Functional cure or very early suppression of HBV DNA to < 10 IU/mL will be the best. In these scenarios there will be negligible production of (erroneous) linear HBV DNA, which is the form that becomes integrated into host chromosomes and causes DNA damage to the host cell.
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Agreed, and now that I think about it, Iām not sure it was powered to detect differences in the patients with low rates of cancer (such as those below 2000) - so even if there is an effect, we may not know just because of probability.
One study of 20,000 people is here: HBsAg seroclearance further reduces hepatocellular carcinoma risk after complete viral suppression with nucleos(t)ide analogues - ScienceDirect
Compared to complete viral suppression, lack of complete viral suppression was associated with a higher risk of HCC (7.8% vs. 5.6% at 8 years, Grayās test, p <0.001) (adjusted hazard ratio [aHR] 1.69; 95% CI 1.36ā2.09; p <0.001); patients who achieved functional cure had a lower risk of HCC (0.6% vs. 5.6% at 8 years, Grayās test, p <0.001) (aHR 0.24; 95% CI 0.06ā0.97; p = 0.045) ā¦
Hope this helps,
Thomas
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Hey @availlant ,
Reading that my doc has not recommended me to start any antiviral treatment as my
Viral Load is 429
Hbeag - negative
Hsbag Quantitive - 1153
he said that I am just a carrier but I dont want to take any risks is there a natural way of reducing hsbag levels as well as hbv dna so that my chances of HCC become even lower? or should I just start taking antivirals and keep my load below 10?
Dear @void ,
Maintaining a active lifestyle and good diet are the best approaches to long term success. However there is very little than can be done naturally to lower HBsAg.
What is your last measured ALT?
Hey @availlant my gaestro did not recommend any type of ALT test ig
But i did do a liver function test results below
I just want to be sure I dont get an increase my hsbag and want to lower it but ig going on meds does not seem a viable option so I am just trying to see what can I do to lower my hbv dna and hsbag levels including healthy diet and exercise but reading throughout here I can see thats not what helps in reducing those
What are your thoughts can I opt in for a peginterferon treatment? As i seem to fit in a idle criteria my hsbag is not much higher then the desired 1000 IU/ML
I am just really anxious waiting for my results every 3 months and hoping everything is fine i wana take some things in my hand to make sure It doesnt go out of hand but i have no options rn
Any help or advice would be appreciated
Dear @void ,
SGPT is another acronym for ALT (sometimes there are differences like this between NA/EU and Oceania/Asia test labs).
serum glutamic-pyruvic transaminase (SGPT) = alanine aminotransferase (ALT)
also SGOT = AST
Your ALT is normal so you have partial cure (excellent). Your long term prognosis in the absence of treatment is excellent.
Starting NUC therapy will reduce HBV DNA to very low levels and will have a marginal improvement on HCC risk but will have little impact on HBsAg.
With such low HBsAg you may indeed expect to have a better than average chance to achieve HBsAg clearance and functional cure with pegIFN. Introduction of pegIFN should be accompanied by a NUC (preferably TDF or TAF) to maximize your chances of achieving functional cure.
All of these options should be discussed with your doctor.
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Thank you @availlant for the quick response
Is it possible for my hsbag levels to go up quickly as i age (22 yrs old rn) or if i dont maintain my diet? Or does it keep the same value unless hbeag becomes positive again and the virus starts to aggressively replicate?
Can hsbag value get lower with time or vice versa?
Also can an inactive carrier spontaneously shed the virus and become hsbag negative or does that only work with when you are on antivirals and theres a 1-2% chance every year to get a functional cure from it?
Hey @availlant @ThomasTu ,
Had some queries in my mind
I am from India so I mostly will have the genotype D and as Iāve read if you are genotype D pegInterferon does not do anything and you never achieve functional cure so Should I go for it yet because my hbsag is around 1156 and HBV DNA is 456
Or as in India Thymosin Alpha 1 is also approved can I go for it will that help me get functional cure if not peginterferon?
Hi, all, Nice to meet you.
I knew that I was affected by Hepb when I was 16 years old. Its mom-child transform.
Iām 31 years old now. Iāve been using entecavir for 7 years as i was suggested to take it by a doctor. I did a blood test 3 weeks ago, here is the result. Can you please review the summary? Any insights from other folks here would be so appreciated! Many thanks!
