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How long to continue with Truvada - HepB Treatment (Please respond)
Dec 8, 2010

I really appreciate your feedback on this. I am chronic Hep B patient but my recent blood test now shows eAntigen = negative and eAntibody = positive, Viral load undetectable, ALT = 21, AST = 22, AFP = 3.4. I have been on Truvada for the past nine months. Before this, I took Entecvir for about a year and before that I was on Adefovir for a year. In 2002 when I was diagnosed with chronic HepB, my virlal load was very high log 8.1 copies/ml, ALT was in 50s. and I had eAntigen = positive and eAntibody = negative. In 2004 the Liver Biopsy showed Fibrosis stage 2 and Inflammation grade1. It seems that all my sisters have HepB surface antigen positive but eAntigen negative/eAntibody positive, undetectable viral load, all three sisters are in 50s. I am the only brother in 40s. Thus it seems that I may have this disease since birth and the liver damage seems moderate (not major). This may be good thing. in other words it may take additional 40 years to get to Firbrosis stage 4(?) - if I do not take any action.

Based on this, my doctor asked me to continue taking Truvada for additional 6 months and after 6 months if entigen is still negative and eAntibody is still positive then I may discontinue the treatment.

My fear is that as soon as I discontinue the treatment eAntibody may go negative and viral load may slowly start increasing. Is this something I should be concerned about? What action I can take to prevent this? Is it risky to discontinue Truvada antiviral treatment? Regardless, I am planning to continue taking Milk Thistle for rest of my life and I do not drink alcohol.

Your input is very valuable to me.

Thanks.

Response from Dr. McGovern

Since you have done extremely well on your medications, I think you have done yourself a great service by adhering to your regimens all along. You have lost e antigen and have gained e antibody. This is a major event called seroconversion. You can talk to your doctor about how long you should be treated after this event. Some prefer 6 months; some 12 months. I personally prefer the 12 month consolidation period.

You will still need careful follow up after treatment to be certain you maintain your non detectable viral load and to follow up on your liver disease. If your viral load stays low you should do extremely well.



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