viread

[roro1851]

my doctor tell me that i can replace baraclode with viread , is that ok if any one knows please tell me

[stef2011]

it depens to your situation, there is a best drug universally you can personalize therapy according to your hbv/liver damage situation.of course the most advanced tests are needed to personalize

in anycase the best eradication rates are from
interferon+etv or tnf
probably even higher if interferon+etv or tenofovir+alinia (interferon 2 years and alinia 4 weeks pretreatment)

as to brands it doesn t matter the chemicals are the same whatever generic or brand

[whaam]

do u known which brand is the most effective first line hbv antiviral.

[stef2011]

http://www.replicor.com/debut_anglais2.htm
REP 9AC
http://www.girindusglos.com/resources/GLOS2009Day1/REPLICorPresentationGLOS2009ver2public.pdf

seroconvertion 55% hbsab on duck model in 28 days, results on human end of march

[April63]

Stefano,which replicor drug do you have in mind? Cyanovirin-N (CV-N)?

[stef2011]

of course for this combo to prevent resistance almost 100% you have to start both naive or start one after the other but without any resistance mutation

in case of mutation only interferon, alinia and in the future replicor drug are free from mutation and reson for this is pretty simple they don't target the virus that can mutate but the host

[stef2011]

All chemical drugs, taken long enough, develop resistance.  e.g. when antibiotics were first used in 1880s, how little a dosage would be needed to do the job.  Today, how big a dosage is needed to show any effect at all?

this is wrong for tenofovir+entecavir combo because resistance mutations from entecavir are suppresed by tenofovir and tenofovir resistance is suppressed by entecavir, so mutation cannot happen with this combo

in virology it is well known that resistance can only be prevented by combos, just look at hcv and hiv....what happened with hbv is very very strange, my point of view is that bigpharma wanted some clients for life because delay with combos and approval of tenofovir cannot be explained in another way and aslo alinia without trials from 2004 is impossible to understand (now they are starting it on flu!?), i am not a docotor but it is very very stupid to do monotx on viruses if you cannot eradicate it 100%

i could have started tx from 2001 but i didn't because it was quite clear that there were tx but just for worsening illness with resistance (only interferon was a cure on a small percentage), now that safe combo entecavir+tenofovir is available i started

[stef2011]

HR knew about tenofovir being the strongest antiviral for hbv well before 2000, in a post he said that he knows a person in california who waited for tenofovir to be on the market for hiv 2001 and then started tenofovir, he is probably still ok without sides otherwise HR wouldn't have mentioned

even my doctors know about tenofovir being free of resistance already
you have zero resistance at 3 years (first antiviral with no resistance at 3 years, all the others have resistance at 1 year, even entecavir has 0,2% resistance first year...)

tenofovir resistance doesn't happen even if hbv is not und,  there is no antiviral who can make this, even entecavir requires hbv und in 3-6 months otherwise resistance develops
lam,adfovir, telbivudine, embricitabine are all out of the question, they all lead to resistance

i am on entecavir now but i will make mono for 1 year maximum (only 0,2% probability of resistance so safe enough) but from october i will combo with tenofovir because data from combo 2007/2010 will be available on october, HR also said this combo will be standard tx from 2011-2012 because only this combo can prevent resistance 100%.this is the only way to be safe as close as possible to 100% with antivirals and waiting for resistance is never a good choice, i will also add combo with alinia if replicor drug will take more than 2 years to lower hsag and eventualy seroconvert.alinia is the only med that lowers hsag a lot and this will lead to seroconvertion when hbs titer gets very low

[cajim]

Right.

[aiqi]

Both Viread and Entcavir are first line medicine for HBV.

[cajim]

Don't know  if you agree:

1.  Not enough time is given to the resistance issue of Tenofovir.

2.  All chemical drugs, taken long enough, develop resistance.  e.g. when antibiotics were first used in 1880s, how little a dosage would be needed to do the job.  Today, how big a dosage is needed to show any effect at all?

[stef2011]

you have to be very clear on this: hiv use of tenofovir is not to be considered because hiv damages kidneys too, on hbv trials kidney toxicity is no issue since only 1% developped toxicity and lowering tenofovir dose resolve this and tenofovir is still very  active on hbv.unfortunately there is no research on optimal dose of tenofovir on hbv without sides (tenofovir is produced by gilead and they wanted to push use of hespera and probably hiden tenofovir from 2001...)

there is no tenofovir resistance reported in vivo (only one patient but in coinfection with hiv so not to be considered), only adefovir resistance can lower response to tenofovir.
so we don't know if sides can become an issue, at the moment at 3 years sides are only in less than 1% cases so if we have new antivirals in 5 years both entecavir and tenofovir are ok.

combo of tenofovir and entecavir will be the next step to prevent any resistance, doctors involved on this trial from 2007 suggest this combo on f3-f4 liver damage patients even if trial is not finished, so probably sides are not an issue even with this combo

[cajim]

From:  http://hivinsite.ucsf.edu/InSite?page=ar-01-07#S3.4.2X

in clinical trials, the presence of 3 or more thymidine analogue resistance mutations is associated with a decreased response to tenofovir, particularly if these mutations include M41L or L210W.(20) The T69S insertion mutations, associated with resistance to multiple nucleoside analogues, are associated with resistance to tenofovir as well. Tenofovir resistance conferred by the T69S mutation or by multiple thymidine analogue resistance mutations appears to be multiplied if the M184V mutation is replaced by wild-type.(21) The K65R mutation, which may be selected by prior nucleoside analogue therapy, is associated with a modest decrease in sensitivity to tenofovir.(22)

Cases of renal impairment associated with the use of tenofovir, including cases of acute renal failure and Fanconi syndrome, have been reported.

[stef2011]

tenofovir (viread) is much stronger than baraclude and has 0 resistance but have some mild sides in 1% cases of kidney toxicity and bone demineralization.seroconvertion on tenofovir is similar to interferon and in case of past use of lam with resistance or adefovir with no resistance is the best safe choice.

baraclude (entecavir) has 1.2% of resistance and on animal models causes cancer at doses 40 times higher than those in humans.seroconvertion is very low at 5% in 5 years and only on hbe pos.

at the moment i am on entecavir but i would prefer tenofovir which is much stronger and since replicor antiviral is on phase II (it has hbs seroconvertion in high percentage and in short time, animal model 55% in 28 days) it won't take long to have it on the market and leave both tenofovir and entecavir.replicor drug has no reistance and no sides.

also alinia is much stronger than tenofovir and entecavir with no reistance and no sides and should be a safe combo especially when we will have slow release high dose available

so my suggestion is keep baraclude if you are naive and hbvdna und or otherwise go for tenofovir to be safer on resistance

[cajim]

Viread (Tenofovir) is an antiviral drug like baraclude.  If baraclude works well with you, what is your doc's reason for changing?

[roro1851]

i was treated with baraclode for 2 years with 1 mg , if i want to take the 0.5 is there any risk to do that , now i had 0 copies ,