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follow up ..Good day
Sep 25, 2005

Hi Dr Barbara

Thank you so much for your kind assistance,

I started taking zeffix tablets since last March . A dna quant. test made for me two months and the result was undedactable !still taking the tablets. My question is how long i will be taking it again ?. and is there any side effect of using this medicin for long periods ?

Thanks again and wish you a good day

Hi Dr Barbara

Sorry to bother you again but i am in deep trouble !!

As i have mentioned in my below last message that the doctor put me in zeffix because of my DNA level reading on the 22/02/05 (more than 85000 c/ml...but i have made onother dna test just before i start the zeffix on the 22/03/05 ..the result just came back and my readin level is 5000 c/ml !! is this possible in one month without treatment!!!?

What i shall do now stop the zeffix as it is no usfull with such low level??

I am so confused ..please help me with your opinio.

Regards,

Dr: Barbara 45 years old , Male , Chronic HEP B .The doctor decided to put me on Zeffix .He blieves that there will be a responce and the reason is for the treatment is my HBV DNA level >10000 IU/ML.I have started Zeffix with the vaccination of A&B HBV and the reason from the doctor to use the vaccination is to help my amune system and Zeffix treatment to deal with the virus.Shall I continue ? and if there is no responce and i stop taking the therapy shall my virus come back worse than it is now ?

1-test in 1996 showed HbsAg: Positive, HbeAg: Negative, Anti HBC total positive, Anti HBC IGM: Negative, Anti HBE: Positive, Anti HBS: Negative. Anti HCV total: Negative. With normal LFT test. 2- Abdomen ultra sound is NORMAL. 3-AFP TEST=1.38 (REF- 00-5.8) - HBV-DNA (qualitative) using COBAS TAQMAN HBV KIT IS POSITIVE.

-HBV-DNA (quantative) using COBAS TAQMAN HBV KIT IS POSITIVE and showed the following results:

A- 14693 IU/ML (Moderate Viraemna). B-85219 C/ML . C-4.17 Log IU/ML . D- Sens.threshold:6 IU/ML LFT's Results : ALP2S=79 U/L Albumin = 4.8 g/dl

Bilirubin Direct= 0.1 mg/dl

Bilirubin Total= 0.61 mg/dl

Gamma GT = 28 U/L

SGOT= 16 U/L

SGPT =24 U/L

Total Protein= 7.51 g/dl

Alk.Phos.=85 U/L Trigl=136 mg/dl

Response from Dr. McGovern

It is very interesting that your virus level has come down so dramatically even before treatment.

Hepatitis B activity can fluctuate significantly, and there is a small percentage of patients who will automatically clear virus on their own each year.

I personally would choose to continue treatment and I suspect your chances of doing well are extremely high since your immune system seems to be doing a great job.

Dr. McGovern

Response from Dr. McGovern

I am so glad your hepatitis B virus is suppressed on Zeffix (Lamivudine; Epivir). However, I cannot tell you how long you will need to be on drug. You will need to ask your doctor if you have hepatitis B e antigen positive or e antigen negative infection. That will be important in determining length of treatment. The drug is well-tolerated. The only thing I would be concerned about with long-term treatment is the emergence of resistance.

Dr. M



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