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hbsag level depends only on your immune system response and correlates only with cccdna which is the virus in the liver cells (all other parameters says nothing about amount of virus but only replication or low replication), but of course on very high hbvdna also hbsag is high.hbsag tends to be very high on hbe positive with active hbv and lower on hbe-ab.
hbvdna is not correlated directly with immune response, you can be inactive carrier with hbvdna 5log iu/ml, even when you seroconvert to hbsab you can have little hbvdna, immune responce is correlated with hbsag mainly or with your being active or inactive.
there is a precentage of lucky ones on cronic (chronic) hbv and a huge number of inactive carriers that have it at 1000-1600iu/ml.
Since interferon can lower hbsag 1-2logs it can make seroconversion on most of these low hbsag.
also antivirals lowers hbsag but very slowly, 1-2logs in 2-3years, so even antivirals can make seroconversion but only when hbsag is low.there is some data on tdf+ftc lowering cccdna, and i found a case of hbv+hdv eradicated by interferon+tdf+ftc in 10 months.trials are very slow on this, even trial on tdf+ftc is still at eraly stage but tdf+ftc is used on hbv-hiv coinfection by years, on recent reports they had a hbsab seroconversion at 11% per year even with depressed immune system on hiv (11% per year is higher than interferon)
also alinia has been found to lower directly hbsag and hbeag in combo
usually on cronic (chronic) hbv hbsag is 3000-10000 or even higher so in this case chance of seroconversion is almost impossible, so having very low hbsag i would try all potent combos to seroconvert on the contrary if hbsag is high i would just make therapy for life long antivirals keeping in mind antivirals can have sides if used for decades so only safe combos with little sides
[ 本帖最后由 齐欢畅2 于 2010-6-25 15:51 编辑 ] |
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