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Continuation of Combo Treatment
Aug 8, 2008

Dear Dr. McGovern,

I am a 33 year old Asian American male with chronic HBV diagnosed two years ago. my HBV DNA levels have been undetectable since Jan 2008 when I began drug combination of Baraclude and Viread. Prior to, monotherapy of Baraclude, and combination of Baraclude and Hepsera was able to reduce DNA levels but unable to reduce below detectable range.

During my last visit, my doctor suggested that we may switch back to monotherapy with Viread. Amongst the reasons is long term financial consideration.

What is your opinion at this point?

Thank you very much!

Response from Dr. McGovern

If I understand you correctly, you did not have viral suppression on Baraclude monotherapy, but then did achieve viral suppression when Hepasera was added.

The financial considerations are certainly something to think about. Viread is felt to be more potent than Hepsera in suppressing HBV. I suspect that switching to Viread monotherapy would be successful. However, close follow-up is very important. I would follow HBV DNA levels every three months for the next six months at least to be certain that you maintain a non detectable viral load.

Best of luck!



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