could anyone give me ideas as to where or who i would contact to get some patient assistance for acute hep c treatment? I am not working, cannot wait on s.s. disability. I try to do some construction work when available, but it is really rough.
Given you are resistant to LAM, staying on Truvada is obviously better. But going mono on Tenofovir should be ok given you current UND. Tenofovir has a excellent resistance profile especially in UND situations. Even if you are resistance to LAM, can you access Entecavir as a possible combo with Tenofovir?
choice is not easy but since entecavir and tenofovir cannot stopped virus if used alone but can only cure a damaged liver, the use of antivirals is not indicated in your case
you may justify the use of those antivirals according to:
high liver cancer risk because of family history, or because having genotype c or precore/bcp mutants.
I am a nurse working with mostly hep c patients. Once in a while i see a hep b patient.
Hep B Serology is confusing!
Patient is
HepBsAntigen negative
HepBe Antibody negative
Hep Be Antigen negative
Hep B CORE TOTAL POSITIVE
PCR is less than 55
Patient wants to go on remicade for crohns.
What to advise? Does he need treatment for the hep b?
your best choice would be tenofovir anyway, without any test available in nigeria you d better use antiviral which works almost 100% to keep virus replication low and prevent liver damage
peginterferon works only on less than 50% patients and clears hbsag only on 7% of patients when hbsag is over 1000iu/ml.
tenofovir is the oldest drug among hbv drug since we share the same drugs as hiv, it is the most potent and generics are on the market.
No Detectable Resistance to Tenofovir Disoproxil Fumarate (TDF) Following up to 240 Weeks of Treatment in Patients with HBeAg+ and HBeAg- Chronic Hepatitis B Virus Infection
P. Marcellin1; E. Heathcote2; A. Corsa3; Y. Liu3; M. D. Miller3; K. M. Kitrinos3
1. Hopital Beaujon, University of Paris, Clichy, France.
2. Toronto General Hospital, Toronto, ON, Canada.
3. Gilead Sciences, Inc., Foster City, CA, United States.
Hi everyone, I was female patient, 39 years, I am being treated for hepatitis B in chronic Entecavir 0.5mg, 1 tablet / day has been three years, and HBV DNA below the level of my found that more than 2.5 years, and every 6 months I still get tested HBV DNA and undetectable to date. I only had a 9-year-old girl, now I want more babies.
entecavir+tenofovir (viread) , is a good choice for you at this point....and also tell your doctor to read up on the results if clinical trials of DIFFERENT antiretrovirals before he puts anyone else on a treatment.
So pls comparatively, lamivudine and tenofovir,which one is more effective in dealing with this virus.And which one has serious side effect.sorry for interrupting ur initial conversation.
hbsag quantity in iu/ml if available and not too expensive otherwise skip this
hbe, hbeab, hbvdna pcr,alt/ast
if you are active and hve problems for cost of drugs you can use tenvir which is generic tenofovir, but only if hbv is active because tenofovir lowers only hbvdna and alt/ast nothing else, you can also make combo with alinia (nitazoxanide) generic nazonide 500 or nitarid if you can afford this too.
tenofovir is the best drug for hbv and the most effective in cancer prevention and it has no resistance.not entecavir which has very low resistance but it has resistance it is not zero, it works less on liver cancer prevention but it is less heavy on kidneys so only if you have kidneys problems it is a better choice.
1 drug-resistance mutation (rtA181T/A181V/rtM204I/rtA194T/rtT184A) in 13.6% of patients with an intra-patient prevalence ranging from 0.02% for rtA181V to 47.5% for rtA181T, both associated with suboptimal nucleotide-analogues (mostly adefovir) response. By UDPS analysis, 29.5% of patients carried >1 immune-escape mutation within the a-determinant (intra-patient prevalence from 0.84% to 100%).
who is the crazy docotor who prescribed lamivudine/epivir, add tenofovir as soon as possible, lamivudine don t cure hbv and makes hbv mutations which can be untreatable and can make liver cancer even if hbvdna undetactable
do add tenofovir as soon as possible, you have just worsen your condition with lam, it is not indicated for hbv anymore, only tenofovir (viread) entecavir (baraclude) interferon are
to know if you are clearing you need hbsag quantitative in iu/ml and to know if you are saf
)
there is no tenofovir resistance reported in vivo (only one patient but in coinfection with hiv so not to be considered), only adefovir resistance can lower response to tenofovir.
so we don't know if sides can become an issue, at the moment at 3 years sides are only in less than 1% cases so if we have new antivirals in 5 years both entecavir and tenofovir are ok.
This is my understanding of the patient assistance programs for Incivek. The list price, which no patient will have to end up paying, is $49,200 for 12 weeks. HOWEVER, the patient assistance programs, are more than generous. Typical Co-pay for the three prescriptions that will be needed will be between $50 and $250 each.
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