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Suggest Treatment For Positive HBsAg
Question: Hi Sir, Since 3 years I am suffering with HBsAg positive/Reactive.. I am taking tablets daily Lamivir 1-0-1 and Adefovir 1-0-1.. but still it showing HBsAg is reactive.. Please advice me what will be the next step?
Brief Answer:
Seems Drug resistant HBV
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Combining agents that are not cross-resistant (e.g., lamivudine and adefovir as in your case) has the potential to reduce the risk or perhaps even to preempt entirely the emergence of drug resistance.
Since you have already been treated with Lamivudine(Lamivir) & Adefovir ,the other option available in the treatment of chronic hepatitis B is PEG IFN- 2b (one regime -100 g weekly for 32 weeks, then 50 g weekly for another 20 weeks for a total of 52 weeks).
The other alternative is Entecavir, an oral cyclopentyl guanosine analogue polymerase inhibitor which appears to be the most potent of the HBV antivirals and is just as well tolerated as lamivudine.Entecavir is also effective against lamivudine-resistant HBV infection.
Telbivudine, a cytosine analogue, appears to be similar in efficacy to entecavir; however, it is slightly less potent in suppressing HBV DNA.
You can consult your hepatologist or gastroenterologist regarding this
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Seems Drug resistant HBV
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Combining agents that are not cross-resistant (e.g., lamivudine and adefovir as in your case) has the potential to reduce the risk or perhaps even to preempt entirely the emergence of drug resistance.
Since you have already been treated with Lamivudine(Lamivir) & Adefovir ,the other option available in the treatment of chronic hepatitis B is PEG IFN- 2b (one regime -100 g weekly for 32 weeks, then 50 g weekly for another 20 weeks for a total of 52 weeks).
The other alternative is Entecavir, an oral cyclopentyl guanosine analogue polymerase inhibitor which appears to be the most potent of the HBV antivirals and is just as well tolerated as lamivudine.Entecavir is also effective against lamivudine-resistant HBV infection.
Telbivudine, a cytosine analogue, appears to be similar in efficacy to entecavir; however, it is slightly less potent in suppressing HBV DNA.
You can consult your hepatologist or gastroenterologist regarding this
Regards
Dr. T.K. Biswas M.D. XXXXXXX
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Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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