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resistance to entecavir-urgent pl.
Nov 9, 2008

Madam, I have been diagnised with hep b two years back. At that time the viral load was 1.24 lakh.Based on the advice of hepatologist i had taken pegasys for 24 weeks and at the end of the treatment the viral load was 1.37 lakh. Six months after that the viral load went upto 82 lakhs after which i was put on baraclude. Three months after starting of baraclude the viral load was nil. I continued baraclude and when the test was repeated at the end of one year after initiation of baraclude thrapy, the viral load has again gone upto 92 lakh. The hepatologist is not really sure what to do. Is combination required or dose should be increased to 1 mg.from 0.5 mg. Please advise early.

Response from Dr. McGovern

I would recommend resistance testing to be certain you and your doctor know which resistance profile you may have to make the best decision about your next treatment.

If you have resistance, you may do better on combination therapy with tenofovir and emtricitabine for example. This would be an excellent combination for you assuming you are resistant to entecavir.

However, I suggest resistance testing since it is extremely uncommon for patients to develop resistance to entecavir if that is the first nucleoside analog you have taken.



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