I have several questions regarding the HBs antigen.
I discovered my hepatitis B in 2010 during my pregnancy; I had a viral load of 8000 IU and an HBs antigen of approximately 50,000 IU. In 2019, the hepatologist put me on entecavir because my FibroScan was at 7 kPa and I had various symptoms. Today my DNA is undetectable, but my HBs antigen is not decreasing and remains around 50,000 IU. And I have developed secondary fibromyalgia.
My questions are as follows:
-What does a high HBs antigen mean?
-Is it more serious for the liver?
-Can it decrease with entecavir?
-Are there any treatments in development addressing a high HBs antigen?
-I have genotype A, is it a good prognosis?
-My ferritin is very low, as are my white blood cells, and my MCV is high; is this related to the treatment?
Hi, I am not an expert or doctor. I will answer some of your questions:. Entecavir will not directly decrease your serum HBsAg (however, some believe prolonged treatment with Entecavir may need to a natural decrease of cccDNA in the liver and a resulting decrease in serum HBsAg). Serum HBsAg is not harmful, as it is just a protein, is not infectious, however it will prevent your own immune system from clearing the HBV virus. Genotype A is the best HBV genotype to have, and genotype A HBV is very amenable to Interferon treatment. There is a company in Quebec, the French part of Canada, Replicor (replicor.com) that develops drugs to very substantially reduce serum HBsAg. You can visit its website to find out all about HBsAg. Also, its Chief Scientific Officer, Dr Andrew Vaillant is an expert here on the forum and he can certainly answer your questions.
Cheers.
Hello, thank you very much for your reply. It is very interesting and important for me to have answers to the questions I am asking myself.
Indeed, I have the impression that with my high level of HBS antigen I will never be cured and that the new treatments under development do not suit my profile.
Kind regards,
Marie
Thank you for your questions and I will try to answer them as best as I can:
1 and 2- High HBsAg is common in many people with Hepatitis B. It means many of your liver cells have the virus in them, which means it is harder to get rid of. This level does not have anything to do with the health of your liver though.
3 - As mentioned in my previous Email, entecavir does not affect HBs antigen levels, but it does stop new virus from being produced. This helps stop liver disease progression and liver cancer.
4 - There are clinical trials underway developed to treat people with high HBs antigen levels, but more testing needs to be done.
5 - In the general case, Genotype A is associated with better outcomes and higher likelihood of clearance compared to other genotypes. We don’t fully understand why.
6 - These lab results could be due to many different causes and it is best to go to your doctor about understanding the cause of this. It is however not a common outcome of antiviral treatment.