my feedback

[flyinsky]

hi everybody
here is my feedback from i know that i have heb till now
my biliburine prothrombine all in normal range


  05/06/2011(pregnant)
alt                   12
ast                   09
hbsag              2700ui
adnhbv            2500ui
hbeag and ab not done            
fibroscan          0.16kps
ultra sound       normal

     //11/2011(pregnant)
alt                   09
ast                  04
hbsag            3000ui
adnhbv          <20ui
ultrasound     normal
fibroscan        0.24kp
hbe not done

     03/2012'  (after delivery baby in january 2012)
alt                 16
ast                 12
adn undetectable  <12ui
ultrasound        normal
hbeag        ----
hbeab        ++99%inhibition
hbsag             3500ui
pre c mutant

    12/2012
nearly same results with march2012

     7/2013   (pregnant)
alat        26
asat       19
hbv adn    2600ui
hbsag       3700ui
ultrasound    normal
fibroscan      2.5kp
hbe ag -
hbeab+

january(feeling pains in arms and every where lUck of vit d  17ui
4/03/2014)
alat      166ul
asat       87
adn        44million

24/4/2014
alat   123
asat    65

7/4/2014
alat  111
asat 60

  22/4/2014
alat     169
asat    97

  10/05/2014
alat209
asat 102
adn   54 million

29/5/2014
fibroscan 6.1
  
7/06/2014
alat   156
asat    83

21/6/2014
alat     80
asat     49
fibroscan   7.4

05/07/2014
asat    49
alat     80

26/07/2014
asat    50
alat     78
adn     119 million
fibroscan  4.2

29/10/2014
asat   48
alat    70  waiting for check for 18/11(maybe fibroscan or biopsy)
viral load  80million
thans i  advance  about your opinions





    

  

[StephenCastlecrag]

As you know I am not a doctor.
Reading your history, I am very disappointed. It seems in March 2012, you achieved undetectable hbvdna, with qHBsAg=3500 iu/ml. This seems typical of the  Immune Control (inactive) phase. However, you also stated you had pre C mutants. To me, this is not unusual, as the transition from Immune Clearance to Immune Control, leading to e-seroconversion may involve some mutations that lead to reduced production of HBeAg. You then enjoyed 15 months of inactive phase, but in June 2013, in your second pregnancy, your hbvdna started to rise, followed by rises in your ALT. Since then your hbvdna and ALT were elevated and fluctuated. This is very typical of Immune Escape (re-activation) phase.
It is my understanding that from the re-activated phase, it is very unlikely that you will return to the inactive phase, and so treatment will be necessary. The good thing is that you seem to be under the care of a very good doctor,the two of you should be able to decide on when to start treatment and what treatment to use. Personally, I think both PegIFN and NUC are suitable. Being female, moderate viral load and elevated ALT, and moderate qHbsAg make you a suitable candidate for PegIFN treatment. Of course ETV or TDF will work for you too.
I am disappointed that you had such a short inactive phase, but treatments are available, and before long, we should have a cure.
Just my opinion. All the best.

[flyinsky]

Thanks Stephen you have resum my history in few sentences according to my doc the pregnancy wich turn me from inactive to active 'iwill see her then we will discuss well she is very listener also do research on hbv cancer always she update me on news of hap b

[flyinsky]

For treatment she told me at this stage with such high viral load it is useless to use peginterf and she want to see how my body react may iwill be again inactive cartier?shel told me baraclude or tdf for the moment and if the hbsag decrease she ask me when I will realy ready we add it and according to my liver conditions

[SafiSifa]

try black cumin, curcumin, and garlic, then see the results :)

[StephenCastlecrag]

I am glad you have such a good doctor. I may have been wrong in suggesting that it is unlikely that you may revert back to the inactive phase. I should have added it may be the case if your HBeAg remains negative. as your doctor suggested, your pregnancy may have reduced your immunity and caused your virus to be active again and you may have reverted back to HbeAg positive. Doctors know best.

[melcul]

hi flyinsky, are you currently under treatment ? or will you start it in the near future ?

