Seven years ago, I discovered that I have chronic hepatitis B. My viral load was 2,000, HBsAb was 1,500, and my FibroTest result was F0. The doctors I consulted did not prescribe any treatment.
Over time, my viral load fluctuated, reaching as low as 600 but also as high as 3,200, while my HBsAb increased to 2,400. Recently, I had a FibroScan, which showed a result of 7.9, corresponding to F1-F2 fibrosis, and my viral load was 2,600. My doctor recommended starting treatment with entecavir.
Is it advisable to start treatment now? What are the risks of beginning this treatment? Did the fibrosis progress due to the virus? Would it have been better to start treatment when I was first diagnosed?
Hi @brezan,
Welcome to the community and thanks for sharing your story and results. Something is not clear, do you mean HBsAg? Because you have stated that HBsAb is 1500. They are two different tests, so please confirm. I am thinking you mean HBsAg quantitative here. If that is the case, I will agree with your doctors to commence treatment if the fluctuation has been seen over time. These numbers might not be considered as very high, but the fluctuations you mentioned is the concern and I think starting treatment is a good idea. Your current viral load of 3200 exceeds the recommended limit of 2000, so your doctor is following the guidelines in his or her recommendation to treat. There are no risks for starting treatments. Entecavir is a single pill taken daily 2 hours before or after eating. I take Entecavir and it is good at stabilizing these numbers and prevents fluctuations. Most patients tolerate these antivirals well. I hope this is helpful. Best, Bansah1
Yes is HbsAg. I have HBsAg positive, Hbsab negativ and anti HBc positive.Do you think the virus is the reason why my fibrosis is getting higher?I am consern because in just 3 years the fibrosis is f1-f2. What is the worse scenario taking the entecavir?
I read that lactic acid can build up in the blood, which can lead to death as a side effect of entecavir. What happens if my body no longer responds to entecavir and my viral load increases?
Are there people who have been taking entecavir for 10 years without any problems? I didn’t fully understand the risks of starting the treatment. I’m afraid that the virus might go out of control and that I won’t have any treatment options.
There’s no issue regarding long term use of entecavir. ARV like entecavir are well tolerated in long term management of CHB.
For now, your main concern should be how to protect your liver, and this is what your prescriber is trying to do. The fibrosis is because of the damage the virus is causing to your liver. I believe you will get much much better when you commence your treatment.
if I will take entecavir, there is any chance to have f0 fibrosis?
my doctor has told me that I have the chance, after some years, to have a low HbsAg <500, and then he will make me anti hepatitis b vaccine and I can eliminate the virus. is it true?
The liver has a strong regenerative capacity. Taken the drug will allow your liver to heal and return to the normal state.
However, ARV like entecavir do not eliminate Hepatitis B virus from your body. But only reduce the level of the virus in your body. Your ability to be hepatitis B negative largely depends on your immune system.
If you’re fortunate enough to have your immune system produce antibody against the virus, you are among the lucky individual (which is not always common)
Until today, Hepatitis B virus has no cure, it’s only managed.
Yes, it is true! Currently, there are several experimental treatments for hepatitis B in different clinical trial phases (phase 2, 3, and even some in phase 4). The goal of these treatments is either to improve virus suppression or to achieve a functional cure (eliminating the need for lifelong treatment).
Some promising experimental treatments:
Capsid inhibitors – Block viral replication in a different way than entecavir and tenofovir. Examples: JNJ-56136379, ABI-H3733.
The responses provided by @1994 above are accurate. Entecavir treatment will likely prevent any further progression liver fibrosis and allow your liver to recover. Indeed it is common that people revert back to F0 if treatment is taken before too much damage has occurred.
Indeed, there are many people who have taken entecavir for many years (>10) and viral load remains low. If there is ever the unlikely event that the virus does not respond anymore to entecavir, the most likely scenario is that you take tenofovir instead. Both entecavir and tenofovir are highly effective at lowering viral load, and have very very low risk of resistance.
My consern is not starting a war with this virus. Now I have a law viral load and I am afraid that after taking for a while entecavir the viral load to expload and to have only tenofovir for this fight with virus.
I read a lot of messages in this grup and now I am afraid. I havetwo little children and 42 years old and I am very frightened of this virus.Can I reach 70 years old with this disease?
Hi @brezan, the antivirals available right now are highly effective, safe, and generally cheap. You should not worry that they do not work, as there has not been any studies showing that this occurs at any meaningful rate.
Many of us with hepatitis B live normal and long lives. When managed appropriately, the lifespan of someone with hep B can be as long as people without hep B. There are definitely people who live longer than 70 with hep B.
This is from clinical trials showing that people with <2000 without treatment fare just as well as people with <200 or undetectable viral load. This needs to be put into context: these trials ran for only a few years, so things may have happened later on.
I was diagnosed in 1980 at age 20.
Didn’t pay much attention to HBV lived life badly for my liver.
Got serious about looking after myself around 40 years old. Now 65 liver results are all good.
God willing I’m going to live for another 20 years.
So you can live for a long time. It’s the self stigma that kills.
My dad died at 58. He drank heavily. Doctors said he had HepB . Not sure if he had it before or alcohol caused the liver damage. He died in 1993 so I would have thought he would have been tested for HepB and been on treatment.
My dad did not look after himself. Takeaway food etc.
We mustn’t think like that.
I’m 65 had the disease for 45 years.
I’m fit and healthy loving life.
All reports good.
I’m not going to let this disease destroy my life.
I’m very close to 70!
I’m 65 this year
Healthy, all results good and within normal.
I’ve had HBV since I was 20.
So yes you can live to 70.
Get monitored, look after your body and liver. Healthy food, exercise, trying to keep stress free.
Enjoy your family and your life as much as you can. I took this disease is a wake up call to love God and live life to the full.
