I said no because of the Interferon treatments I didn't want to go through as part of it. They said there wasn't going to be room last year and 1 year later it's brought back to me. I have yet to say yes or no, but with my HBSAG increasing so much, I can't see how this trial would cure me of anything unless that number goes closer to 1,000.

Anyway, wanted to share my latest here! Hope everyone is well!
4 Responses
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Avatar universal
I would strongly recommend two things:

1. Take 2000 IU of vitamin D every day.  -- this will stop your  Hep B Surface Antigen Quant from going up any more.
2. Make coffee with 'Folgers Columbian Coffee (Medium blend)' and drink two cups a daily. -- This will cause your Hep B Surface Antigen Quant to start going down.
3. If you drink 'Great Value Classic Medium Roast Instant Coffee' your weight will go down slowly. But the Surface Antigen Quant will not go down.

This is my advice. You don't have to listen to me. Just sharing with you what I strongly believe will help you. Vitamin D & Folgers coffee.


Helpful - 0
Avatar universal
let's start from the point they will try to avoid exposing this or compare taf directly to etv....

https://journals.lww.com/aidsonline/Fulltext/2022/08010/Switching_from_tenofovir_alafenamide_to_tenofovir.2.aspx


CLINICAL SCIENCE
Switching from tenofovir alafenamide to tenofovir disoproxil fumarate improves lipid profile and protects from weight gain


Switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) increases low-density lipoprotein cholesterol (LDL-C) and body weight. Metabolic effects of the opposite TAF-to-TDF switch are unknown.
Objectives:

To investigate the effect of TAF-to-TDF switch on plasma lipids, body weight, and atherosclerotic cardiovascular disease (ASCVD) risk score.
Design:

A retrospective chart review.
Methods:

One hundred and forty-six patients with TAF-to-TDF switch (Switch group) were compared with 146 patients matched for sex, age, and third antiretroviral agent class who continued unchanged TAF-containing regimen (Control group). Data were collected at approximately 1 year (follow-up FU-1) and 2 years (follow-up FU-2) after baseline values.
Results:

In Switch group at FU-1, total cholesterol (TC) and LDL-C decreased 12.1% and 12.4% (P < 0.001 in both), respectively. High-density lipoprotein cholesterol (HDL-C) also decreased 8.2% (P < 0.001) in Switch group, but TC/HDL-C ratio did not change. No statistically significant changes were observed in Control group in any lipid values. TC remained similarly decreased through FU-2 in Switch group, but LDL-C increased from FU-1 to FU-2 in both groups. ASCVD risk score decreased from 6.3% at baseline to 6.0% at FU-2 (P = 0.012) in Switch group but increased from 8.4 to 9.1% (P = 0.162) in Control group. Body weight increased from 83.4 kg at baseline to 84.9 kg at FU-2 (P = 0.025) in Control group but remained stable in Switch group (83.1−83.7 kg, P = 0.978).
Conclusions:

TAF-to-TDF switch improved plasma lipid profile and ASCVD risk score, as well as prevented weight gain, when compared with ongoing TAF-based antiretroviral therapy.

Helpful - 0
Avatar universal
i was just checking safety and new data on TAF for a family member and unfortunately there is increased bmi and cardiovascular risk with this drug, just google "Tenofovir Alafenamide cardiovascular", all your metabolic problems might be due to tdf/taf
Helpful - 0
2 Comments
Hi stef,
Thanks for this info. My weight has increased 4 pounds and triglycerides has also increased, HDL decreased since taking vamlidy in march, 2022. my HBV is undectable.
any idea what the HBV count will be if I stop taking this drug because the drug label warned stop taking it. Or have you heard from other members after stopping the drug?
My right foot has very serious pain after I get up from bed every morning or after sitting or lying down.
Or better to switch to cheaper TDF. Thanks in advance for any insights.
you can use entecavir 0.5mg or 1mg if you have no resistance from exposure to other nucs.generic tdf is also an option but keep an eye on kidneys (cystatin C and creatinine clearance) and get a bone scan before starting.tdf is the most potent drug for hbv but it does have side effects if you have to use it for decades
Avatar universal
Hi thanks for sharing with us your results. Have you ever done intermittent fasting? If not you should check Dr Berg intermittent fasting. https://m.youtube.com/watch?v=1rfzjRoalWM

So far I’ve lost over 10 pounds which I don’t want to lose anymore.  Please keep us posted on results
Helpful - 0
1 Comments
Intermittent fasting doesn't work with me and neither does Keto. A good healthy diet works with me. But thanks for the suggestion.
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