Do Fibro scan now or wait?

I am on interferon. Should i do Fibroscan or wait till treatment is over. My one gastero doctor said wait. But other gastero doctor said you can do.

Please suggest as i have appointment tomorrow for Fibroscan but i can delay it for few months.

Dear Suresh,

You should not do a fibroscan on interferon as mild liver inflammation (part of the normal process of the liver tying to rid itself of infection) will artificially inflate the fibroscan reading. There is no point in doing a fibroscan until at least 6 months after you have stopped interferon.

The only things you need to monitor during your interferon therapy are the following:

  1. How you feel. Very strong aches, joint pain or fatigue. These symptoms in mild form are normal but in severe form should be reported to your doctor.
  2. ALT/AST/bilirbuin/abumin/INR/platelets.
  3. HBV DNA and HBsAg (and anti-HBs if HBsAg is cleared).

God luck.

3 Likes

thanks a lot, same thing one of gastro doctor said

dear @availlant,

thanks a lot for constant support, God bless you.

in your view how often to test HBsAg during this intereferon time, as I haven’t got quantitative so if i do frequent qualitative tests, will it be of any use? like once a month

i am already 36 injections and only 12 injections left.

in case if HBsAg is still not negative after 48 injections then do we continue the injections?

thanks a lot again

Dear Suresh786,

Quantitative tests can help early on in pegIFN therapy to catch early declines in HBsAg (which can signal future therapeutic success if they are strong enough). Now that you are in the last 1/4 of therapy, a qualitative test can tell you of you have cleared HBsAg but not how low your HBsAg is.

Extension of pegIFN therapy from 48 to 72 weeks only very marginally increases the chance of achieving functional cure but it does increases the chance. Your current quantitative status would be helpful here as previous clinical data shows that HBsAg < 1 IU/mL is a positive indicator for functional cure. If you are tolerating your pegIFN well, you can discuss therapy extension.

Are you currently taking a NUC as well (ETV, TDF or TAF)?

Best regards,

Yes i am taking the TAF

@availlant
Sir, if , i know its big IF , that HBsAg becomes negative then do i still need to continue pegINF for 48 weeks ?
i mean can i stop IF hbsag becomes negative at 36 weeks

Dear Suresh786,

Clearing HBsAg during treatment is an important milestone for functional cure. However, the second important event is the restoration of immune function which now can effectively occur in the absence of HBsAg. Other than flares in ALT/AST, we don’t have any good markers for when this has actually occurred.

All of the functional cure rates with pegIFN occur with at least 48 weeks of therapy. I would advise to complete the 48 weeks of therapy.

Best regards,

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dear @availlant ,

my AST / ALT is slightly raised like 55, my one doctor says it could be due to fatty liver but other doctor said its normal for LFTs to be deranged during pegINF.

what’s your view on this please

Hi Suresh786

This is absolutely normal during pegIFN.
Check your bilirubin, albumin, and INR. These are the true indicators of liver function and should be normal.

Best regards,

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@availlant please find attached my latest results




Hi Suresh786,

Mild to moderate declines in white blood cells and platelets are normal with pegIFN. These are not concerning. The fact that your doctor is monitoring these tells you that you are been followed properly during your treatment.

Best regards,

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@availlant
Sir, when to do next HDV quantitative. Last test was done at 24 injections.

Dear Suresh,

Do mean HBsAg quantitative?

You can think of doing this test after 36 injections.

Beat regards,

No sir i mean HDV quantitative. Its costly test and it came zero when i did on 24 injections.

Dear Suresh786,

The most important HDV RNA test result in your case will come after you complete pegIFN to see if the control of HDV infection is persisting off therapy. Unless you develop symptoms of liver disease earlier, I would wait until 6 months after you have stopped pegIFN. Also I would not stop TAF unless your HBsAg is also negative after stopping pegIFN.

Best regards,

1 Like

@availlant

I did HBsAg qualitative test and it came Reactive.