tenofovir is the only antiviral for hbv with zero hbv resistance to date and it will probably never develop any resistance
it is not possible to stop a drug all at once you have to combo for 2-4months and then if you like you can discontinue sebvivo
remember that hbvdna has nothing to do with clering infection while hbvdna is und you can also get more liver cells infected (this usually happens with antiviral monotherapy) and the only way is to check if hbsag is decreasing
check also our off
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.
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.....
they are dangerous because they all make resistance mutants if you have used lamivudine monotherapy, the only drug without hbv mutants is tenofovir, if viral load is 400c/ml under continuous antivirals you have resistance to them
take a combo of the current antiviral+tenofovir for 2-3months and then discontinue and take tenofovir only
to be very safe a combo of tenofovir+ftc (truvada)+nitazoxanide is the best and safe choice
this is the only drug with no resistance mutants at all on hbv, every other drugs has mutant resistance starting from 1 year, tnf none
the reason of no resistance is the way the drug is absorbed and used by liver cells, and the quantity and time the drugs stays in the cells (i dont remember exactly the pathway and names in english of the process) but all other nucs are different in this
anyway they ll keep monitoring for it but very very unlikly
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
interferon (2 years)+tenofovir or entecavir+alinia, interferon will prevent development of resistance so both tenofovir or entecavir are safe
also alinia should prevent resistance but there are no human trials on this, only in vitro data
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.
the only drug with no resistance to hbv is tenofovir, it is the most potent and it gets hbsag loss by 17years on genotype D (probably also on others).all other antivirals dont clear hbv.
2s/co
mutation genome test
but i wouldn t wait for 100% security of resistance add nitazoxanide as soon as possible, it is effective also on hbv mutated strains and after 4 weeks add tenofovir and slowly discontinue entecavir or keep combo of both
did you have previous resistance or used antivirals before etv?is hbvdna und?
no kidneys toxicity
higher or same levels of drug in the liver
no resistance mutations
i am afraid about no resistance mutations, at the moment it is not known why tdf has no resistance on hbv, the guess is tdf stays longer in liver cells (all nucs are very poor to reach and keep stable quantity in liver cells).
Below is a not so good news about possible resistance of hbv against tenofovir in previously entecavir resistant patient. But this could just be an isolated case.
http://www.ncbi.nlm.nih.
tenofovir (most potent, no resistance), entecavir (resistance very high on lamivudine users so it cannot be used if not naive to treatment), peginterferon
many years of tenofovir (3-6years) and then peginterferon add on are showing 50% cure of hbv by 1 year of combo, al low hbsag less than 1000iu/ml is a good time to add on peginterferon to clear definitively in more cases
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