emails about YMDD mutants

liver411

I think my case is very similar to yours although I don't develop precore mutant, I have YMDD mutant due to Lamivudine. The results of my liver biopsy which I did 2 weeks ago showed no fibrosis or cirrhosis but with mild inflamation and very mild fatty liver. My ALT is 52 and all other LFT results are within normal range. But my viral load is way higher than yours, mine is 7658pg/ml which I did in September this year. There are 2 options given by my doc, first one is to wait a little longer for Adefovir or Entecavir and continue taking Lam which I had since Feb 2000. The second option is a combination of Lam with Zadaxin for 6 months and Lam alone for another 6 months but it's difficult to tell the effectiveness due to my high viral load and borderline abnormal ALT. So I'd most probably opt for the first option since Adefovir is expected to be available mid to end of next year.

Just my personal opinion. What's your thinking Doc ?



Steven



-----Original Message-----

From: Jackie Benson

Sent: Thursday, November 22, 2001 9:46 AM

To: Doc; hepatitis b

Subject: [HB] Re: Question about liver biopsy





Hi again,

Just a question. If I opt to wait on treatment what is the liklihood that

something will come along soon that will help my situation? I don't know how slow a virus this is. Is lamuvidine not a good option for me? Could I develop more mutants from that medication?  How infectious am I? I am not sure. I know I am infectious but because

I have both the HB surface antibody and core antibody as well as e antibody, is that a good sign even with my high viral load?  Do the results of the biopsy indicate I have a mild disease or just a slow one. This is so confusing!  From what I have read on some web sites, precore mutant hep b could indicate serious liver disease. Karen

thought precore sometimes indicated more mild disease than the wild virus.

Thanks

again.  Jackie



Doc wrote:



> Your AST/ALT are just borderline abnormal and with

> a high viral load that makes you a poor response

> candidate for conventionally approved therapy. You

> are right , you are a precore HBV mutant.

> Our friend Karin is in an almost similar

> situation.

> Well, I never like that high viral load, seems

> like someone is going to choke your breath but you

> dont know when!

> I think you should wait..for promises yet

> undelivered!

>

> Come to the B Informed 2002 ..for the hot

> discussion will be on when to treat?

>

> Dr Sharat C Misra MD,DM

>

> > Hi Doc,

> > I just came back from my first liver biopsy and

> here are the results.

> > First of all, I have chronic hepatitis b. I am a

> 53 yr old female and

> > think I acquired this in 1999.

> > I have been told I have the mutant core virus

> because I am e antigen

> > negative and e antibody positive. ALT of 66 and

> AST of 50. Viral load is

> > 659 pg/ml. Biopsy results are mild chronic

> active hepatitis b with mild

> > inflammation. Could you explain this to me and

> in your opinion should I

> > go on Lamuvidine or wait until something better

> comes up. I know that

> > Lamuvidine causes more mutations so I wondered

> because I am precore

> > mutant if I should wait.  Al my liver enzymes

> are normal and I have no

> > symptoms.  Thank's for your advice.     Jackie

>



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