Test Results Overview:
Alpha-Fetoprotein (AFP):
Result: 2.32 ng/mL
Reference Range: 0.0-7 ng/mL
Interpretation: Normal
Hepatitis B Virus Surface Antigen (HBsAg):
Result: >250.0 IU/mL
Reference Range: 0-0.05 IU/mL
Interpretation: Positive
Hepatitis B Virus Surface Antibody (anti-HBs):
Result: <2.0 mIU/mL
Reference Range: 0-9.99 mIU/mL
Interpretation: Negative
Hepatitis B Virus Core Antibody (anti-HBc):
Result: 28.37 S/CO
Reference Range: 0-0.99 S/CO
Interpretation: Positive
Hepatitis B Virus DNA Quantification (PCR Test):
Result: Target Not Detected
Detection Limit: 1.0E+01 IU/mL
Interpretation: No active viral replication detected
Liver Enzymes and Other Markers:
Alanine Aminotransferase (ALT):
Result: 22.4 U/L
Reference Range: <50 U/L
Interpretation: Normal
Aspartate Aminotransferase (AST):
Result: 21.0 U/L
Reference Range: <40 U/L
Interpretation: Normal
Alkaline Phosphatase (ALP):
Result: 65 U/L
Reference Range: 40-129 U/L
Interpretation: Normal
Ī³-Glutamyl Transferase (GGT):
Result: 23 U/L
Reference Range: <60 U/L
Interpretation: Normal
Total Protein:
Result: 76.7 g/L
Reference Range: 63-82 g/L
Interpretation: Normal
Albumin:
Result: 52.3 g/L
Reference Range: 35-50 g/L
Interpretation: Slightly Elevated
Total Bilirubin:
Result: 5.2 Āµmol/L
Reference Range: 3-22 Āµmol/L
Interpretation: Normal
Direct Bilirubin:
Result: 2.1 Āµmol/L
Reference Range: 0-16 Āµmol/L
Interpretation: Normal
Hi @john29,
Thanks for sharing your results. The antivirals are working as indicated by your results. There is nothing abnormal or concerning about these results. Continue taking your medicine and following up with your doctor. Keep up the good work. Best, Bansah1
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Hi, @Bansah1 Thank you for your reply.
Yes, that sounds good. Is it completely okay to take this life time?
I saw a lot of articles about stopping antiviral can cause a serious problemā¦
And as you know, taking medicine for a long time isnāt also easy.
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Donāt mention it. Yes, currently most of us are taking it for life. As you rightly mentioned, there are no other alternatives at the moment. So we have to keep taking it until either we get cured or there is a cure available. I understand this might be a lot, but we have to do it to avoid suffering liver failure, cirrhosis or HCC. I have been taking it for almost 10 years now and there people on it for over decades. We have to do the best we can. Letās remain hopeful. Bansah1
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Thank you so much! @Bansah1
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Hi, @Bansah1 I have one more question.
Iāve been taking Entecavir so far, it seems to be working fine as you can see.
But I heard that Tenofovir could be better than Entecavir.
What does this mean? Is tenofovir obviously better than entecavir? If so, Iām thinking to replace entecavir with tenofovir.
But Iād love to know this from all folks here.
Many thanks.
Hi @void,
Generally genotype doesnāt have much effect in determining clinical decisions. Your HbsAg levels are relatively high and may not respond particularly well to either Thymosin Alpha or interferon. It is best to talk to your doctor about this, as they are able to appropriately examine you and your medical history.
Thomas
Hi @john29,
Both entecavir and tenofovir are similarly effective in preventing liver damage and controlling the virus. If things are going fine, there is no real need to consider changing.
Thomas
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Hi, @ThomasTu Thank you for your reply.
Its my pleasure to receive your reply. Yes, I wontā change it, I think entecavir has been working fine for me.
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Hi @ john29,
There is no difference. They both work and are safe. TDF can cause bone loss and kidney problems in some patients while TAF can increase your cholesterol, but does not have the bone loss or kidney problems. You have to switch if there is a side effect or the medicine is not doing what itās supposed to do or availability rather than one being better than the other. Because all 3 are good at doing what they are supposed to do. You donāt need to switch if entecavir is working for you. Switching would not be making much difference. I donāt know where you heard that tenofovir is better than entecavir? All three first line treatments are effective and safe with fewer side effects. I hope this is helpful. Bansah1
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