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Bogdan Ag

Buna Seara

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Buna Seara,

 

 

Ma numesc Bogdan, sunt din Arges recent am fost diagnosticat cu Virus hepatic B. Am fost la Matei Bals, sa imi fac analizele in luna aprilie,atunci am fost diagnosticat cu acest virus. Viremia mi-a iesit :

Incarcatura Virala :

931 copii ADNHVB/ml

2,97 log copii ADN HVB/ml

 

160 UI/mml

2,20 log UI/ml

 

Limita de detectie :

116 copii ADN HVB/ ml

2,06 log copii ADN HVB/ml

 

20 UI/ml

1,30 logUI/ml

 

Markeri Hepatici

AcVHF-IgG Negativ

Anti_Hbe 0.02

Anti_hbe_1pozitiv

HBeAg 0.48

HBeAg_I Negativ

HBcAb_IgM 0.05

HBcAblgm_I Negativ

HBsAgQ2 3707.11

HbsAgQ2_I Pozitiv

Hcv_3 0.05

Hcv_3_I Negativ

 

 

Markeri Tumorali:

-AFP 2.2

 

Analizele le-am facut in luna aprilie, singurele modificari au fost la Hemoglobina 13.96, Latimea Distributiei Trombocitara 18 si Creatinina Serica 0,6. In rest toate au fost foarte bune. Acum problema mea este urmatoarea, pana acum am fost mai plinut, am 1.80m si 120kg iar de un an si ceva m-am apucat de facut sport la sala de fitness. Am slabit intr-un an aproape 30 de kg, Sa fie acesta un motiv de mi-a iesit valorile asa?. Acum am o alta problema astazi am facut analizele de ficat adica TGO si TGP acestea fiind urmatoarele Tgo 39 Si TGP 80. Cu o saptamana in urma am simtit palpitatii in zona ficatului. In  iuliee am avut un accident si am fost operat de Humerus cu deplasare unde mi sa pus o placuta ca sa imi prinda osul. Se poate ca de la anestezia aceea totala sa imi fi afectat ficatul? Este intradevar ceva de speriat ca am luat si Hepato protectoare timp de 2 luni.1 luna Essentiale si 1 luna Lagossa. La ecograf ficatul si splina sunt normale. Ce sa fac sunt putin speriat si nu stiu ce sa fac.Daca se poate sa ma ajutati cu un sfat.

 

Va Multumesc

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la inceput cand am aflat de hepatita, eram extrem de speriat, si nimeni nu imi raspundea pe forum, ei bine, am luat problema in propriile maini si m-am documentat singur printre forumistii internationali si asa am reusit sa inteleg acest virus

 

analizele ce trebuiesc urmarite sunt : 

HBVDNA (viremia)

alt/ast

fibroscan

Ag hbs cantitativ ,Nu calitativ !

 

la noi in tara abia de anul trecut au inceput doctorii sa aiba in vedere cel mai important lucru in tratarea hepatitei B , AGHBS cantitativ,  viremia este utila doar pentru a vedea raspunsul la tratament.  daca aghbs cantitativ scade sub 1000 UI/ml sansele sunt foarte mari sa scapi de virus .oricum conferinta de anul acesta AASLD care abia fost au venit cu rezultatele urmatoare : in momentul de fata cel mai potent medicament este Tenofovir, iar in urma unui studiu s-a observat ca dupa 10 ani de Tenofovir urmatoarele rezultate : The median percentage reductions of HBsAg, ihHBV-DNA and cccDNA at last biopsies were 71.46%, 99.85% and 99.89%, respectively. 

 

Atasez rezultatul studiului pentru cei interesati : 

 

1855 

Profound Reduction of HBV Covalently Closed Circular DNA with Long-term Nucleoside / tide Analogue Therapy 

Medicine, TheUniversity of Hong Kong, Hong Kong SAR, Hong Kong; 

State Key 
Laboratory for Liver Research, The University of Hong Kong, Hong 
Kong SAR, Hong Kong; 

Pathology, The University of Hong Kong, 
Hong Kong SAR, Hong Kong; 

Medicine, Johns Hopkins University 
School of Medicine, Baltimore, MD; 

Medicine, Columbia College 
of Physicians and Surgeons, New York City, NY 

Background:. Long-term nucleoside / tide analogue (NA) treatment suppresses serum HBV DNA to undetectable levels in a majority of patients We aimed to investigate the effect of long-term NA on the suppression of covalently closed circular DNA (cccDNA) and intrahepatic HBV DNA (ihHBV-DNA). 
Methods: 
We recruited 40 patients (median age 44.2 years, range 24.3-63.2) who had been on continuous long-term (5 - 10 years) NA All patients had 3 liver biopsies:. At baseline, after 1 year of treatment and at the last follow-up. Serum HBV DNA 
and HBsAg were measured by the COBAS TaqMan HBV Test and the Elecsys HBsAg II Assay, respectively (both Roche Diagnostics). ihHBV-DNA and cccDNA were assayed by real-time PCR, with lower limits of detection of 0.001 and 0.005 copies / cell, respectively. 
Results: The median duration of treatment was 10.5 years. (Range: 6.0 - 11.9 years) At baseline, 13 patients had 100mg lamivudine, 11 had 600mg telbivudine, 
9 had 0.5mg entecavir, 4 had 30mg clevudine, and 3 had 10mg adefovir. At the last follow up, these patients were on 0.5-1.0mg entecavir (n = 23), 600mg telbivudine (n = 9), 10mg adefovir (n = 4), 300mg tenofovir (n = 2), or combination therapy of lamivudine plus adefovir / tenofovir (n = 2). Histology of the third biopsy showed complete resolution of interface hepatitis in 60% of patients with the remainder showing mild-to -moderate activity. Persistent immunoreactivity for HBsAg was found in 80%, the mean number of hepatocytes positive for HBsAg 
being 10.4% (range 1-80%). All but 1 (2.5%) was immunoreactive for HBcAg. At baseline, the median serum HBV DNA, HBsAg, ihHBV-DNA and cccDNA levels were 6.84 logIU / mL, 3.38 logIU / mL , 286 copies / cell, and 7.3 copies / cell, 
respectively At the time of the last biopsies, 36 (90%) patients had undetectable serum HBV DNA (<20 IU / mL), all but one patient still had detectable HBsAg. (median: 2.74 logIU / mL), all had detectable ihHBV -DNA. (median: 0.4 copies / cell), but 18 (45%) patients had undetectable cccDNA There was a trend of reduction of HBsAg, ihHBV-DNA and cccDNA levels from baseline to 1 year to last follow-up (all p <0.0001). The median log drop of HBsAg at last biopsy was 0.55 logIU / mL. 
The median percentage reductions of HBsAg, ihHBV-DNA and cccDNA at last biopsies were 71.46%, 99.85% and 99.89%, respectively. 
Conclusions: 
Long-term NA treatment significantly reduced cccDNA and ihDNA. 45% of patients had undetectable cccDNA, although small amount of ihHBV-DNA were still 
detectable in all patients. Integrated HBV DNA may be a possible source of detectable ihHBV-DNA and HBsAg. Continuous long-term NA therapy can reduce cccDNA to undetectable levels, suggesting a possible end-point of treatment.

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