Dear Suresh,
The regularly normal bilirubin and albumin should provide you with comfort that your liver is ok (despite the GGT flare). I suspect the HDV RNA test results are in different units and thus not directly comparable.
thanks for fast and quick reply.
what your thoughts on Bulevirtide
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Dear Suresh,
Bulvertide is a recently approved medicine in Europe for the treatment of HDV infection (previously known as myrcludex B). You take this medicine via a daily subcutaneous injection in addition to therapy like ETV, TDF or TAF for your HBV infection. A doctor may also add pegylated interferon into the treatment regimen to increase your chance that contorl of HDV infection can be achieved after removal of therapy.
Bulvertide works by blocking the entry of HBV and HDV virions occurring via a specific receptor on the surface of liver cells. Although this medicine has very little effect on HBV infection, it is well tolerated and works very well in most patients to eliminate HDV viremia from the blood and importantly to normalize ALT in these patients. This medicine is an important advance in the treatment of HBV / HDV co-infection.
Unfortunately, evolving clinical data indicate that like ETV, TDF and TAF for HBV, bulvertide will also be a life long treatment. Also, there are a small fraction of patients who either do not respond to bulvertide or who experience viral rebound on bulvertide. We do not yet have good clinical data demonstrating the reason for this.
Hi Thomas
I wanted to ask you some question , u told me before at my viral is very low is 1450 ul/ml
and my viral dna is about 148 ul/ml positive
There is risk of transmission in this level?
Im al so hbv e negative
Hvb E anti body positive
My regards ibrahim
Thanks availlant.
life long treatment for HBV or the HDV ?
I have been given price for Bulevirtide as 70,000 USD per year.
Dear @ibrahim_barry
There is some risk of transmission because your virus DNA is detectable, but it is very low.
Thomas
Hi Suresh,
Bulvertide is being used for the treatment of HDV infection. Limited clinical data have shown that withdrawal of bulvertide is accompanied by rebound of HDV RNA. Currently there is no data demonstrating the establishment of HDV RNA suppression with finite therapy of bulvertide.
I am currently on pegINF.
Shall i wait for pegINF to show results or shall i combine it with bulevirtide to maximize chances of success.
Do you think that i should try bulevirtide, specially it is costing 35,000 USD for 6 months and 70,000 USD for 12 months.
Dear Suresh,
I assume that you do not live in country which covers treatment with bulvertide?
Do you have any tests results with HBsAg?
Yes country i am living does not cover bulevirtide and my consultant has never used it. I will be the first in the country to use it. It will require special permission. Also as doctor has no experience then he does not know what to expect in terms of side effects.
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Dear Suresh,
The decision about to proceed has be one that you discuss with your doctor. What I can tell you is this:
-
we know that TDF/TAF + pegIFN can give a persistent elimination of HDV RNA after treatment but only in a small proportion of patients.
-
while we don’t have any clinical data that this is improved with the addition of bulvertide, we know that bulvertide + TDF/TAF works well to control the disease.
Again it would be useful to have a quantitative HBsAg result to provide more commentary.
I hope this helps you with your decision making.
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Hello am chukwu
I went for a blood test and I was told that I have
Hep B e Ab and Hep B Surface Ag positive
Please what does that means
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Hi Chukwu,
Some additional test results would be helpful to advise you: these are HBV DNA and ALT.
Ok. I haven’t done any additional test. This what my doctor sent to me. But I think I should go for more test
So what does that means
Hep B e Ab and Hep B Surface Ag positive
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Hi Chukwu,
You likely have chronic HBV which has entered the immune tolerant phase (HBeAg seroconversion or the presence of HBeAg antibodies). The other test results are important to provide you with more information.
Damn. Does that means have been damaged in my liver. And I haven’t been sick or have any symptoms.
Dear Chukwu,
This is certainly very disappointing but please know that chronic HBV can persist for years without causing any liver damage. The fact that you feel fine is a good sign.
However, you should get your HBV DNA and ALT evaluated as soon as possible: this will determine of you should receive antiviral treatment.
Ok I will try and do that. But what surprise me most is
How did I get it.
And does that means that it has been in my body for long time
Can I also marry with this. Or I can’t marry. And can it go away with time or it can’t. Am shievering
Dear @Chukwu,
Thank you for sharing your story. I understand it is a stressful time at the moment, but please know that many of us in the forum live with Hepatitis B and lead normal lives.
Regarding your blood tests:
- if you are Hep B Surface Ag positive, it means you have a Hep B infection
- if you are HBeAb positive, it means your immune response has started to fight the virus infection. This generally means your risk of passing the virus on is lower.
To get a better understanding of what is happening in your body, you should go back to your doctor and ask for:
- a liver function test (this will let you know if there is liver damage happening now)
- HBV DNA test (this will help you know if you need to take medication)
- fibroscan or ultrasound (this will help you know if there has been liver damage in the past)
Regarding when you got it, it is very hard to tell with each person because it can stay in the body for so long without making you sick. Most people get it when they are babies or children, and this could just be from scratches and blood exchange.
You can still marry with this condition. I myself have Hep B and have been married for almost 7 years. There are many on this forum who are also married and have children. There are many ways to protect others around you.
A chronic infection can go away in some people, but in most people it stays. Getting the appropriate monitoring and treatment is the best way to live with it, if it doesn’t go away. If you get proper management of the condition, then you won’t have as much liver damage.
Hope this helps,
Thomas
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