On Friday I visited another Dr but the same hospital regarding your suggestion for HBV DNA lab test. During discussion with the Dr, he said HBV DNA is the as Hbv viral load is it true? Again because the ALT looks normal he suggested to wait for three months then we do fibro scan again. When the number increase then he can suggest to start medication.
My doubt is this here in our country there is no other hospital taking care of Hep B except the national hospital and there is a certain organization that is conducting a project regarding hep B and they are the one sponsoring the treatment, of course the treatment here is free. But I doubt the hospital is keeping the number of patients in medication to be small for the sponsor budget or something. Perhaps I can start medication myself instead of waiting things to be worse.
Please advice
Thank you all
dear availlant,
as his HBsAg is ver low then he may be able to get rid of Hep B with treatment of pegINF
what are your thoughts on this
dear gongo,
have you tested the hepatitis D
Hi Suresh
I haven’t tested for hepatitis D
as your viral load for Hep b is low and fibrosis is high then you must test Hepatitis D.
Wish you best of luck and wish your D is negative
HI VJim,
Yes having a family is possible with HBV infection. This would consist of you starting antiviral therapy and your partner getting vaccinated for HBV. Ensuring that your HBV DNA becomes undetectable on therapy is also important. It is important to get your family doctor involved in this discussion.
Best regards,
Hi Gongo,
HBV DNA = viral load. Your result posted here (870 IU/mL) indicates low level viremia but this still could be the cause of your abdominal discomfort and elevated liver stiffness.
Since your HBV diagnosis was first made in 2019 your infection is clearly chronic. Even though your ALT is normal, fibrosis can still be present and you clearly have some sort of liver involvement which is most likely due to your chronic HBV infection.
You should start antiviral therapy to control your HBV infection and then followed regularly to see how this therapy improves your viral load and liver symptoms.
Best of luck.
Hi Suresh,
I might have missed it but I don’t believe Gongo posted a HBsAg result, only HBV DNA (870 IU/mL).
If his surface antigen was low (< 1000 IU/mL) there is good clinical data showing the response to pegIFN is stronger with low HBsAg.
Hi Availlant thank you for your response.
What if I choose entecavir and later my Dr prescribe tenofovir because is the one that is available here and I think there must be a limit in importing the drugs unless I have a Dr permission.
Please advice.
Thank you
Hi Gongo, there may be some doctors who can weigh in, but my experience has been that there is no problem switching from entecavir to tenofovir. With that said, however, why don’t you want to start tenofovir if it’s readily available where you live? Maybe I missed an earlier post, but my personal suggestion is to take that rather than switch. Plus there are no food issues with tenofovir as there are with entecavir (you have to take that on an empty stomach and avoid eating for 2 hours after taking the drug). But please follow your own ideas. I just couldn’t resist making a comment! Always, Joan
Hi Joan_Block
I was wrong considering Entecavir as my priority instead of Tenofovir. I misleaded myself that entecavir has less effect compared to Tenofovir. Sorry to all if this cause trouble to any one.
Thank for the awakening whistle. Any one knows how I can import the drugs directly to me
Thank you
Dear Gongo,
It is important that you (and all of the community following posts on any of the topics on this forum) know that for all of the verified science and heath experts, participating in this forum is a privilege and something we asked to do and get a lot of satisfaction from (helping people like you).
There are never too many questions and no issue is too small to discuss.
Joan’s experience in the realities of daily dosing regimens with ETV and TDF is important to consider. Both of these drugs have similar efficacy in controlling the production of virus in the liver and preventing the progression of liver disease. There is no issue with migrating from ETV to TDF to TAF.
However, TDF does have a very mildly increased impact on the ability of the kidney to perform its clearance functions. For persons with no prior exposure to older generation NUCs like lamivudine (aka Epivir) or adefovir dipivoxil fumarate (aka Hepsera) and who have preexisting issues with kidney function, many hepatologists prefer to place these persons on ETV.
In your case, your serum creatinine (an indirect marker of kidney function) is in the normal range (which is good). Before you start on your NUC therapy I would recommend another blood test where your eGFR (estimated glomerular filtration rate) is measured - this is a more direct measure of your kidney’s filtration capacity. With all of this looking good, I would agree with Joan that TDF is the best place to start.
Sorry I don’t have any useful information on drug importation in East Africa.
Good luck!
dear Availlant,
Sorry for confusion I was asking for @VJim as he posted HBsAg 2.11 so if he take pegINF then he might be able to get rid of HBV completely.
Understanding qualitative versus quantitative HBsAg test results
Dear Suresh,
The HBsAg test result that VJim posted was from a qualitative HBsAg test which reports the test result as a ratio of the HBsAg “signal” in the blood sample provided to an established “cuttoff” where HBsAg has been shown to be negative. This is what S/Co means.
The cutoff for some qualitative tests has been shown to equate to HBsAg < 0.02 IU/mL (actually better sensitivity than the quantitative cuttoff for detection: 0.05 IU/mL). However, these tests are not able to tell us how much HBsAg is present when the signal is greater than cutoff.
In VJim’s case, although it might be tempting to assume that a S/Co of 2.11 means a very low HBsAg, we cannot make this assumption because the performance of the test above the cuttoff has only been validated to indicate the presence of HBsAg, not how much HBsAg is actually present.
This being said, the lower the baseline HBsAg, the better the performance of pegIFN will be.
Hope this helps.
Ok I understood. I thought the qualitative result only comes as positive / negative or reactive/ non-reactive
Hi all,
I recently tested for Hepatitis B and received the following results.
- Hep B surface Ab, qual is non reactive.
- Hep B core Ab, tot is positive
- Hep B core Ab, IgM is negative
- HBsAg screen is reactive
- HBV IU/mL is 40
- log10 HBV AS IU/mL is 1.602
- HBV genotype, rtni
Could you please help interpret them for me?
Thank you! A
Dear Anonymous,
You have chronic HBV infection but the level of viral replication is very low.
Can you tell us what your liver function tests look like?
ALT/AST/GGT
Bilirubin/albumin/INR/platelets
Have you had an ultrasound or fibroscan? How are you feeling?
Can you tell us if this is the first time you have been tested for HBV?
Best regards,
Hi Availlant,
I’m doing well. This is the first time I’ve ever tested for Hep B. I am very shocked by the result.
I am still yet to see a gastroenterologist this week for further testing. Thank you for your feedback.
A
Make sure you get all of the blood work I mentioned in my previous post.
Since you mention these are the first test results you have ever had, the important part of equation for you is that you don’t know how long ago you became infected.
Your gastroenterologist may be reluctant to perform an ultrasound or fibroscan but given that your HBV infection could actually be many years old, it is important to understand well how your liver is doing and this may not be accurately reflected by the tests I mentioned.
Good luck!