OK, thank you…. I will ask my doctor if he can switch my medication from Entecavir to Tenofovir…
Hi @Charles_Nsimbi,
I agree with @et5656 and @Caraline. This is something that keeps coming up; it is not recommended for patients to stop treatment only because their HBV DNA becomes undetectable. I will not stop the treatment, and no need to change the medication. Stopping treatment will cause the virus to rebound and lead to severe liver damage and a bad prognosis. I will raise this with the provider and ask them to refer to all the available treatment guidelines or recommendations. You can Google AASLD, WHO, etc. HBV updated guidelines. Best, Bansah1.
4 Likes
I personally would switch or stay on Entecavir. Tenofovir gave me bone loss and kidney trouble. Tenofovir can do this is a small percent of users.
I was switch to Entecavir and haven’t had any issues
I’m not a medical expert. Lived experience 40+ years 
1 Like
Hi @Charles_Nsimbi,
I’d agree with the others that antiviral therapy should be maintained as long as you are HBsAg-positive: the risk of the virus coming back (and there to be liver inflammation) is relatively high unless you are HBsAg-negative.
4 Likes
@Caraline The reason I recommended tenofovir is because @Kr2025 mentioned wanting to take PrEP. I don’t know a ton about HIV, but here’s what I know based on the reading I have done. There are 4 drugs approved for HIV prevention in the US. I’m not sure if other countries have more/less, but those break down as follows:
- Truvada (emtricitabine/tenofovir disoproxil fumarate): once-daily combined pill that also suppresses HBV. This one is available as a generic, and is by far the least expensive option
- Descovy (emtricitabine/tenofovir alafenamide): once-daily combined pill that also suppresses HBV. Similar to Truvada, but it uses the “new and improved” formulation of tenofovir (same drug that’s used in Vemlidy), and has a lower risk of kidney and bone toxicity compared to Truvada.
- Apretude (cabotegravir): This is given as an injection every other month (6x/year). It does not treat hepatitis B. This is a newer drug, and can be quite expensive.
- Yeztugo (lenacapavir): Another long-acting injectable form of PrEP, but this one is only needed every 6 months. It also does not treat hepatitis B. I believe this is the newest drug on this list, and is very expensive.
If you choose to take any of the long-acting injectable medications for PrEP, it would make sense to stay on entecavir for hepatitis B. If you choose one of the oral options, I’m not really sure that there would be any benefit to taking entecavir, as the HIV PrEP pills should fully suppress hep B as well.
2 Likes
I also read somewhere that tenofovir + lamivudine can be used as PrEP, with similar efficacy rates to the tenofovir + emtrictabine combination. I’m not sure if TDF or TAF is available as a single combined tablet with lamivudine though, so you might need to have 2 separate prescriptions. TDF + lamivudine would also be an affordable generic option.
1 Like
Thank you, one more question if a person achieved functional cure, will that person can still transmit hep b to other via unprotected sex?
No, if you’ve achieved functional cure (undetectable HBsAg and undetectable HBV DNA), you can no longer transmit the virus to a sexual partner. However, you could still contract and spread other sexually transmitted infections, so you should still use barrier methods, especially if you’re not sure of the other person’s status.
2 Likes
Well noted, thank you..
1 Like