Hepatitis B :: Hep B DNA Flare Up During Tenofovir Treatment/viread


Apr 7, 2016

When I first began treatment with pegasys in january 2014, GGT was 60 (normal max is 35), ASAT 51 (normal max 35), ALAT 76 (normal 10-40), LDH/Bili/CK all within normal range. With pegasys, a few months later down the line, the values continued to go higher. At their highest, GGT 223, ASAT 116, ALAT 156, LDH 274, Bili/CK remained within normal range.

At the beginning of the treatment, Hep B ie/ml  was 2400. Four months later, it became 2600.  When I was shifted to tenofovir/Viread three or months after beginning treatment since pegasys wasn't solving the issue, the ASAT, ALAT, LDH came back down to normal levels quite fast.  So I have been on viread ever since.

10 months after beginning treatment, Hep B ie/ml was down to 1800. In 2015, it was less than 150. Hep B Dna was undetected by May 2015.  I get regular blood tests every three months since the start of the treatment.  

Yesterday's blood test showed:   ASAT 36 (normal max 35), ALAT 38 (normal 40, but having checked past blood tests, it seems in the last few months it has been gaining one or two points steadily so this is worrying me), LDH and Bili are normal. The bad news: Heb B DNA detected...and IE/ml was a whopping 3400!!!! More than when I started started treatment!

The first thing I was asked was whether I missed a dose of viread. Answer is no. However, I have had incidents where I did forget to take it on time, but it has never exceeded 5 hours (still, I know, it's a huge gap). Not a lot of times, but I find that I am beating myself over this now, as it may be the reason I am having a viral overload and maybe made the virus resistant to viread.

Since taking viread, I have experienced and continue to experience extreme muscle pain (I ended up in the hospital once when diclofenac  failed me and I needed an extra morphine shot to get relief). I am continuously tired, some days it is a real struggle to move (feels like going through mud - heavy body, wanting to simply just crash on the floor). I have not had a pain free day in the last two years and worse, kidney stones! I am already prone to them, but I can't get over the suspicion that Viread has ensured I have a stone that needs to be taken out each year.

I've read that viread is one of the best treatment there is (hardly any side effects, probability of virus resistance low) so my latest blood test is worrying me no end. I am not due for another DNA test until 6 months later. I've also read that ASAT and ALAT values can increase and it's not necessarily liver related (I think my ongoing and increasing muscle pain is reflecting higher ASAT and ALAT values but who knows?!?).  

My doctor says that as long as those values remain within normal range and not in the hundreds, it should be ok. But there is this unspoken thought that I am in deep trouble if the DNA continues to manifest and my liver enzyme values continue to increase.  My liver scan in 2014 has me a point JUST before entering cirrhosis stage. I can't help but think I may have actually crossed that line already (the cassandra in me speaking) though I am assured that viread treatment tends to pull back the damage.

My question..Has anyone ever experienced a viral increase during the viread treatment, and if so, was it temporary, or was viread stopped? I am not sure how to read/interpret  this ie/ml, but the fact that it has increased can't be good news at all.

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