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Jun 2, 2013

If someone has done post exposure prophylaxis after a needle prick using lamivudine/zidovudine..and later realized he has hepatitis b. 6 months after prophylaxis..and doctor prescribed emtricitabine/tenofovir.would the Hepatitis B virus develop resistance to emtricitabine/tenofovir .Thanks

Response from Dr. Young

Hello and thanks for posting.

In short, it's possible, but very unlikely. Lamivudine (but not zidovudine) has activity against both HIV and hepatitis B virus. Monotherapy for HBV with lamivudine can eventually select for drug resistance, but unlike HIV, resistance to monotherapy usually takes quite a while to develop. Lamivudine and emtricitabine (FTC) are similar from a resistance perspective, so resistance to one confers resistance to the other.

Moreover, since you did not receive tenofovir during HIV PEP, there's no risk that the HBV developed resistance to this drug. Dual therapy with tenofovir and FTC should retain activity, even in the face of FTC resistance.

Lastly, it would be relevant to know if you had HBV during the time that you were taking lamivudine/zidovudine PEP. If you did not, then there's clearly no risk of drug resistance.

I hope that helps, BY

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