U.S. Doctors Still Clinging to Hepsera Monotherapy

Stefano and others, thanks for your help.  As I posted before, 2 of my relatives are currently undergoing Hepsera monotherapy.  I went to a new doctor for a second opinion and the Hepsera-prescribing current doctor for an explanation of treatment choice.  

The first doctor agreed that Baraclude and Viread are to be dispensed per current AASLD guidelines but, once you've started with Hepsera, there is no need to change.  He felt that the resisitance rate for Hepsera (vs. Viread and Baraclude) is overstated; many patients develop no resistance at all, and the resistance rate, while higher than those for Viread/Baraclude, is not that much higher.  Plus, if you do develop resistance, that's when you should start taking Viread (as mono or combo, he didn't say).  And Viread is very effective in stopping Hepsera resistance.  Recommendation:  continue on Hepsera; no Viread until resistance is definitely found.

Another doctor parrotted the same about Hepsera's resistance effect:  Viread and Baraclude both create resistance, and the rate isn't really significantly lower than Hepsera's.  Plus, if patients develop serious side effects (like lactic acidosis for Baraclude), there is really no choice but to give Hepsera (didn't say why Viread wasn't given instead).

What do you think?  Everything you've said and my reading of the latest research cited by the AASLD and European/Asian organizations, indicate that Viread and Baraclude are much more effective than Hepsera.  And resistance is a serious issue by complicating future treatment.  But it seems that some doctors are still clinging to Hepsera and defending its prescription.  Is it time to switch to doctors who will change treatment to Viread or Baraclude?   Thanks.

[stef2011]

sorry i cannot read all post now but i have to anser to such a moron, only entecavir and tenofovir can be used safely as hbv monotherapy, that is all, plus why use a weak drug since we have more potent

you can judge the doctor yourself and wonder if he has any pay back from drug makers or distributors about prescribing a dead market drug, i don t say he is stupid because it cannot be

[stef2011]

The first doctor agreed that Baraclude and Viread are to be dispensed per current AASLD guidelines but, once you've started with Hepsera, there is no need to change

wrong, hespera is weak so it might not clear hbsag in 10-15 years and have resistant mutations that make tenofovir if not useless less effective.one pill of hespara is more toxic than a bottle of tenofovir but more than 100% fold weaker, ask doctor why to damage kidneys and bear toxicity?

He felt that the resisitance rate for Hepsera (vs. Viread and Baraclude) is overstated
just read the trials....and what do you do after resistance develops?resistance is correlated with more liver cancer even after you reach hbvdna und and why to risk?

And Viread is very effective in stopping Hepsera resistance.
no it is not because hespera and viread are almost the same chemical, viread is just higher dosage because they changed an atom which makes compound less toxic
since viread is not enough you should combo with baraclude in case of resistance

Another doctor parrotted the same about Hepsera's resistance effect:  Viread and Baraclude both create resistance
where the hell did he see viread resistance?it is not yet found on any hbv patient until now, i think he never read the trials.....

patients develop serious side effects (like lactic acidosis for Baraclude), there is really no choice but to give Hepsera (didn't say why Viread wasn't given instead).
latic acidosis has been found only in severe decompensated cirrhosis and so rare on hbv patients.hespera is more toxic than viread so it shouldn t be given

i am very sorry but these doctor seams to be paid by drug maker or extremely ignorant.easy question for them what would you do to your son in this situation and what would you do if i sue you for millions when i develop resistance since guilines do not allow sue of hespera?

Is it time to switch to doctors who will change treatment to Viread or Baraclude?  
no it is time to sue ignorant doctors, in my country, italy, you can sue doctors if the drug choice is wrong or not per guidelines.we are full of these trials so doctors are very afraid in my country and don t talk so easily as you are saying, plus it is illegal to use lamivudine, hespera, telbivudine here and also when they check blood they cannot use old cheap hbvdna assays in public healthcare system but they must use the newest

i bet you are writing from US and the more i hear from there the more i am disgust since the most works with the money not the patient intrest above money

[yheoj]

hi!
i like reading your post.
i just like to know if you have success story of your patient using zeffix and hepsera before?
i would like also to know which of these group of medicine comes first in the medical market...is it zeffix and hepsera or baraclude and viread?
i'll greatly appreaciate if you could answer me.
thanks!
God bless!

[stef2011]

zefix and hespera are not firstline drugs for hbv from many years end of story, their mutants have made people treated with such drugs much worse and some without any working drug and escape mutants made by those drugs have made hbv a public danger even for vaccinated people and mutants infection have been reported in poor countries who cannot afford the new and more expensive hbv drugs

in my country it is not possible to prescribe those drugs anymore and if so a doctor can be sued