Tenofovir

[az12345]

Brief Intro: have been on Truvada for more than 3 years now, switching from LAM (lam resistance, I took lam for 3 years). HBeAg +, AntiHBe - , 25 years old, genotype B.

Ultrasound, fibroscan (around 5.0 kPa) & blood test (AST, ALT, Creatinin,... HBV DNA undetectable) every 6 months comes back normal (been doing this for 5 years now).

I'm thinking about taking Tenofovir only because I will move to a place where Emtricitabine is not available. I know it is better to combo. But can you tell me how risky it is if I take tenofovir only (LAM resistance)? stef2011?

[MiddleAge67]

Hi.

In my opinion, you should not take entecavir if you are LAM reisistant.

LAM resistance is to ADD tenoforvir, not switch. You could ADD adefovir if tenoforvir is not available.

entecavir has a very good resistance profile for naive patient. But for LAM resistant patient, entecavir resistance is 6%(1 year) 15%(2 year) up to 51%(5 year)

that info is from:

Hepatitis B Virus Resistance to Nucleos(t)ide Analogues
REVIEWS IN BASIC AND CLINICAL GASTROENTEROLOGY
GASTROENTEROLOGY 2009;137:1593–1608

Dan

[az12345]

Yes, I think they do have access to Entecavir.

Regarding to my LAM resistance, would Entecavir be easy to develop resistance as well? If yes, how effective is Tenofovir in that case?

[stevenNYer]

"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?