No need to change the resistance to adefovir, entecavir in China?

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Adefovir dipivoxil curative effect, because the price is cheap, the resistance rate is low, is widely used in our hospital as the preferred

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Adefovir dipivoxil curative effect, because the price is cheap, the resistance rate is low, is widely used in our hospital as the preferred antiviral drugs. In recent years the domestic entecavir price decreased gradually, some have been taking adefovir dipivoxil for many years and has remained below the detection limit of HBVDNA patients to switch to domestic entecavir, this kind of practice is desirable?

Adefovir dipivoxil for HbeAg negative chronic hepatitis B patients, the cumulative drug resistance gene treatment for 5 years when the mutation rate is 29%, virologic resistance rate was 20%, the incidence rate of clinical drug resistance is 11%. (from the 2010 edition of "Chinese chronic hepatitis B prevention guide"). Entecavir related research data showed that entecavir treatment resistant, 6 years when the rate is only 1.2%.

An American study shows that adefovir or tenofovir treatment for 2--9 years, 15% patients had renal dysfunction, with other antiviral drugs can be partially reversed. The study recommends careful monitoring of serum creatinine, creatinine, and urine levels in patients who have been treated for a long time. The study was published online April 16, 2012 in the Journal of digestive pharmacology and therapeutics. The study included 51 patients and found that patients with renal tubular dysfunction were significantly older than those without the disease, with significantly lower baseline glomerular filtration rate. After 6 patients switched to entecavir, serum phosphorus, creatinine, uric acid and urine protein were improved. Entecavir listed since 2008, millions of users, with no reports of adverse reactions are especially serious, it is one of the safest antiviral drugs.

So, if there was no prior experience resistant lamivudine or telbivudine, affordable, even taking adefovir dipivoxil has the virus clearance for years, or should change with the world recognized the first-line anti HBV drugs - entecavir.

 

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