Interest in ETV+ADV vs LAM+ADV efficacy.

http://clinicaltrials.gov/ct2/show/NCT01023217

In our country, there is no official data about ETV+ADV vs LAM+ADV. Who has similar result?

[stef2011]

they are still making trials but not for use now, both lam and adv are useless, too weak for anybody.
in your specific case you also have resistance already the only drug that can be used in your case is tenofovir, nitazoxanide combo or interferon all the others worsen your condition, so you must get tenofovir many people in china have ordered it online by normal post and received it

your resistance is both lam and adv even if test detects only lamR you have also advR registered in cccdna because you are using it too long

[stef2011]

dat on combos is not available anywhere for now, only lam combos which are useless.combos are too expensive for insurance companies or healthcare systems while etv mono and tdf mono might work on majority of patients so very little data will be pubblic on these combos

[stef2011]

http://www.clinicaloptions.com/Hepatitis/Journal%20Options/Collections/2010%20JO%20Hepatitis%20Volume%204/Articles/Van_Bommel-Hepatology-2010/Commentary.aspx

this study is about your situation of previous use of lam and adv and tenofovir as the only drug working, but after both lam and adv use combo is necessary

[stef2011]

http://www.clinicaloptions.com/Hepatitis/Journal%20Options.aspx?id=b3b32c2a-6bbd-4fba-aa09-30e86405f4be

check all tenofovir studies on people with lam and adv use

[Skyclimber]

thank you for your advice.

today i got the result from hospital. the result shows that i have not got any mutation by any drug, including LAM and ADV.

-LAM
Wild  +
rtV173L -
rtL180M -
rtM204I -
rtM204V -

-ADV
Wide +
rtA181T -
rtA181V -
rtN236T -

-ETV
Wide +
rtI169T -
rtT184A -
rtT184G -
rtT184I -
rtS202G -
rtS202I -
rtM204I -
rtM204V-
rtM250V -

-LdT
Wide +
rtL180M -
rtM204I -
rtM204V -

-FTC
Wide +
rtM204 -
rtM204V -

-TDF
Wide +
rtA194T -

Now i want to know whether to use Combo? Which combo? Maybe i have suboptimal response to adefovir. Now I may have choices like following.
ETV, ETV+ADV, LAM+ADV, TDF(not available in China, and expensive a lot),TDF+FTC (truvada), LdT+ADV

Which combo or mono is better? cost and efficacy both.

[stef2011]

are you sure about result, can you post name of test used for resistance because you cannot have wild type if lam and adv are not making hbvdna und, wild type gets und on anybody with time.
the mutants which don t make lam and adv work is rtq215s the one i got, they lower respose to these drugs, there are probably others too

does the test detects all mutants and what population 5% or 20%?

the best combo is etv+tdf because the 2 drugs protect each other from respective resistance mutants, monotherapy tdf, the only one available in china is etv but you risk resistance because you might have lamR, keep in mind that even in trials 2 had undetected lamR and developped etv resistance because the only way to know 100% is cccdna biopsy but these stupids didn t make this test even on the main etv trial

[Skyclimber]

The hospital is very reputed in China, it's website is as below:

http://www.rjh.com.cn/chpage/c1352/

I don't know test detect 5% or 20% of mutants.

[stef2011]

the hospital doesn t matter, they must write the method used and limits with the result

on me they used direct sequence of hbv on the pol region population >20%, of course i don t trust it because 20% is too high but better than nothing

in any case you'd better use tdf+etv, they don t consider resistance anymore because all tests are not reliable when a weak drug is used they assume you have resistance even if hbvdna und on these weak drugs