Options for people with resistance to entecavir.

Question

Madam, I have been on entecavir for last five years since detection of chronic HBV. Prior to startign entecavir I was on pegasys which was not successful. Please let me know what are the options, if there is resistance to entecavir as i have been entacvir for long period and develop resistance. The DNA has been undetectable after entacavir is started.

Answer

Actually the most important fact you mentioned is that your HBV DNA level is undetectable. As long as you take your entecavir every day for treatment of your HBV infection, you will do well.

Resistance develops in patients with ongoing virus in their blood. You have already suppressed...That is fabulous news.

The other important issue is that your prior treatment was interferon and not lamivudine. Patients without prior lamivudine exposure do great on entecavir. The chance of resistance is about 1 percent in those patients while the chance of resistance is much higher if they already have lamivudine resistance. Importantly, prior exposure to PEG IFN does not cause HBV drug resistance.

So, you are golden....Just keep taking your entecavir every day and you will do great. Also be certain to have ongoing monitoring of your liver with ultrasound imaging.