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9624973 tn?1413016130

Peginterferon treatment started for HBV

Hi guys,
Today i started my first shot of Peginterferon, It's really scary with all the side effects lurking around it.
My liver was always F2/F3.
Discovered 5 years ago.
ALT > 2-5 times the normal limit
High HBVDNA
HbeAg Positive
HbeAb Negative

I just wanted to give it a try, even if there's only a 30% chance of making HbeAg negative, before starting nucs.
If anybody has any advice it's much appreciated.


9 Responses
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Avatar universal
good luck. could you please remind in which conditions Peginterferon could be tried ?
Helpful - 0
3 Comments
From what i know, for best results you have to be genotype A or B, ( i don't know mine), Need to have HbeAg positive, high ALT, and HBVDNA not too high (like it is mine: "in millions" ). And, of course, you should not have decompensated liver disease or seriously damaged liver.
thanks! all the best. keep us posted. If I understood correctly Peginterferon will try to activate (immunomodulating) liver to fight back to virus right?  
Deciding to try is already a sign that you are courageous.  I am sure it will help.  
9624973 tn?1413016130
The first day i felt miserable. Now i feel ok. My biggest concern is that i may seriously scar my liver and not be able to reverse it. and i want to be able to stop before that happens. Anybody has any insight on how their doctor managed this?
The nurse told me she would check my blood test in a months time but nothing else.
Helpful - 0
1 Comments
why not simply asking doctor to have more frequent fibroscan test ? lets say every  months. you should not hesitate to ask !  
Avatar universal
Good luck mate.
Helpful - 0
9624973 tn?1413016130
You cannot do fibroscan every month.. it’s not accurate while on treatment anyway.
Now i just have to wait and check blood tests results.
I don’t see many Peginterferon choices on this forum, most people seem to opt for nucs
Helpful - 0
9624973 tn?1413016130
Does anybody know if generalized pruritus (itchy skin) is a normal side effect in pegyinterferon ?  I have a rash on my chest the size of my palm and itchy skin everywhere.
Helpful - 0
1 Comments
Interferon can cause many side effects.

In order to know if all this effort with interferon is worth taking in, is to monitor HBsAg quantification, to know how good the treatment works. IF HBsAg quantification does not drop, then the effort is useless (to take interferon).

Today, HBcrAg is already used in Japan in routine monitoring, in combination with HBsAg quantification, to identify patients where nucleos(t)ide analogue (NA) treatment can be discontinued.1

Serum HBcrAg levels vary significantly among the different phases of HBV infection.  HBcrAg is therefore also a good virologic marker to differentiate HBeAg-negative chronic hepatitis B patients (active disease) from HBeAg-negative chronic HBV infection (inactive disease).2

http://www2.fujirebio-europe.com/lumipulse-g-hbcrag?gclid=EAIaIQobChMI1OLi8Mzv5wIVFeWaCh0B8QW7EAAYASAAEgIUEfD_BwE
Avatar universal
And this is vital info:

The determination of HBsAg level is pivotal to individualize pegylated interferon (PegIFN) treatment; it
is the key investigation to decide early termination of PegIFN among non-responders
Helpful - 0
1 Comments
here is the source link: https://www.journal-of-hepatology.eu/article/S0168-8278(16)30441-X/pdf
9624973 tn?1413016130
Second shot of Peginterferon today. Blood test after 4 shots they say.
I asked for a fibroscan which they did, it was 8.8 kPa. although i had half a litre of water 1 hour prior. I’ve read online that it can alter the reading. At this hospital i had  the same reading 4 months ago, but when i double checked it the next day with an actual doctor at a different hospital, , it was 7.2 kp. . I will ask again next month and be sure I don’t eat or drink anything prior, only because it’s weird to have a 2kp difference in 48h time.
As side effects, i only had flulike symptoms for the first 24h and muscle pain, and for the past 2 days i experienced skin pruritus and a red chest rash.
I was hoping they will check the blood test faster at the beginning of the treatment, but hopefully it’s safe this way.
Helpful - 0
2 Comments
hopefully when they do boold test hbsag qualitative will decrease and it will be good news for you ! fingers are crossed!
regarding the "have a 2kp difference"  thanks for the details. that is really interesting last year I had fibroscan 7.3 kpa and because my blood test (ast, alt) shows that chb is immune escape mode dr did not start antiviral yet. I will have another fibroscan (+blood test) in july. so that day I will not eat and I will not drink anything to be sure,  
    
Not saying that it had any influence. I only read that you should not eat or drink at least 3 hours prior, mentioning only sips of water if needed and i had a bottle the hour before. But to be honest, i can't remember if 4 months ago when i had the reading of 7.2 kpa  i did or did not drink anything prior.
The lower reading was done by a doctor which makes me stretch a little bit on that bed and also makes me breath in, breath out, etc. On today's reading for example, it was done by a nurse, without any of that, so i'm hoping the doctor knows better. Anyway, we'll see.
9624973 tn?1413016130
2 weeks after peginterferon treatment started, i have ALT: 848, AST: 319 !!!
I've already scheduled a doctor visit, this is extremely high, i'm afraid of serious liver damage going on
Helpful - 0
2 Comments
I am soryy to hear that you are worried. Let's not interpret the results negatively. Maybe your liver started fighting with virus as interferon aim for the same.
@melcul how old are you? Whats your HBVDNA?
there are few studies that says that ALT flares are associated with HBsAg seroconversion. Hope for the best.
9624973 tn?1413016130
I’m only 29. But liver not in very good condition. Very high hbvdna,  millions
Helpful - 0
3 Comments
I'm sorry and don't worry. But you are young for the treatment to respond. All we can do is that stay positive and maintain healthy. If there is any decrease in your HBV DNA after few weeks ( may be after 6th or 12th week shot) then you are more likely a interferon res-ponder. Rather now you should be monitoring your CBC closely in the beginning i.e. for me my doctor checked my CBC ( mainly neutrophils ) every week before giving the weekly shot he gave only if CBC is fine, otherwise he used to delay the shot a day or 2. Your body will get adjusted to interferon after few weeks shots, later you will feel side effect only for that day. Even if you become non-responder your liver histology will improve a lot.
How did your alt flare  to the initial shots of interferon ? Also how much was your fibroscan before and after? Was the treatment successful for you ?
As far as I understood - 100% success of peg-intf is measured as HbsAg seroconversion. However, Peg-Intf's treatment effect will take few years to work on the virus, it will be in effect even after stopping it. We need to wait for it.
I didn't have ALT flare and not much HBVDNA reduction. After 48 weeks, my ALT became normal, HBeAg turned -ve from +ve and i had better ultra sound results though I was termed as non-responder for PegIntf. Also those days we didn't have affordable fibroscan.
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