Interruption in antiviral treatment after moving country

hank you @ThomasTu for this community. I was diagnosed in 2017 when I went for a routine medical check-up as part of a new job I got in Ghana. I am 31 years. When I was diagnosed, I went through some anxiety and depression moments but my sister was very supportive and helped me to recover from the depression. I did not start any treatment but I had intense itching. The cost for treatment is too expensive and it is even hard to get a hepatologist. I was lucky to have got a scholarship to study in the UK and had a free medical cover so I went for further testing and my liver was normal. My viral load was 20,000,000. The hep b specialist put me on Interferon for 2 months but the viral load did not reduce so we switched to Tenofovir. After 2 months on Tenofovir, that is December 2019, my viral load reduced to 50,000s. I continued the treatment till February 2021 when I moved to Canada and my drugs got finished. I am now a Ph.D. student in Canada and have so much aspiration to contribute to the world. Most of the time, I just want someone to open up to or a platform to connect with but never got it. It’s been a very lonely journey of keeping this big secret-- Only my sister knows it. My problem is that in Canada, I need a prescription to buy Tenofovir. I have health insurance from my Scholarship but things are quite complicated because I had to run health issues through the Students Health before I can get a specialist. After getting off Tenofovir for almost 2 months due to a shortage of it, I have started feeling intense pains in my upper right quadrant. I am feeling very anxious because I don’t know where this pain is coming from and I just want to get back on medication to avoid serious liver damage. The student doctor I contacted to get me a prescription mentioned that he is not a hep b specialist so he can’t give me the prescription. My UK Doctor sent all my medical records and I forwarded them to him. Now my earliest appointment I have to see a gastroenterologist is June 28. Last Monday (April 12, I decided to go to the emergency unit of the hospital since the pains were unbearable, the doctor who saw me did some blood work because I told her about my Heb p situation, about 5 hours later she came and told me my liver is normal and they did Biliburin and other tests–she didn’t mention the rest and my liver is normal). Due to covid-19, it’s too difficult to get an appointment and I am new to Canada. I have booked an appointment with the student doctor tomorrow and I want to tell him to just get me the prescription so I can get at least 90 days to refill while I wait for a liver specialist appointment. Thomas and Joan and other experts, do you think this is a good decision? Will Tenofovir work well on me once again after getting off it for few months? I feel very stressed and tired. I am hoping that these pains aren’t so serious. I still remain hopeful and positive.

Dear @kk9,

Thanks for sharing your experiences. It sounds like a really tough situation you are in and I hope you can find the support you need there.

I am unsure about the health care system in Canada, but there are some helplines that might be able to give you more detailed information at the Canadian Liver Foundation that can help: https://www.liver.ca/patients-caregivers/liver-diseases/hepatitis-b/. It may be worth also asking if they have a list of GPs that do have some specialisation in Hepatitis B.

Regarding the restarting of Tenofovir, from the studies I have read, it will still work just as well.

I wish all the best to you and please keep us all up-to-date on your status.

Cheers,
Thomas

Dear @KK9,

I am a senior HBV scientist with expertise in HBV replication and drug discovery. Tenofovir will almost certainly work just fine when you gain access to it again. Drug resistance to it is exceptionally rare, and your case does not carry any indication that you were having a breakthrough while on therapy. Rather, you are in what is referred to as a “treatment interruption”. Furthermore, if Tenofovir does not work for some reason, the physicians would likely shift you to Entecavir. Entecavir works the same way as Tenofovir, but it is chemically different and there is no reported cross-resistance between Entecavir and Tenofovir that I’ve heard of.

I wish you the very best, and I am sorry you have been having such a difficult time obtaining your medications.

John Tavis, PhD

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Thank you for your assuring word @ThomasTu. I will update you on my status.

Thank you so much Dr. Tavis! I appreciate this community support.

Hey kk9,
I hope you are doing well. Where in Canada are you? I am asking some friends out there and they want to know your location, so they can make some calls and see what they can find out there for you.
Thanks, Bright.

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Hello Bright,
Thanks for this follow up. I am in Ontario. Kingston.

Ken

I was told to ask you to try contacting Kingston Community Health Centres. I think if you Google it you should find their contact information.
Hopefully, they can be of help or know someone that can help.
Keep me posted.
Thanks,Bright.

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I spoke to the doctor today and he is still adamant to give me a prescription until they find a Hep B specialist. I have told him about my symptoms and concerns and he mentioned that he is currently doing some consultations to find me a specialist. I am just worried about being off the TDF for a long time may hurt my liver. I will follow up by Thursday.

Cheers

@kk9, thanks for keeping us up to date. That’s good news that things are moving forward. Keep on top of it, and I hope you can get the medical support you need.

Thomas

Thank you @ThomasTu. I will keep the community updated.

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@kk9 I lived in Canada as well. I have been seeing specialist for my HBV. I would like to know more of your update.

A post was split to a new topic: Possible side-effects from long-term antiviral therapy

Thank you @saadepoju. I had an appointment with a specialist last week. I have done the tests so I am waiting on the results ( which normally takes 2 weeks ) to come out. I will update you on my progress. Nice to e-connect. Cheers!

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@kk9 I am glad you had an appointment with specialist. Thanks for the update.

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