Functional cure or very early suppression of HBV DNA to < 10 IU/mL will be the best. In these scenarios there will be negligible production of (erroneous) linear HBV DNA, which is the form that becomes integrated into host chromosomes and causes DNA damage to the host cell.
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Agreed, and now that I think about it, I’m not sure it was powered to detect differences in the patients with low rates of cancer (such as those below 2000) - so even if there is an effect, we may not know just because of probability.
One study of 20,000 people is here: HBsAg seroclearance further reduces hepatocellular carcinoma risk after complete viral suppression with nucleos(t)ide analogues - ScienceDirect
Compared to complete viral suppression, lack of complete viral suppression was associated with a higher risk of HCC (7.8% vs. 5.6% at 8 years, Gray’s test, p <0.001) (adjusted hazard ratio [aHR] 1.69; 95% CI 1.36–2.09; p <0.001); patients who achieved functional cure had a lower risk of HCC (0.6% vs. 5.6% at 8 years, Gray’s test, p <0.001) (aHR 0.24; 95% CI 0.06–0.97; p = 0.045) …
Hope this helps,
Thomas
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Hey @availlant ,
Reading that my doc has not recommended me to start any antiviral treatment as my
Viral Load is 429
Hbeag - negative
Hsbag Quantitive - 1153
he said that I am just a carrier but I dont want to take any risks is there a natural way of reducing hsbag levels as well as hbv dna so that my chances of HCC become even lower? or should I just start taking antivirals and keep my load below 10?
Dear @void ,
Maintaining a active lifestyle and good diet are the best approaches to long term success. However there is very little than can be done naturally to lower HBsAg.
What is your last measured ALT?
Hey @availlant my gaestro did not recommend any type of ALT test ig
But i did do a liver function test results below
I just want to be sure I dont get an increase my hsbag and want to lower it but ig going on meds does not seem a viable option so I am just trying to see what can I do to lower my hbv dna and hsbag levels including healthy diet and exercise but reading throughout here I can see thats not what helps in reducing those
What are your thoughts can I opt in for a peginterferon treatment? As i seem to fit in a idle criteria my hsbag is not much higher then the desired 1000 IU/ML
I am just really anxious waiting for my results every 3 months and hoping everything is fine i wana take some things in my hand to make sure It doesnt go out of hand but i have no options rn
Any help or advice would be appreciated
Dear @void ,
SGPT is another acronym for ALT (sometimes there are differences like this between NA/EU and Oceania/Asia test labs).
serum glutamic-pyruvic transaminase (SGPT) = alanine aminotransferase (ALT)
also SGOT = AST
Your ALT is normal so you have partial cure (excellent). Your long term prognosis in the absence of treatment is excellent.
Starting NUC therapy will reduce HBV DNA to very low levels and will have a marginal improvement on HCC risk but will have little impact on HBsAg.
With such low HBsAg you may indeed expect to have a better than average chance to achieve HBsAg clearance and functional cure with pegIFN. Introduction of pegIFN should be accompanied by a NUC (preferably TDF or TAF) to maximize your chances of achieving functional cure.
All of these options should be discussed with your doctor.
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Thank you @availlant for the quick response
Is it possible for my hsbag levels to go up quickly as i age (22 yrs old rn) or if i dont maintain my diet? Or does it keep the same value unless hbeag becomes positive again and the virus starts to aggressively replicate?
Can hsbag value get lower with time or vice versa?
Also can an inactive carrier spontaneously shed the virus and become hsbag negative or does that only work with when you are on antivirals and theres a 1-2% chance every year to get a functional cure from it?