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YYMD treatment and cirrhosis
Sep 4, 2003

I, Sivsun, Male, age 43 (Indian) has been diagnosed as HBV positive Chronic Liver disease (Decompensated) HBV with cirrhosis and pedal edema in June 2001. I was given Lamivudine -100 mg and after one year in June 2002 HbeAg was tested and found Negative. But the doctor advised to continue Lamivudine -100 mg/one per day.

In May 2003,when I was tested for the viral load, it was 62,400 copies/ml and in July 2003, when Hepatitis B Virus Genotyping test was conducted and found YYMD Motif : M552 to Isoleucine (YIDD) to (YVDD) & FLLAQ Motif:L528 to Methionine (L528M).

Now my doctors given Prescription for Adifovir Dipivoxil (Hepsera), but is not available in India.and also it is too costly in Indian Rupees. Dear Doctor, my question is how effective is the medicine, even though Manufacturer claims its effect. How long it has to be taken and is the Lamivudine -100 mg/one per day to be continued along with this Medicine. Any liver dialysis is required on account of the toxin of this medicine during the treatment. Any other drug can you suggest (Genetic name Pls.) Do I need Pre core Mutant tests now. Pls. advice.

As you said in few replies in this forum that cirrhosis will be taken care by liver itself, once the virus has gone. But the Indian doctors pushes me for Liver Transplant as the only option. And they tell the reason that Cirrhosis progress will continue and cant be treated and HBV may get relapse. But even in my dream I cant think of (LT) that due to the cost and post maintenance cost and number of LT surgery failures in India. Pls. advice me.

Day by day I am get too worried about how to get out of this Disease? and How to survive and manage as the treatment is endless and costly.

I am sorry for writing too lengthy mail to you.

Albumin 2.2, Globulin 4.3, PT 29.7 , Control 12.1, INR 2.69

Treatment Given as on 02 Sept 2003. 1 Lamivudine -100 mg 0-1-0 2 Ensox plus contains 1-1-1 Pancretin 192mg Bile constituents -25 mg Activated dimenthicone -40mg 3 Udilive contains Urosodesoxycholic acid - 150mg 2-0-2 4 Aldactone contains 1-0-0 Spironolactone -50 mg 5 Vitmin B complex and Vitamin C 1-0-0

My wholehearted thanks for supporting us and waiting for your reply. With hope, sivsun.

Response from Dr. Dieterich

Adefovir works very well for HBV that is resistant to lamivudine. I usually keep the lamivudine on board for at least 6 months while taking the adefovir. There is nothing generic that will work. However if tenofovir is approved in India for HIV then that will work just as well as adefovir. Good luck! DTD



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