无药可治啦？？？好郁闷！

83958645

MiddleAgeMan

To: 98mmx:

2007年11月上拉米，2009年5月变异。2009年5-7月拉米贺威力联用。后撤掉拉米，单用贺维力，2011年10月刚查出阿德变异，我该怎么办？（当时单用贺维力是想要小孩）请高手赐教，很郁闷！！

10月31日再次检测，依旧为10的3次方。所以判断变异
this is the drug resistance test.

Hi. You case is really complex.

LMV resistance: add TDF (add ADV if TDF not
available);
● ADV resistance: it is recommended to switch to TDFif available AND add a second drug without crossresistance.
If an rtN236T substitution is present, add
LMV, ETV, or LdT or switch to TDF plus emtricitabine.
If an rtA181V/T substitution is present, it is
recommended to add-on ETV or to switch to TDF
plus ETV or TDF plus emtricitabine (as a single
tablet: Truvada);

From:

Hepatitis B Virus Resistance to Nucleos(t)ide Analogues
REVIEWS IN BASIC AND CLINICAL GASTROENTEROLOGY
GASTROENTEROLOGY 2009;137:1593–1608

You should do the following:

1. Double check 拉米变异 ]阿德变异. Just to make sure.
2. You should read the paper (Hepatitis B Virus Resistance to Nucleos(t)ide Analogues).
3. Find a really good doctor to present you whole case.  (找老王) 老王 is not a good doctor, in my opinion. 老王 is alway boasting to put his patient on 拉米, which is against the update treatment guide.

you CAN NOT USE 恩替卡韦 if you have LAM resistance.

I am a HBVer in US. I am not a doctor. My advices are for you reference only.

Dan

MiddleAgeMan

Sorry. a type. repost:

To: 98mmx:

2007年11月上拉米，2009年5月变异。2009年5-7月拉米贺威力联用。后撤掉拉米，单用贺维力，2011年10月刚查出阿德变异，我该怎么办？（当时单用贺维力是想要小孩）请高手赐教，很郁闷！！

10月31日再次检测，依旧为10的3次方。所以判断变异
this is NOT the drug resistance test.

Hi. You case is really complex.

LMV resistance: add TDF (add ADV if TDF not
available);
● ADV resistance: it is recommended to switch to TDFif available AND add a second drug without crossresistance.
If an rtN236T substitution is present, add
LMV, ETV, or LdT or switch to TDF plus emtricitabine.
If an rtA181V/T substitution is present, it is
recommended to add-on ETV or to switch to TDF
plus ETV or TDF plus emtricitabine (as a single
tablet: Truvada);

From:

Hepatitis B Virus Resistance to Nucleos(t)ide Analogues
REVIEWS IN BASIC AND CLINICAL GASTROENTEROLOGY
GASTROENTEROLOGY 2009;137:1593–1608

You should do the following:

1. Double check 拉米变异 ]阿德变异. Just to make sure.
2. You should read the paper (Hepatitis B Virus Resistance to Nucleos(t)ide Analogues).
3. Find a really good doctor to present you whole case.  (找老王) 老王 is not a good doctor, in my opinion. 老王 is alway boasting to put his patient on 拉米, which is against the update treatment guide.

you CAN NOT USE 恩替卡韦 if you have LAM resistance.

I am a HBVer in US. I am not a doctor. My advices are for you reference only.

Dan

shantihbv

目前国内在替诺福韦上市前，拉米+阿德联合用药是变异最小的最好方案！