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.