Recent infection and viral load going down

Hi,
I was diagnosed with HbsAg + in June 2022 though in Jan 2022 it was negative. In October my HBV DNA was ~10K . I was advised by the doctor to wait for 6 months before starting the medicine.

I recently got my blood work done and it has not cleared on it’s own but my DNA levels have come down to ~4k now. Is there still a chance of seroclearance for me? What percentage of people get delayed seroclearance?

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Hi @ramanuj,

In order to understand better what is happening in your situation, you need to have HBV DNA and HBsAg results from the same blood test. A table of dates and results would help.

It appears as thought there is no urgency to start antiviral therapy in your case but it is difficult to provide you with more detailed feedback with the information you have provided.

Best regards,

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Thanks Andrew for responding. Here are other results from the same blood test. I hope this gives you enough information for a better suggestion.




I’m really determined to fight it out with my own immune system. Hoping for a good advice. Thanks in advance.

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Dear @ramanuj,

Are these the blood test results when your HBV DNA was ~4K IU/mL?

Yes Andrew, you are right.

Thanks

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Hi @availlant , any advice on these results?

Thanks

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Hi @ramanuj

You have HBeAg negative chronic HBV with very mild liver enzyme elevation. If the decline in HBV DNA continues to < 2000 IU/mL, you will have a relatively inactive form of chronic HBV where people typically do not develop liver disease or liver cancer. Your “sporadic” HBsAs loss may be a sign this this could be happening. Your doctor is correct to revisit the status of your HBV infection in 6 months.

Best regards,

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Thanks @availlant , this was really helpful. Though I would like to understand that what are the chances that I will be able to clear out( seroclearance) by itself through my immune response? If you could be help me out with this info with some pervious data and research.

Hi @ramanuj

Based on your previous posts you have been HBsAg negative in the past but now you have low level HBV infection. It really is not possible to provide you with any kind of definitive response about your chances to re-establish HBsAg negativity moving forward in the future (although this could happen).

The best way to evaluate the potential chance is to keep track of the patterns in your HBV DNA over time (in the absence of NUCs) or quantitative HBsAg (if you end up starting NUC therapy).

Best regards,

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Thanks@availlant for the advice.

You guys are doing great work for the Hep B community. Please keep this up. This is really helpful.

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Hi @availlant
My Doc has put me on NUC therapy. I’m really scared that how will NUC (Tenofovir af) will affect other aspects of my life? Also what are the common long-term side effects of being on NUC therapy?

Also curious to know If suppressing the DNA through NUCs would send a signal to my immune system to stop working again the virus in my body?

Thanks in advance :pray:

Hi @ramanuj ,

There is no data that I am aware of that NUCs “turn off” the immune system. Rather, there is data that suggests that certain NUCs like ETV, TDF and likely also TAF actually have some ability to assist immune function in patients.

I don’t think you should have any concern about this.

Best regards,

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Thanks @availlant. This is a big relief.

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