I am a new member, thank you @ThomasTu for approval.
I am living in Australia and have hep B since birth and have been taking Entacavir for few years and I am in good health. However, I have a brother who is living in Vietnam and has chronic hep B.
My brother has had it for very long time and hasn’t use any treatment. He’s just had all the tests done recently including blood test, abdominal ultrasound and the results are quite scary. I have a few questions here hopefully someone can assist, it would be really appreciated.
Is there any Gastroenterologist who specialises in hep B in Vietnam/ Hanoi that you can recommend for my brother to see for consultation for treatment? I’ve done some research but haven’t found any organization or foundation in Vietnam.
If I have my brother’s lab results, would anyone able to read and help with medication suggestions?
Which medication is the most effective and safe among these:
Pegylated interferon alfa (PEG-IFN-a);
Tenofovir disoproxil fumarate (TDF);
Tenofovir alafenamide (TAF).
Is there any Hepatologist here who is willing to help consultation via the phone or online for my brother as he can not travel overseas due to his job restrictions, but he willing to commit to the treatment and I understand that it comes to a cost.
Thank you for reading and any response will be greatly appreciated.
I am also happy to set up a sub-forum here for Vietnamese speakers here if there is enough demand for it and if you and @lien.tran are happy to help. I only know enough Vietnamese to order Cơm Sườn and Chè Ba Màu .
Prof Thành at Thu Cuc hospital is very good. He has helped some achieved hbsag seroconversion, including myself, though the rate is low.
You should not worry too much about particular doctor or treatment. All doctors will just give you anti viral and maybe some supplements of questionable effectiveness. There is no cure anyway so there are nothing one can do for you better than another. Unless you believe the herbalist of course, who claim they have a cure for everything. They’re everywhere in Vietnam.
The antiviral all works, and taking them regularly is the most important. Theoretically TAF is the best due to lower dosage than TDF and higher effectiveness than ETV. It also significantly more expensive and not covered by insurance. Personally TAF give me quite bad stomach pain. Your milage may vary.
Thank you got your information re Thu Cuc hospital, where my brother has just had all the tests done there.
I had taken the TAF before for few months and it upset my stomach too, then my doctor changed to Entecavir which I have been taking for 3 years now and have no issue. My concern was for my brother as his liver has fibrosis F2, but I guess there’s not much treatment except taking the antiviral as you mentioned.
Just a comment here about grading of liver disease and fibroscan.
A liver biopsy is still the most reliable method for determining both the stage of liver disease and the source of the liver disease (for instance fatty liver can be directly assessed using this technique).
Ultrasound is less invasive and can also be used to diagnose the kind of liver disease but only if it is moderate to severe.
Fibroscan cannot be used to assess the cause of liver disease.
A finding of F2 fibrosis (especially if established by biopsy) and elevated HBV DNA are definitely signs that therapy should be initiated as soon as possible in order to prevent further progression of liver disease. As Thomas has stated, there are a variety of NUCs which will work well to suppress viremia and prevent further progression of liver disease.