Hello everyone, this is my first post . Have been following every activity on the forum for a while.
HBV sufferer since birth from vertical transmission .
On Lam since 1998 till present, Adefovir added to Lam 2005 and replaced with Tenofovir in 2008 so at present on Lam / Tenofovir.
August 2010 doctor ( same doctor for 30 years) discontinued both( Lam and TDF) and in December 2010 had a near fatal Virological and Biochem. breakthrough and both Lam and TDF were restarted.
As of 2007 resistant mutants: L180M, M204V&I, A181V, N236T. Some of them unlike the wild type are proven to be cytotoxic (via apoptosis).
HBsAg: in Dec/2010 52.02, Jan/20111 31.59 and Oct/2011 >250.00 , Why increasing? Antivirals suppressing immune response? Units?(doctor wouldn't say)
Genotype unknown, doctor says probably D.
Fibroscan Oct/2011 - 8.1kPa
DNA at present undetectable
ALT / AST 24/22 U/L at present
Ultrasound and Biopsy show Diffusely fatty liver.
November 2011 for first time HBeAg-ve and Anti-HBeAg still -ve , is it because of natural progression? Antivirals? or precore and/or CP mutants?
Read a study that Tenofovir has a potential to develop resistance to N236T and A181T/V.
So my question is, given the history of long term use of Lamivudine and creation of "bad" mutants with possibility for phenotypic, mutant caused flareup , is it safe to discontinue Lam and continue TDF only as monotherapy?
Any and all responses will be sincerely appreciated , no comment will be slighted
Thank you all,
studyforhope, Stef2011, StephenCastlecrag?