A netizen consulting Xinjiang I, said he had taken two years after telbivudine resistance, viral load increased to six times of ten, ask wha
A netizen consulting Xinjiang I, said he had taken two years after telbivudine resistance, viral load increased to six times of ten, ask what should I do? I advised him to change with tenofovir treatment. I have many treatment with telbivudine after hepatitis B drug resistance in the clinical work, although the amount of virus in most patients have been effectively controlled, but after all there is resistance, after antiviral treatment on the road narrow, there will be more money.
Why do some doctors are keen on the first choice in the treatment of chronic hepatitis B? I think mainly from drug manufacturers propaganda: E antigen in serum of telbivudine conversion rate is very high, even close to the interferon E antigen seroconversion rate after HBeAg into small three will have more chance to stop drug. E antigen seroconversion and telbivudine is high? China's 2010 version of the guidelines for chronic hepatitis B related introduction of telbivudine pointed out: a global multi center 2 years of clinical trial results of telbivudine in the treatment of HBeAg positive chronic hepatitis B patients, antiviral effect and drug resistance rate were significantly superior to lamivudine, but HBeA serum conversion rate with lamivudine treatment is similar to that of 2 years is about 22.5%. In fact, the hepatitis B guideline and related authoritative magazines were no telbivudine with E liver antigen in serum high conversion rate of the description, we are exposed to in the so-called "strong viral suppression, high serum conversion" of the publicity, the only man-made myth.
The biggest problem for telbivudine treating chronic hepatitis B or drug resistance rate, telbivudine resistance rate after lamivudine resistance is the drug rate ranked second, more than nine months after the use of telbivudine resistance rate gradually increased, the annual resistance rate is as high as 5---10%. Imagine, then, that the high resistance rate may be as high as the E antigen seroconversion rate?
The advantage is the use of telbivudine in men and women of childbearing age in pregnancy, telbivudine is grade B medication, China in pregnant women with experience for the fetus is relatively safe. But with tenofovir in China market, this advantage telbivudine is gradually weakened, the European Institute of liver disease in February 2012 released a new version of the "clinical guidelines for the management of chronic HBV infection", the guidelines clearly pointed out: in all FDA B pregnancy drugs, tenofovir should be used as the first choice for tenofovir virus inhibition more, the incidence of drug resistance data security is very low and now there has been considerable.
In 2013 the British issued guidelines clearly pointed out: chronic hepatitis B is not recommended for use in the treatment of chronic hepatitis B. So from the perspective of drug resistance prevention, in order to achieve the purpose of long period of stability, suggest that patients with chronic hepatitis B as the preferred domestic entecavir or tenofovir treatment. Taking telbivudine, has not yet happened resistance should also be an early replacement of entecavir or tenofovir. Antiviral treatment of the road is a real "Long March", only not resistant to our ability to successfully reach the destination, for the prevention of drug resistance!!