Ask Your Questions About-HCV! of our Hepatitis Experts:
Continue treating Hep B with lamivudine in presence of lamivudine and resistant HIV virus?
What are the chances that lamivudine is still effective against Hepatitis B if testing shows lamivudine resistance to HIV. Would you advise stopping the lamivudine or would you advise continuing to treat the Hep B virus?
The development of resistance to HBV is independent of resistance to HIV. Thus, unless the HBV has shown signs of escaping from control with lamvudine, I would continue it for HBV. However, your physician may wish to alter your HIV regimen. RC
answer from Jules Levin--
But if a person coinfected with HBV & HIV is taking a 3TC regimen for HIV, 3TC resistance to HBV can develop. For patients naive to HBV & HIV treatment it may be worth considering the pros & cons of using 3TC in a HIV regimen, as I think this is a controversial question.
You may want to consider saving 3TC for future use in a multiple drug regimen treating HBV, as a number of new drugs for HBV are in early development stages. However, use of 3TC currently in an HIV regimen could be useful for treating HBV & holding it in check and for HIV, and any HBV resistant virus that develops may be treatable later on by new drugs in development. Some of the new drugs in development may be successful in treating 3TC resistant virus.
For a person with HBV/HIV and currently taking 3TC they should talk to a doctor knowledgeable about HBV and HIV, and about these considerations and the advisability of continuing 3TC use or not.
Study results reported at the EASL Liver Conference show adefovir used for HBV was successful against 3TC resistance. Here is the link to the study: HIV/HBV Co-Infection Reports at 36th EASL (Section A) --JL
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