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HepB - LAM - eAg Neg
Feb 5, 2003

Doctor, I started treatment with LAM 8 months ago. At that time my HBvDNA count was over 180 million copies, ALT=318, AST=147, eAG neg. Last October my viral load was 4,700 copies, ALT=128, AST=69.

Last month I had two lab tests: The first one showed: HBvDNA (Qualit.) Negative, HBeAg Positive and HBeAB Positive, ALT=71, AST=73, Bilirubin= 1.1

The second one (1 week later, another Lab): HBeAg Negative and HBeAB Positive, ALT=73, AST=62, Bilurubin = 2.3 (The highest in the last year).

What would be your recommendation in terms of tests, for how long should I continue with LAM knowing the risk of the appearance of the YMMD mutant? What about adding PegIFN?

From my current status, what are my chances to seroconvert the HBsAg and get HBsAB?

What does it mean to be in my current HBeAB positive status in terms of further damage to my liver, and being contagious? Thanks a lot.

Response from Dr. Dieterich

Hepatitis B is a very confusing problem. It sounds like you are doing well but are not out of the woods yet. Keep up the LAM and eventually the e Ag will stay away and the e Ab take over. If you are more comfortable,you can add adefovir now which is very active against even LAM resistant HBV. Keep up the good work and good luck! DTD

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