Last week my doctor told that you HbeAg should be non reactive after 2 yrs of Tenofovir but since it over 3 years so might be Tenofovir resistance So you need to change my medicine.
Please suggest me what i do.
(20) The T69S insertion mutations, associated with resistance to multiple nucleoside analogues, are associated with resistance to tenofovir as well. Tenofovir resistance conferred by the T69S mutation or by multiple thymidine analogue resistance mutations appears to be multiplied if the M184V mutation is replaced by wild-type.(21) The K65R mutation, which may be selected by prior nucleoside analogue therapy, is associated with a modest decrease in sensitivity to tenofovir.
"Risk" is relative. You just have to choose the best option that is available. 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?
tenofovir has 0% resistance so it cannot build any resistance while the opposite may happen with all the other antivirals
especially entecavir which makes many mutations for resistance....
tenofovir works perfectly even if you have lam resistance but it is better to have no resistance since you might develop resistance to tenofovir as well since these are life tx at the moment
check for mutation and start tenofovir immediately, do not wait any day
knowing if you have mutation is important because i would definitely start a combo in this case.
My doctor suggests that I participate in the drug trial of Tenefovir (Viread) versus Tenofovir in combination with Emtricitibine (Truvada). I have chronic Hepatitis B and Lamivudine resistance last year. He gave me a document to read and I did a bit of research on internet on the side effect. My concern is the side effect especially on Kidney. Could you give me some advice if I should participate in the drug trial or stay with my current medicine Hepsera.
this is very old post today we have tenofovir which has no resistance and is the most potent antiviral, other antivirals like lam, tlb, adv are not useful today as first line
the kidneys toxicity was used at first to keep tenofovir away from hbv becuase of no resistance development, the potency of tenofovir on hbv was known to researchers even before 2000....but all failed hiv drug were used
now dont let you fool by drug makers which need a new patent for tenofovir because it will become extremely cheap in a few years.....
tenofovir is safer because no resistance has been detected until now, 4 years, all the other antivirals start with resistance from less than 1 year especially if hbvdna is not und by 6 months
entecavir has 0.2% from first year and 1.2% at 3 years, tenofovir 0% even if hbvdna is still high-it is very probable that no resistance will be detected for a lot of time, the reason why this happens is not known.
tenofovir, no resistance
entecavir, 1,5% resistance but cannot be used on those using lamivudine because in this case resistance can go higher than 50%
interferon
if i had a doctor prescribing me such rubbish useless toxic.....i d destroy his life....
Entecavir treatment after Lam resistance is not that much safe. Tenefovir is absolutely better option if she does not have a problem in her kidneys.
attention entecavir works only in naive patients and even in naive patients it has 1,2% resistance, truvada is tenofovir+ftc (ftc similar drug to lam) in combo to prevent resistance and of coruse it has zero resistance until now
entecavir is also less potent than tenofovir, tenofovir is the only drug with zero resistance until now, all other drugs have resistance mutations
entecavir mght be used in case of adefovir resistance or even better a combo of tenofovir and entecavir
take tenofovir immediately, if you have finiancial problems or cannot have it in nigeria you can look for tenvir generic from cipla
also combo with nitazoxanide if you find lam mutation resistance, both tenofovir and nitazoxanide are active against lam mutants
lam resistance muattion can lower response to other drugs this is why i suggested combo tnf+ntz
in theory ntz is active against all mutations since acts on immune system, not the virus, by now we have vitro studies on lam and adv mutatio
there is no data on entecavir resistance blocked by tenofovir and it is not known if tenofovir can keep hbvdna for long so she absolutely must keep that combo, if she is hbe negative she can add nitazoxanide and hopefully clear hbsag in 1-2 years
we have this data about lam resistance:
1) entecavir useless and much less potent than the other options below
2) lam+adv, much more potent than etv, no other resistance mutations development
3) tenofovir, best choice and if doesn t get hbvdna un
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.
tenofovir little more potent antiviral activity especially on hbe neg, no resistance, possible sides effects after decades of use
entecavir no sides, about 1% resistance at 6 years
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