Non reactive HBeAG and reactive Anti HBe after 10 years of treatment

[Afifah1962]

My son (now 30 years old) started Hep B treatment 10 years ago (tenofovir taken everyday). 3 years ago, the status was HBV DNA undetected, quantitative HBSAg decreased from time to time but stuck at 150 to 200 IU/ml and HBeAg and Anti HBe were reactive. At this point his doctor asked him to take the medicine only once every two days and after a year the status of his Hepatitis B was more or less the same as before. Based on this 'good' laboratory result, my son was then advised by his doctor to  take the medicine once every three days and after a year the HBV DNA was still undetected, quantitative HBSAg was about 200 and HBeAg and Anti HBe reactive. Actually his doctor advised him to continue taking the medicine once every 3 days but my son kind of ignored this advice and he completely stopped taking the medicine since about a year ago. Worried, a week ago  I urged him to check his hepatitis status  and I am very happy to see the results: HBV DNA undetected, quantitative HBSAg at 128.73 IU/Ml. His HBeAG is now non reactive but Anti HBe is still reactive.

My question: with current status of Hepa B as above, do you think continue taking the medicine (tenofovir) will help make the Anti HBe non reactive and in turn eliminate HBSAg completely?

[Jatashankar]

No don't continue the medicine. Your son is in remission phase. He may clear hbsag on further cessation of drug. There have been a lot of trials showing positive outcome on stopping nucs after long term therapy. Keep monitoring, and if number deteriorates then start the medicine again. Wait for atleast 76-78 weeks from start.

[StephenCastlecrag]

I a not a doctor. In my opinion, your son can stop taking Tenofovir  since he is most likely in the Immune Control phase (also known as Chronic Hepatitis B disease phase), because his hbvdna is less than 2,000 iu/ml and his serum HbsAg is less than 1,000 iu/ml. He will still need regular checkups, at least once every twelve months. I also want to tell you that antibodies, such as HBeAb, are made by the human bodies to neutralize the antigens, such as HBeAg, made by viruses and foreign organisms. They are good proteins and are a very important part of our immune system defense against diseases. Your son will be functionally cured when his serum HbsAg disappears (less than 0.05 iu/ml). This may take a long time but not impossible.

[halt651]

Hi Stephen, very pleased to see you active after long time. I hope you are doing good. Thanks for your comment this is actually something I was not aware of it.

[Quincyw33]

Did you son start drinking a little coffee?

[melcul]

I think your son is in a really good place if his HBVDNA or HBSAg staid the same, even if he stopped the pills. Of course I would not have stopped the treatment, he is really close to cure it with such low results. I would definitely follow doctor's advice.

[Afifah1962]

Thank you for your insight.

[Quincyw33]

Tell your son to start drinking a cup of coffee every other day or so. And it might make his HBSAG go to zero.

[Afifah1962]

Thank you for the suggestion.

[Gyancanus]

Please are there any serious side effect when taking tenofivir?

[Jatashankar]

No don't continue the medicine. Your son is in remission phase. He may clear hbsag on further cessation of drug. There have been a lot of trials showing positive outcome on stopping nucs after long term therapy. Keep monitoring, and if number deteriorates then start the medicine again. Wait for atleast 76-78 weeks from start.