Resistance management in chronic hepatitis B complicated by renal failure.
Therapy of chronic hepatitis B has improved by the invention of the potent nucleos(t)ide analogues entecavir, telbivudine and tenofovir disoproxil. Due to increasing prevalence of lamivudine resistance the appropriate first line therapy may prevent emergence of any new resistance and avoid combination therapy. The present case describes a complex history of chronic hepatitis B in the setting of renal failure after two renal transplants illustrating why lamivudine should not be used as first line treatment option any more. Instead, entecavir offers high antiviral potency, low risk for resistance and possible individual dose titration by an oral solution.
Wiegand
J
J
Department of Medicine & Dermatology, Division of Gastroenterology and Rheumatology, University of Leipzig, Leibigstrasse 20, 04103 Leipzig, Germany. johannes.wiegand@medizin.uni-leipzig.de
Karlas
T
T
Schiefke
I
I
Krasselt
U
U
Bock
T
T
Mössner
J
J
Tillmann
H L
HL
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D000075202:Contraindications; D004351:Drug Resistance; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000601:surgery* / Q000821:virology*; D016030:Kidney Transplantation; D019259:Lamivudine; D008297:Male
D000998:Antiviral Agents; D019259:Lamivudine; C413685:entecavir; D006147:Guanine