any one else have a co-infection with HVB?

This topic has 36 replies, 17 voices, and was last updated 7 years, 9 months ago by Dr James.

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28 January 2016 at 6:32 pm #10674
Suzy-Cox-facebook
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- Acolyte
@suzy-cox-facebook
Thanks again dr James, that’s all really very interesting and I feel much better prepared for my next appointment.

Genotype 1a since 1973, f1-2, treatment naive, VL 6,56 log on 05/08/15; co-infection hepB (occult). Started 12 wks Twinvir on 17th march 2016.
6 February 2016 at 12:26 am #11275
Suzy-Cox-facebook
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@suzy-cox-facebook
Just a short report after seeing the hep dr, my tests are good, blood almost normal, even seems to be a little less fibrosis (I have stopped all alcohol). I complained about my joints & so on, and what if I got the magic pill myself? Hors Parcours, she isn’t allowed to follow me, although she did put viral charge vhc on the bottom of the next blood test (prescription dated for early july), also a scan. We exchanged a bit, the sort of price, how secure the source, I’m the first one to ask her about it, though she’s heard stuff in the staff room. I asked if there was any danger, and the hep B is quite clearly Not a problem at all, wasn’t even mentioned, what she actually said was: if I have an EMG and it can be shown that my aches&pains or neuropathy is due to the hvc, she would make the demand for harvoni, in 6 months time, herself. Also that if somehow magically I was virus-free during that time, I would still get routine follow-up afterwards.
Well to fill in the time while I’m saving up my pennies, it’s back to the GP for me, get a letter for an EMG. If it shows that thing is due to hvc, I don’t think I shall wait at all.
Bye for now, thank you all for being there,
suzy

Genotype 1a since 1973, f1-2, treatment naive, VL 6,56 log on 05/08/15; co-infection hepB (occult). Started 12 wks Twinvir on 17th march 2016.
20 March 2016 at 8:51 am #14249
Penn
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@penn
Dr James, can you tell us which tests need to be negative in order to be cured of hep b?
20 March 2016 at 8:57 am #14250
Penn
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@penn
http://hepatitiscnewdrugs.blogspot.com/2016/03/ema-to-review-new-hepatitis-c-drugs-for.html

This says hep b can reactivate
20 March 2016 at 9:36 am #14251
Dr James
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@fixhepc
You want a positive Hep B surface Antibody. You get this from immunisation or infection with natural clearance.

YMMV
20 March 2016 at 9:41 am #14252
Penn
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@penn
Ok, once you have the positive antibody you are cured and can do DAA without any fears of any reactivation?
20 March 2016 at 9:44 am #14253
beaches
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@beaches
Hey Suzy,
I contracted Hep B a couple of years after you (approx 1975) and it hasn’t been a barrier to my starting on Harvoni treatment. Hope this helps

Genotype 1a
Diagnosed in 2004, had HCV for all my adult life. Until 2016!!!!
Harvoni treatment, started 19 March 2016
4 week results Bilirubin 12 down from 14 pre treatment,
Gamma 25 down from 52, ALT 19 down from 63, AST 19 down from 47,
VL <15 down from a lazy 6 million or so

EOT Results
Bilirubin 10, GGT 18, ALT 19, AST 21, VL UND

12 Weeks post EOT
Bilirubin 11, GGT 16, ALT 22, AST 20, VL UND
Cured baby
20 March 2016 at 10:37 am #14258
Dr James
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@fixhepc
Ok, once you have the positive antibody you are cured and can do DAA without any fears of any reactivation?

There are antibodies to surface, core and e.

The protection to infection comes from surface antibody so that’s the one you want and you can get it from either vaccination OR infection with natural immune clearance. Chronic Hep B is characterised by failure to develop effective levels of surface antibody.

The correct screening is to do all 3 of:
- Surface Antigen
- Surface Antibody
- Core Antibody
From which you can work out a person’s status, however if you just want to know immune/non-immune status and don’t care if it is vaccination or past infection that triggered it then surface antibody will do.

