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恩替卡韦初始治疗低耐药,预防耐药和不良反应,要重视随访 Entecavir initial treatment with low drug resistance, prevention of drug resistance and adverse reactions, attention to follow-up

Original title: Entecavir initial treatment with low drug resistance, prevention of drug resistance and adverse reactions, attention should be paid to follow-up

After the initial treatment plan for chronic hepatitis B is determined, follow-up will become a regular issue for hepatitis B in the future. Follow-up is a very important detail, just like the mobile phone is charging, the car is refueling, and the kettle is boiling water, it is best to have someone closely watch.

Entecavir initial treatment with low drug resistance, prevention of drug resistance and adverse reactions, attention should be paid to follow-up

For example, during the long-term use of entecavir (ETV), follow-up can understand the effect of antiviral treatment, and assist clinicians to determine whether to adjust the drug dose or increase the drug at different resistance sites. Of course, as a reminder, the resistance rate of entecavir is relatively low. This is one of the reasons for the current first-line treatment of hepatitis B. It is important to follow up to help detect and prevent resistance.

These nucleosides (NAs) are also regularly monitored in clinical trials from 24 weeks to half a year after initial administration. Therefore, special attention should be paid to chronic hepatitis B. Periodically review the two pairs and a half of hepatitis B, liver function, and serum HBV-DNA within the first 24 weeks to six months of using nucleoside drugs. This period of time can reflect whether antiviral drugs are working, such as whether liver function gradually returns to normal, whether serum HBV-DNA is negative, and so on.

Only when the above indicators return to normal and overcast, can the initial treatment regimen be correct and should be continued. If, for example, Lamivudine (LAM), which has a relatively high incidence of drug resistance in the past, some people still have high transaminase after use, and serum HBV-DNA is still positive but not negative, we need to consider adding another Cross-drug resistance continues treatment, such as increasing adefovir dipivoxil (ADV).

Therefore, the drug resistance in many chronic hepatitis B is mainly caused by the lack of regular follow-up indicators and liver doctors. If drug resistance can be detected in time and drugs without cross-resistance sites can be added under the guidance of clinicians, it can be controlled in time. Resistant. Drug resistance can be prevented, reasonably controlled, and the antiviral drugs prescribed by clinicians cannot be interrupted at will as soon as the indicator rebounds.

On the other hand, follow-up can also promptly discover adverse reactions of the drug to the human body. Each nucleoside drug (NAs) has other indicators that need to be closely monitored, such as renal function, CK levels, and so on. New hepatitis B drugs also have their indications and adverse reactions, but the overall incidence of adverse reactions is relatively low, that is, they have passed the phase III clinical trial of the new drug, and the first phase of the safety assessment of the human body is effective.

We cannot eliminate all drugs without adverse reactions, including tenofovir alaviramide fumarate (TAF) before use, but also under the guidance of the clinician to understand its toxicity to liver and kidney, and periodic review requirements, Monitor closely. Xiaofan Health reminded that chronic hepatitis B needs to develop a good mentality before it can actively cooperate with clinicians' treatment and follow-up indicators.

Although no cure for HBV has been available so far, controlling the progress of chronic HBV is completely done. There are two directions for anti-HBV drugs that are recognized in the guidelines and mainstream medical opinion, nucleosides (NAs) and interferon. (IFN), which can be used for indications, can delay or prevent the progress of chronic hepatitis B, thereby reducing the incidence of cirrhosis and liver cancer. Back to Sohu, see more

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