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First line therapy

First line therapy

What should be recommended as first line therapy for HBV ? Truvada or baraclude?

I think truvada (tdf+ FTC) is a better choice since baraclude may develop resistance? Is baraclude resistance become less potent when switching to tenofovir?

How do I know if a person is in immune tolerant phase and doesn't need treatment?
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What should be recommended as first line therapy for HBV ? Truvada or baraclude?

tenofovir (not truvada)
entecavir (baraclude)
peginterferon which will be changed with new interferon lambda which doesn t have all severe sides normal interferon has

truvada is association of tenofovir+ftc, some more potency than tenofovir alone, some more sides on kidneys, more genetic barrier to resistance.i'd not use it if tenofovir fully suppress hbvdna since we haven t seen any resistance from tenofovir.
in a couple of years if not earlier we will have cmx157, new formula of tenofovir, no sides, 4.5 fold more potency, so i think truvada is ok only on resistant hbv strains, when tnf doesn t work

think truvada (tdf+ FTC) is a better choice since baraclude may develop resistance?
tenofovir is much better and little more potent than etv, but the good of etv is it has no sides at all, so every drug has its pros and cons.
for example this week i have tried tenofovir+etv+ntz, unfortunately not for me, creatinine jumped to 1.21 (still normal range) in 1 week, maybe i will try again after the use of some antioxidants that prevent kidneys damage

there is no clear data but one thin is certain it is better to use tnf without any resistance be baraclude or lam

how do I know if a person is in immune tolerant phase and doesn't need treatment?
hbvdna in the millions/billions, alt normal, hbsag very high log4-5 or more, fibroscan or biopsy with no fibrosis

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