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Posted by Susan on August 07, 1999 at 04:14:43
Recently, I've heard that there is a new drug called Zeffix lamivudine for chronic hep B. I've got a few questions in regards to this drug:-
1. Is it really useful for chronic Hepatitis B?
2. What are the criteria that one has to meet before he/she can try/use this drug?
3. I've heard that it has lesser side effects as compared to interferon.....but what are those side effects of this drug?
4. Can a person with other kind of ailments such as kidney disorder,diabetes and hypertension try on this drug?
5. What is the average cost of this drug per month or per dosage?
Posted by HFHSM.D.-D.M. on September 05, 1999 at 21:01:14

Dear Susan:
First I regret the delay in answering the MedHelp questions in the last month but the delay was due to factors outside my control.  I appreciate your question which I feel allows me to give useful information to a number of patients with hepatitis B.
Lamivudine is an pill (taken by mouth) that is called a nucleoside analogue that is very effective against the hepatitis B DNA polymerase which is a protein that the virus needs to replicate.  Lamivudine is a very potent supressor of hepatitis B DNA polymerase and it will no doubt have an increasing role in the treatment of active hepatitis B infections.  It has very few side effects.  In fact, in at least one trial, the lamivudine had fewer side effects than the placebo pills.  It is much better tolerated than interferon.  In addition, it can be used in people with diabetes, hypertension and kidney disease though the dose has to be adjusted for those with renal disease.
However, the problem with lamivudine is that when it is used as a single agent, it rarely results in eradication of the virus (about 10% of patients).  In addition, with time, individuals can develop mutated forms of the virus that are resistant to lamivudine.  As a result, at Henry Ford, we tend to use lamivudine for hepatitis B patients with advancing disease or other unusual circumstances.  We hope that in a year or two, we will have several different drugs similar to lamivudine that can be used in combination to more effectively eradicate the virus.  
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