Without taking any drugs, viral load was 22,000 in september 2009. 46,000 in december 2009. Doctor recommended lamivudine in January. Took lamivudine and by June 2010, viral load was undetected. have read in many forums that lam is not the best, approached my doctor with this concern and she sugessted tenofovir. Should i start tenofovir immediately, how should i start. Should i just abruptly stop lam and move on to tenofovir, should i use both and gradually stop lam after a few day/weeks.
I have been on lamivudine and adefovir for 4 years (after resistance to 6 years of lamivudine).I have developed renal tubulopathy because of the toxic effect of adefovir.my DNA is undetectable ALAT ASAT normal.My doctor advised me to take lamivudine every day and adefovir just one pill every 48 hours.He also thinks that he might put me on Baraclude(entecavir) monotherapy.What do you think? Please advise me .Thanks very much for your help.
Please note Tenofovir is principally cleared through the kidney and dosing adjustments due to renal impairment have not been clinically tested.
The followings are extracts from the label information for Tenofovir:
2.3 Dose Adjustment for Renal Impairment in Adults
Significantly increased drug exposures occurred when VIREAD was administered to subjects with moderate to severe renal impairment [See Clinical Pharmacology (12.3)].
To evaluate how much kidney protection telbivudine confers, researchers monitored kidney (renal) function in 831 hepatitis B patients who received a combination of antivirals for 96 weeks, including:
Telbivudine and adefovir
Adefovir plus lamivudine
Adefovir plus entecavir
Adefovir alone
and entecavir alone
Among the five treatment groups, significant improvements in kidney function was observed in the adefovir plus telbivudine and adefovir plus lamivudine groups over the study period.
I am not aware that impaired renal function precludes treatment for HCV. I have read that kidney disease is a negative predictor of SVR but, so too are a lot of conditions yet people have overcome them. I have seen articles which discuss the plasma levels of ribavirin with renal impaired patients. The suggestion is that rather than weight base dose these patients the dose should be arrived at by considering GFR (glomerular filtration rate).
This is from Clinical Care Options @ http://tiny.
By "AGE" I'm assuming you mean a persons age in years. I don't believe age has anything to do with Janumet's "effectiveness" but age has a larger role with renal function. To make it clear for other readers, Janumet is combination of two drugs; Sitagiptin and Metformin.
This a brief from the Merck web site - makers of Janumet - Section 8.5 - Geriatric Use JANUMET.
I also have kidney damage from a bout of high blood pressure 4 years ago, and I am a frequent kidney stone former, so I am being watched carefully by a nephrologist too. I have renal panels frequently too. I was wondering if any of this could increase my stone risk. I was reading about the cytomel and stones. The nephrologist wants me to remain on the synthroid and cytomel.
I think it depends on some individual factors, particularly renal clearance of the drug. I found this information in the drug reference:
According to the manufacturer's tests, the drug reaches maximum serum levels between 15 and 44 hours after subcutaneous injection of a single dose. The mean elimination half-life is 22 to 60 hours (mean = 40 hours). So, I would expect that after 7 days (4.2 half-lifes) that the concentration would be about 5.5% (0.5^4.2) of the maximum levels.
Although our analysis showed that nucleos(t)ide analogue treatment does not increase overall incidence of liver, lung, breast and urinary/renal malignancies, it did reveal that patients with Hepatitis B virus on this treatment had a higher risk of developing colorectal and cervical cancers," said Professor Grace Wong, Department of Medicine & Therapeutics Academic at the Chinese University of Hong Kong and lead study author.
Glomerular filtration rate or its approximation of the creatinine clearance are measured whenever renal disease is suspected or careful dosing of nephrotoxic drugs is required. The normal ranges of GFR, adjusted for body surface area for males is 70 ± 14 mL/min/m2 (56-84) . Risk factors for kidney disease include diabetes, high blood pressure, family history and older age.
Take care and keep us posted.
stop lamivudine immediately or switch to tenofovir, it is decades now lamivudine is not used because it can lead to cytopatic hbv mutations that cannot be control with any medication leading to cancer and cirrhosis despite hbsag negative, hbvdna undetectable and normal ast-alt, another reason not to use lamivudine is that it is even totally useless on hbv
the hbsag of the virus mutates to a form where the virus destroy cells directly even without replication
hbv cure is achieved only by sequen
Since then, I have been taking Zeffix (Lamivudine). Recently my doctor decided to put me on Viread (Tenofovir) instead. As I have read, some people are experiencing bone density loss due to Tenofovir therapy. Is it advisable that I start taking supplements like calcium and vitamin D along with my therapy to prevent bone loss? Thank you.
Hepatic decompensation was not prevented by lamivudine compared to placebo or entecavir compared to lamivudine in three underpowered trials.
Hepatocellular carcinoma was not prevented in four studies with inadequate size and duration. In one RCT, analysis that adjusted for country, sex, baseline ALT level, Child-Pugh score, and Ishak fibrosis score and excluded five individuals who developed HCC within the first year of the study found a borderline significant effect of lamivudine.
10.300 copies/ml . I got lamivudine 100 mg /day vitamine E 4oo ui /day, orange juice everyday 50 cc/day ,and others fruits,2 months later my blood test showed DNA/HBV/PCR negative (<200 copies ),checked regularly every 3 months untill now still negative level. SGPT 75- 90 ui/ml constantly,never down a normal range,since 2008 March untill now. HBsAg negative level ,HBsAb negative level ,others test are normal levels .Is i got recovery from Hepatitis B ?
A recent study of decompensated CHB pts showed that renal function significantly improved for pts receiving telbivudine (LDT) but continually worsened for pts receiving Lamivudine (LAM). Renal dysfunction can reduce clearance of oral nucleot(s)ides increasing drug-associated toxicities resulting with high mortality.
Methods
We performed a meta-analysis of pooled data to determine the effect of LDT vs LAM treatment on renal function of CHB pts.
I have tested positive to Hbsag for more than a year now. I was placed on lamivudine, methionine and essential forte. d doctor never ask me to do viral load test anytime I see him he do ask me to do LFT and subject me to d early medications I listed. so a friend advice me to go teaching hospital were I can see a specialist. my question here is now that I have been on medication for a year without knowing my viral load what is d implication ?
BACKGROUND: Nucleoside analogues such as lamivudine for chronic hepatitis B have an excellent safety profile while patients are on therapy but reactivation flares occur in 19-50% of patients after stopping therapy, some of whom develop liver decompensation. AIMS: To describe and report three cases who developed fatal hepatitis B reactivation after stopping nucleoside analogue therapy.
I am a 26 year old male having hbsag and hbeag=+ve,hbv dna =1070 iu/ml(Taqman) but my LFT results are normal(sgpt=37,sgot=33).My doctor has asked me to take lamivudine 100 mg for 6 months or until hbv dna becomes -ve.My mom is taking lamivudine for the last 7 months after her hbv dna crossed 8 lacs iu/ml.Probably I have been infected from my birth.Is it possible for both of us to completely cure Hep. B after taking lamivudine.
1. I am HBV carrier, and I am also under treatment with taking lamivudine 100mg daily. Will this impact the result? Will lamivudine/HBV virus cause false negative?
2. Because I am taking lamivudine daily, will this cause the delay of seroconversion. I think the test was done about 18 months after events that I thought maybe risky.
3. My test is Combo TypeI/II antibody and p24 antigen QUAL CMIA. Is it reliable?
4. My HBV DNA level is sometimes undetectable, but sometime a few hundreds.
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