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Ask the Experts about Hepatitis and HIV Coinfection
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URGENT!! PLEASE ANSWER!!
Oct 4, 2009

I am HBV positive, EAg negative. My DNA became non-detectable after 4 weekly injections of Pegasys. The doctor says I would therefore use injection for 24 months instead of 48. Do you agree? My other liver tests are normal. Also I usually take my shot on a Wednesday but I missed last week and took it on Thursday (20 hours late). Is this time enough for resistance to the drug to be built up? I am on my seventeenth injection and I am worried. My next tests are due end of Oct.

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   Response from Dr. McGovern

The optimal course for patients with HBe antigen negative infection is unknown but the minimum of treatment duration considered by most is approximately one year. The reason for this is that patients with e antigen negative infection are at increased risk for relapse following treatment than those who are e antigen positive. In fact, the major trial of hepatitis B patients with e antigen negative infection with pegylated interferon was 48 weeks in duration.

I think it is great that you have attained suppression so quickly - that is fantastic news!

But I think in order to assure that you don't have viral rebound after treatment is stopped that you should go for 48 weeks. However, there may be good reasons your doctor is suggesting this, so talk with your doctor again to understand the reasoning for offering a shorter course of treatment.

Whatever you decide...if your virus does rebound, know that there are multiple other drugs that are also available for treatment.

I am not worried about the late dosing...just try to keep on schedule in the future.

Best wishes for your health....



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