Should I Take Liver An Neng and Liver Shi Neng Together or Choose Beileke?

Is it better to take Hepanone and Hepanorm together, or should I take Belek?

Hello Doctor, I apologize for writing you so many letters.
Previously, my e-antigen was over 300, and I took Tenofovir for more than a year, during which my e-antigen turned negative.
After taking it for another six months, I stopped the medication.
Three months after stopping, my e-antigen was also negative, with a level around 80.
However, three months later, my GPT skyrocketed to 720, and my GOT was 250, while the e-antigen remained negative.
A week later, my GPT reached 960.
Three months ago, my GPT was 80, and my HBV DNA was over 60,000.

My doctor advised me to take both Hepatitis B medications, Tenofovir and Entecavir, together.
I saw your weekly publication and understand that this combination may have a lower risk of resistance.
However, it seems that the cost is higher than taking Baraclude.
Do you recommend that I take both medications together, or should I take Baraclude first, or start with Tenofovir? Thank you very much.
I still feel uneasy about the medications from mainland China and am worried about potential side effects.
I will wait for your response before making a decision.
Thank you, Doctor.

A-Hua, 20~29 year old female. Ask Date: 2007/03/24

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! Some studies have confirmed that taking both together can reduce the likelihood of developing drug resistance in liver function.
However, as you mentioned, cost is a significant consideration.
When you referred to medications from mainland China, what specifically were you referring to?

Reply Date: 2007/03/24

More Info

When considering the treatment options for hepatitis B and fatty liver disease, it is essential to understand the implications of your current health status and the medications available. Based on your previous treatments and the recent surge in your liver enzyme levels (GPT and GOT), it is clear that your liver health requires careful management.

Firstly, it is important to clarify the medications you mentioned: Gan An Neng (Liver An Neng) and Gan Shi Neng (Liver Shi Neng) are traditional Chinese medicines often used for liver health, while Beileke (likely referring to a Western medication, possibly antiviral) is a more conventional treatment for hepatitis B. The choice between these options should be guided by your specific health needs, the severity of your liver condition, and the advice of your healthcare provider.

Given your history of elevated liver enzymes and the fluctuation in your HBV DNA levels, it is crucial to prioritize effective antiviral therapy. The fact that your e-antigen remains negative is a positive sign, indicating that your body may be controlling the virus to some extent. However, the significant rise in your liver enzymes suggests that there may be ongoing liver inflammation or damage, which needs to be addressed promptly.

In terms of medication, combining traditional Chinese medicine with antiviral treatment can be beneficial for some patients, but it is essential to ensure that these treatments do not interact negatively. Your doctor’s recommendation to take both Gan An Neng and Gan Shi Neng together may be aimed at providing supportive care for your liver while also addressing the viral load. However, the efficacy and safety of these combinations should be closely monitored.

On the other hand, Beileke, as a conventional antiviral medication, has a well-established track record in managing hepatitis B. If your liver enzymes continue to rise, it may be prudent to consider switching to or prioritizing Beileke, especially if you have concerns about the efficacy of the traditional medicines. The cost of treatment is also a significant factor; however, the priority should be on what is most effective for your health.

It is also worth noting that while traditional medicines can support liver health, they should not replace conventional antiviral treatments, especially in cases of significant liver inflammation or elevated viral loads. The potential side effects of any medication, including those from traditional Chinese medicine, should be discussed with your healthcare provider, who can provide guidance based on your specific health profile.

In conclusion, while both Gan An Neng and Gan Shi Neng may offer some benefits, the rising levels of your liver enzymes and your hepatitis B status suggest that a more aggressive antiviral approach, such as Beileke, may be necessary. It is crucial to have an open discussion with your healthcare provider about your treatment options, including the potential benefits and risks of each medication, to make an informed decision that prioritizes your liver health. Regular monitoring of your liver function tests and HBV DNA levels will also be essential in guiding your treatment plan moving forward.

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