YMMV
20 March 2016 at 9:35 pm #14287
Penn
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@penn
Thank you for this explanation. I will try to get my lab copies and compare them to this chart.
20 March 2016 at 9:44 pm #14288
radtek
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@radtek
I had some blood work done in 1996. It stated I had a negative surface antigen for Hep B and a positive core antibody for Hep B. I was told then that I had Hep B but am now cleared. Later on 2004 I again was tested by my provider and was told I had not had Hep B and needed a vaccination (s) which I did get. My confusion is who was right. I became acutely ill from Hepatitis in 1971. I was very sick for about a month or so. Because of my life style then I did not go to any Dr.s or have any blood tests. I had a some hippy girls treat me naturopathically, with their herbal magic. My thinking is I had Hep B then along with Hep C. What does late convalescence mean?
20 March 2016 at 11:21 pm #14290
Fara
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@fara
Hi Radtek, I also have coinfection with hep b, and had a blood exposure in late 1970’s. I was ill for about 1 mo.also, and was told it would resolve itself. I was Dx with hep c in 2004, (a blood test for insurance). I am now on hep c tx with sof/led, and have had no issues. I also had Hep B panel with results of surface AB+, surface antigen neg.,, and core AB- pos.. …….good luck .Cbg

HCV since 35-40yrs., GT 1a , Dx 2004; VL 4-5 mil, F2-3
Tx sof/led started 3/4/16
4wks VL <15
9 weeks VL UND, ; Alt-15,Ast-13
16 weeks VL UND Alt-20, Ast-22;
EOT 24 wks UND
SVR 4 UND
SVR 12 UND, Alt.15, Ast. 17
SVR 24 UND
21 March 2016 at 11:31 am #14316
Dr James
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@fixhepc
Thank you for this explanation. I will try to get my lab copies and compare them to this chart.

It’s pretty simple:

+ve Hep B surface Antigen = you currently have Hep B

+ve Hep B surface Antibody = you don’t have Hep B and are immune to it (from vaccination or exposure)

+ve Hep B core Antibody = you have been exposed to Hep B (so let’s you tell if positive surface antibody was immunisation or exposure)

YMMV
14 May 2016 at 3:01 pm #17216
Suzy-Cox-facebook
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@suzy-cox-facebook
I think you all may be interested to know that the European Commission has ordered the manufacturers of Label DAAs to do Risk Assessment on hvb/hvc patients, to see if the product information needs to be changed.

This decision was made earlier this year.

Here is the EU notice, and the list of questions that the PRAC wants answered.
ema_referralnotice.pdf

PRAC_listofquestions.pdf

These files are only available in english!

It may also interest (europeans) to know that one month later, ie mid-april, my gastro rang me at home to say that changes had occurred in (french) treatment qualification, and I now qualify for state-paid harvoni, which she will apply for.
I have infact already started treatment with Twinvir via David Cowley in the UK on march 17th, but I didn’t say so; little surprise for her !

I have support from a retired medical doctor, but no monitoring because of being off the Patient Pathway (parcours des soins)….
I feel OK…

best
suzy

Genotype 1a since 1973, f1-2, treatment naive, VL 6,56 log on 05/08/15; co-infection hepB (occult). Started 12 wks Twinvir on 17th march 2016.
14 March 2017 at 10:32 pm #25587
akiniai
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@akiniai
Hello I am pretty new to this forum. Just yesterday I have registered to Redemtion trial 2 and still waiting for appointment with monkmeds. Doctors in London do not want to help me in my journey to get better so with a help of fixhepc I am trying to figure out eveything myself. Coud anyone please help me to figure out what theese test results means as I am completely lost. I knew long time ago that I have Hep B antibodies and a year ago I have find out that I have Hep C as well. I really want to get treated, but I am scared that Hep B reactivate it self. On my blood result sheet says:
HB surface antigen qualitetive (HBsAG)- Dublicate request
HBe antigen quatative (HBeAG) – antigen not detected
HB e antibody qualitative (anti HBe) – antibody detected.
Could somebody please help me to understand what does that mean? And how big is the chance for Hep B to be activated. And how big is the risk of using those meds?
15 March 2017 at 2:05 am #25589
Dr James
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@fixhepc
Hello akiniai,

These results do not provide an answer to the question of whether you do, or do not have chronic Hep B. While you have certainly had Hep B exposure the results you’ve shared don’t answer that question.

What I would need to tell you is Hep B surface antibody. It sounds like you do have that and are immune to Hep B due to prior exposure.

The standard set of blood to answer the question of Hep B status are surface antibody, core antibody, surface antigen as well as some liver function tests.

YMMV
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