[flyinsky]

for the moment i am not next check i will discuss with my doc
safy i start 3 daysago the mexture you suggest fo garlic i introduce it in salad better i cant eat it directlly!!!!!!i decide to try this mexture for a long time and see
i hope avoid treatment becaue it is for life i have just 32years so hopping every thing get in order sooner

[flyinsky]

So m'y check is done.
M'y doc see That m'y viral load is stable and very high
So she decides to wait Just more 3monthes again to accomplish a year . i Will do on the end of February fns fibroscan ultrasound asat alat DNA Platel biliburine protho .if the viral load remains high and fibrosis proved so treatment immediately with viread or baraclude

[SafiSifa]

You should start treatment immediately. What does your doctor wait, a miracle?

[flyinsky]

May my immune syst restart!

[stef2011]

no it will never restart, without treatment it just damages the liver and sicne we know the cure is slow 10-15years by antivirals and then peginterferon add on.....it does not make any sense to wait.especially if you consider that if you clear the virus after 50yo there is no benefit, you still carry the high HCC risk

[flyinsky]

i know in reality she wants to introduce treatment this time ,realy i am not ready also my last fibroscan was good 4.2 for this i want to wait more ,but next time if monotoring will be not good and fibrosis improved sure i will start it
why stef you say no it will never restart, without treatmen;could you please explain more

[stef2011]

without treatment you better it does not start, it is immune system to damage the liver without making any difference to hbv.
you have to start tenofovir or entecavir for 5-10years to repair your immune system and then add peg, all the rest is just wasted time since 10years is not short

[melcul]

hcc is due to high viral load or hbsag or both ? can appear at any age/phase/fibroscan score etc or its just bad luck ?

[stef2011]

it is not known exactly but if you clear hbsag by the age of 50yo you lower the risk like those who were never infected, if you clear later it makes no difference

i think hcc is due to our immune system not clearing hbv and making inflammation and cellular damage.i read a study long time ago that said cells degenerate to hide from immune system and not being killed...maybe also this is part of hcc degeneration but it is probably a mix of inflammation, hbv integration in our dna.......how you prevent it for sure:
making hbsag less than 1000iu/ml on hbeag neg and of course no hbvdna and fibroscan less than 5kpa

[stef2011]

on hbeag pos/immune tolerant there is very little immune response so the HCC risk is very low whatever

[flyinsky]

and do you think with low fibroscan like 4.2 is it necessary to star nucs immediatly?

[flyinsky]

melcul few days before you waited for my check here it is but sure next time i will take treatment ,what about you?

[melcul]

Hi, I only checked my hbsag which got up now to 380k my hbvdma was 170 mil 3 months ago, alt flaring at maximum 110, mainly being 80-50-80
I currently take Vitd D 10.000 IU/day after i find a lab to do my tests i will increase to 20.000/ day .my doctor wanted to wait few more monnths because i had a bit of fatty liver and wanted to exclude that as a cause of high alt . also i only discovered that i am hbv carrier since June so since than i started to check everything. my fibroscan came at first 7.3 or something like that but after that i checked again and was 5.6 then 3 weeks ago was 5.3kp so i guess its just inflammation. the doctor told me to wait 6 months since i've discovered so that will be in dec. after this, in January if alt does not calm down i should start treatment. he suggested me interferon as a first line of treatment, saying that maybe i am one of the lucky ones who responds well to it, and that it is not harmful and can be stopped at any time.the other doctor wanted me to take 3 months entecavir then interferon. now i am just waiting and thinking what to do. of course i am thinking of sequential treatment with tenofovir like i've seen here so many times, but i think of all of the possibilities

[flyinsky]

For interf it doesn't work with such high viral load.in my opinion as many doc suggest take first nucs to reduce your viral load and transa then you and doc will see when you start interf.personally my doc for moment avoid interf because my hbsag high with high viral load so nucs first and we see.give me your news

[12345e]

hi .ik not understand how it verchil in FibroScan can be within one month the value of 7.4 to 4.2 kPa gaat.is we FibroScan reliable my internist says can often be wrong. I had also had previous years FibroScan was 11,4kpa since I use Baraclude 0.5 but want to do it again. it would have had in 2010 biopsy and then it was f0, to my drop .

[melcul]

That's because you had inflamation in the liver and not fibrosis ! If you have fibrosis, then it will take months to lower it under medication. Fibroscan should be interpreted by your doctor along with other reliable blood tests

[April63]

Liver inflammation influences liver stiffness measurement by FibroScan. Melcul is right, the doctor has to also look at ALAT, AST results, before coming to a conclusion.

[stef2011]

i am suggesting starting treatment not to control hbv but to clear it definitively by peg add on after long term nucs.

it ll take more than a decade in the worst scenario or 5 to 10 years