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HepB case: failed hepsera, what next?
Nov 8, 2004

Dr Dieterich, I am a chronic HepB patient, tried all three medications, including combination of lamivudine and hepsera the past year, virus came down and slightly up again, now ALT ~45, DNA 4500 copies. My doc suggests to switch to Viread. Should I continue current treatment or switch to Viread? Sounds like there is no long term study done with this medicine. If I developed Hepsera resistance,is Viread going to work at all? Then what next? I heard about L-FMAU and thymosin, are they available, or better? I feel so desparate about the future right now, especially possibility of relapse after treatment, since I have been on medication for 3 years now. Doc, what should I do? Appreciate any help on this.

Response from Dr. Dieterich

We just presented a small paper at the liver meeting in Boston on this subject. Lucas is the first author. 8 patients just like your case were described. We switched them to combination tenofovir(Viread ) and FTC (Emtriva). They are all undetectable now. Actually both medications come together in one pill once per day called Truvada. That is the best treatment for Hepsera "suboptimal responders". Hepatitis B may really be a chronic disease. Relax, as long as we can get it undetectable and keep it there, you should be fine. Stay well! DTD

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