Sub-optimal response with Adefovir.
May 29, 2005
I have been on Adefovir (10mg) for the past 6 monts and I just read an article on this. I wanted to know if I fall in to this category beacuse of suboptimal response. Can you please comment on the article at the link below?
Here are my lab results.
I have chronic HepB. For the last 6 months I have on Adefovir (10 mg). Here are my latest lab results.
5/4/2005 HBV DNA lOAD 6.2 (LOG) or 1584893 AST = 29 (0 TO 35) ALT = 37 (0 TO 55) Total Protein = 7.1 Albumin = 4.4 WBC = 3.9 RBC = 4.7 Hemoglobin = 15 Platelets = 135000 AFP = 3.0 HBeAntigen = Positive HBeAntibody = Negative
2/2/2005 HBV DNA lOAD 6.5 (LOG) or 3162277 copies (?) AST = 35 (0 TO 35) ALT = 44 (0 TO 55) Albumin = 4.4 HBeAntigen = Positive HBeAntibody = Negative
AFP = 5.2 WBC = 4.0 RBC = 4.91 Hemoglobin = 15.9
HBV DNA lOAD 8.1 (LOG) or 125892541 copies (?) AST = 37 (0 TO 35) ALT = 52 (0 TO 55) Albumin = 4.4 HBeAntigen = Positive HBeAntibody = Negative Fibrosis Stage 2 Inflammation Grade 1
9/28/2004 ALT = 52 AST = 37 Ultrasound = Normal I had acute Hepatitis in June 2002 but did not start the treatment until 10/20/2004.
Thanks for your very valuable help.
Response from Dr. McGovern
It would be reasonable to discuss switching to entecavir (Baraclude) with your physician. Entecavir is more potent in terms of reducing viral load. It has similar efficacy in terms of seroconversion as lamivudine. It has not been compared head-to=head with adefovir. As with other medications, entecavir is more effective in patients with high ALT and AST levels than in patients with low ALT/AST levels (like you). It is still reasonable to switch since entecavir is a potent anti-viral.
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