Worried, pretty high viral load... antiviral treatment?

[cheng302]

Hi guys, just got my viral load results tested last month. They have to send my blood to Toronto, which takes a long time to wait... They didn't test my HBSAG (quantitive). They said they don't care that. Nonetheless, The viral load is pretty high! I am quite worried now. Do I need antiviral treatment right now? Since last October, I began to feel tiredness, especially when I walk upstairs. Also, I lost almost 10 pounds in the last few months. They still want me to see a doctor of internal medicine to make sure these symptoms are not related to other diseases.

2015/01/16
Male, 27
HBV surface Ag:  Reactive
HBV Surface Ab: 0.5 mIU/ml
HBV DNA: 1.1*10^8
ALT U/L [0-54]  197 H
AST U/L [5-45]   94 H
ultrasound: A small amount of free fluid around the liver. The liver parenchyma appears within normal limits otherwise.

I was first diagnosed with hep B in June 2013. The viral load was undetectable that time. HBEAG positive. My parents all have HBV Surface Ab >200 mIU.ml.

[stnana123]

Had liver function test....result given below
billirubin total= 0.9 mg,/DL
billirubin direct =0.18 mg/DL
billirubin indirect= 0.75mg/DL
SGPT= 040.2 iu/L
SGOT= 031.9iu/L
Alkaline phosphate=0149.2 iu/L

is this normal?? kindly suggest

[stef2011]

of course is i took 16.2kpa to 4.5kpa (3.5kpa is only babies liver or some women, any below 5kpa is ok)

[varsa]

Stef is it possible to bring down 7.5 kpa value to 3.5?thanks

[stef2011]

can you get a supplement with lower dose so you can take 10.000iu daily?

so you can go with daily dosing untill you can check vitd25oh and intact pth again next month and see if you can go with 50.000iu daily or every 3 days.

unfortunately this study showed that even weekly dose is not ok, if i find it i will post here on medhelp too because they checked tissues for vit d after 1 dose of 50.000iu weekly and after few days there were none in tissues although you see levels high in blood

[cheng302]

Thanks, stef.

I've been on this dose for nearly two months, one capsule per week for the first month, and then increasing to one per 5 days (Amount
Per Capsule is 50,000 IU). I might check the vitd25oh level again next month (they only do it every three months for free).

I agree, I also think my fatigue is mainly from hbv. But both my family doctor and the internist don't think so...

[stef2011]

bit higher than normal (<7 kpa).

normal is less than 5kpa, some consider even 6kpa ok but 7.5-8 starts to be considerable fibrosis and also hcc risk is increased on hbeag negative

offer me antiviral treatment. Any suggestions?

go for tenofovir if any antiviral is needed, its the most potent


Now I am taking vitD 50,000 IU /5 days (Biotech). But sometimes I still feel extremely fatigue.

there is new study showing only daily dose is good because the vitd25oh we see in the blood is transformed to other type to get in to tissues and this other type has about 24-48hrs halflife and then goes down.
i use this biotech type too but my doses are very high so it is ok to take daily, what is your last vitd25oh level?so we see if you can take every 3 days at least

if you go on no diaries diet (even those present in processed food), water with calcium less than 10mg/l and drinking 2.5L per day, you are relatively safe for a short time even taking every 3 days but check calcium and intact pth every month if you go so high dose

fatigue is mainly from hbv, how long are you on this vit d dose?