Above is my hepatitis b profile and LFT
M.D also told me that my ultrasound scan is fine,M.D didn’t asked for DNA quantification test as at now. At the time of this results M.D told me to start antiviral for 6 months. After the 6 months of taking antiviral he asked to perform DNA quantification which came out undetected i even believe that before he put me on antiviral my DNA quantification should be on the very low side(That’s before taking antiviral for six months I don’t really know because he didn’t ask for DNA quantification before asking me to start antivirals). Now after
6 months of taking antiviral he asked me to stop taking antiviral and be monitoring half annually. I proved stubborn and have been taking antiviral on my own for over a year now, right now I’m confused what do I do?
@ThomasTu @availlant @john.tavis @ScienceExperts
Dear @Godsown,
The handling of your case has not been done according to established guidelines - this is unfortunate and understandably disappointing for you. It is impossible to know what your HBV DNA was prior to treatment since HBV DNA titers can still be high enough to qualify for starting treatment (in the absence of detectable liver disease) while still being HBeAg negative. In any case, HBV DNA should have been performed prior to starting NUC therapy to see if you met guidelines for starting therapy.
After becoming HBV DNA TND on antiviral therapy, it is now impossible to know if it is safe for you to remove NUC therapy without becoming HBsAg negative. From a safety perspective, this is the best path forward.
Quantitative HBsAg may provide more information how you are progressing while NUC therapy.
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Hi Godsown,
I have been on antiviral therapy for more than 20 years and all that time my HBV DNA has been undetectable. My doc tried to take me off the medication 10 years ago, and HBV DNA came back and so did my liver enzymes so he decided to restart antiviral therapy. I am still HBV DNA negative and my HBsAg level is 900 IU/ml and my current doctor, who is liver and HBV specialist, doesn’t think I should stop my medication, but I believe some doctors would try to take me off the drug and see what happens. There are many research paper showing that this would be reasonably safe, if close lab monitoring is possible. My doc says we should wait for new medications…Anyway, I hope this will make your decision easier. Good Luck!
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Dear @Godsown,
Removal of NUC therapy without HBsAg loss is definitely NOT safe and NOT recommended by any current HBV treatment guidelines. This has only been done in a clinical trial setting with very frequent patient monitoring.
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Thànk you for the advice. I will discuss the option of constant monitoring with MD also
I do not undestand this management………….
Regards
PL
Sorry, The MD asked me to start antiviral after the Tests above without viral DNA quantification test. After six months of taking antiviral MD asked me to do Viral DNA quantification test,it came out undetected( i strongly believe that before starting antivirals my viral DNA quantification would be on the very tiny side but MD didn’t request for it so I don’t really know).MD asked me to stop taking antivirals (that’s after the six months of taking antivirals and my viral DNA quantification test came out undetected.
I have been stubborn and continue taking antiviral on my own for a year now. Right now I’m confused I don’t weather to stop taking the antiviral or to continue. To be sincere if there’s a way I can stop and just be monitoring the disease through the recommended test I will be glad since I don’t really think I’m supposed to start antiviral when MD placed me on it.
Thanks
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I am not a MD, but based on your lab tests you said you took before antiviral was started, I think you were probably an inactive carrier (ALT and AST within normal range). When I was an inactive carrier long time ago, no treatment was needed, but I understand that now some doctors treat inactive carriers, if HBV DNA levels are high, despite normal liver blood tests.
Thanks for the answer.
MD placed me on antivirals after the above test results without DNA quantification test. After six months of taking antivirals he now asked me to do DNA quantification which came out undetected, he now asked me to stop taking antivirals after the DNA quantification test came out undetected. Before the MD even placed me on the antivirals for six months I believed my DNA quantification should be on the very tiny side but I don’t really know because he didn’t test me for DNA quantification before placing me on antivirals.
I have been stubborn and continue taking the antiviral for one year now from the six months the MD asked me to stop.
Right now I’m confused weather to stop taking antivirals or continue
Hi @Godsown,
As others have mentioned do not stop the treatment. There are no guidelines anywhere today that recommend patients stop taking their antiviral after 6 months. I can see this happen if you have an acute infection and have developed antibodies, but that is not the case here. Please, without any evidence of you losing HBsAg continue taking the antiviral. It is hard to understand the care management here. Get a second opinion or find a different hepatologist who treats HBV patients and understands the disease. It is very unusual in many ways. Best, Bansah1
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Hello @Godsown
I agree with @Bansah1 and others. Do NOT stop taking the antiviral.
We are blessed to have the medicine. Others have died because they don’t have the antiviral.
It is ONE tablet a day. Not a hard ask! I would rather take one tablet a day then say, chemotherapy or insulin injections. It’s like blood pressure tablets or cholesterol tablets some need to take. Than risk damaging my liver and not being able to go back or having to go on medication with serious side effects.
Can I ask why you want to stop?
Seek a second opinion or change doctors.
It’s unusual to start antiviral and than stop. Unusual and in my opinion, dangerous.
Blessings
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