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HBV Antivirals, Viral Breakthrough, and Drug Resistance

Virological breakthrough is common among people taking nucleoside/nucleotide analogs for HBV, but nearly 40% are unrelated to drug resistance.

As described in the June 2011 issue of Hepatology by Chanunta Hongthanakornand colleagues from the University of Michigan Health System, medication adherence is likely to be lower in real-world clinical practice than in clinical trials. Differentiating between virological breakthroughs caused by drug resistance and those due to poor adherence can help clinicians provide better care and treatment for people with hepatitis.alt

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Entecavir Effective for Hepatitis B Patients with Liver Cancer

Initial treatment with entecavir (Baraclude) monotherapy worked well in chronic hepatitis B patients with hepatocellular carcinoma, lowering viral load and improving liver health.

Over years or decades chronic hepatitis B virus (HBV) infection can lead to serious liver disease including cirrhosis and hepatocellular carcinoma (HCC). Treatment with antiviral drugs can lower HBV viral load, potentially clear the virus, and reduce the risk of liver disease progression, but its effectiveness in people who already have advanced disease has been less extensively studied.


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Tenofovir Improves Outcomes of HBV Acute-on-Chronic Liver Failure

Treatment with tenofovir (Viread) lowers HBV viral load, reduces liver injury, and decreases the risk of death in patients with acute-on-chronic liver failure due to hepatitis B reactivation.


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Prolonged Entecavir for Slow Responders

Treatment-naive hepatitis B patients who stay on entecavir (Baraclude) monotherapy despite suboptimal response at 48 weeks are likely to go on to achieve undetectable viral load. alt

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Switch to Lamivudine Not as Effective as Staying on Entecavir

Hepatitis B patients who switch to cheaper lamivudine (Epivir-HBV) after achieving undetectable HBV viral load and normal ALT on entecavir (Baraclude) are more likely to experience viral rebound. alt

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