LAMIVUDINE?

[oshoppey]

Hello,
Was diagnosed with Hep B sometime in 2001. Hbsag+, E ant. neg. Had a viral load check in september 2009 which came up to 22,000. Did another in December, 09 -was 46,000. Doctor said i was a candidate for treatment and recommended Lam. Being taken lam ever since, but recently feeling very uncomfortable in the liver region(sometimes affecting my sleep). This is Africa (Nigeria) options and info very limited. due for another viral load test in a month  what should i do.

[Sharp7]

Tenofovir is one of the best options available... so you don't have to worry about missing out on good drugs ;-).

Since your doctor is not doing the require home-work, it is now up to you to do it. Do go through http://www.viread.com/en/600.cfm and http://www.viread.com/common/Viread_FPI.pdf

However, Tenofovir comes with this warning:
Can include acute renal failure and Fanconi syndrome. Assess creatinine clearance (CrCl) before initiating treatment with VIREAD. Monitor CrCl and serum phosphorus in patients at risk.

[oshoppey]

Hi,
What do i do next?
Without taking any drugs, viral load was 22,000 in september 2009. 46,000 in december 2009. Doctor recommended lamivudine in January. Took lamivudine and by June 2010, viral load was undetected. have read in many forums that lam is not the best, approached my doctor with this concern and she sugessted tenofovir. Should i start tenofovir immediately, how should i start. Should i just abruptly stop lam and move on to tenofovir, should i use both and gradually stop lam after a few day/weeks. No other options here. Nigeria (Africa), so i cannot combo with other drugs. NEED YOUR ADVICE HOUSE.  

[stef2011]

take tenofovir immediately, if you have finiancial problems or cannot have it in nigeria you can look for tenvir generic from cipla

also combo with nitazoxanide if you find lam mutation resistance, both tenofovir and nitazoxanide are active against lam mutants

lam resistance muattion can lower response to other drugs this is why i suggested combo tnf+ntz
in theory ntz is active against all mutations since acts on immune system, not the virus, by now we have vitro studies on lam and adv mutations and ntz is active on these

if possible make also genome  mutation test

[kc00]

Lam is not good due to high rate of resistance so would suggest you change now before its late or do a combo. You will get better response here with time so goodluck

[cajim]

You may have LAM resistance.  Consider adding or changing antiviral, according to the 2007 guideline.