Hello doctors in the house, kindly help me understand between EMTRICITABINE tenefovir disoproxil fumarate and Tenefovir disoproxil fumarate LAMIVUDINE… which one amongst the two drugs is best suitable for HBV Patients?
Lamivudine (aka 3TC) is an early generation inhibitor of HBV replication which is no longer widely used due to the development of drug resistance in about 30% of individuals.
Emtricitibine (aka FTC) is a mid-generation inhibitor of HIV and HBV replication which is found in approved medications used to treat HIV infection but is not approved for the treatment of HBV infection.
Entecavir (aka ETV) is a later generation inhibitor of HBV replication which is approved for the treatment of HBV infection. Drug resistance to ETV is rare but more common place amongst people who have previously developed drug resistance to 3TC.
Tenofovir disoproxil fumarate (aka TDF) is a prodrug formulation of tenofovir which improves its stability and is a later generation inhibitor of HIV and HBV replication. TDF is approved for the treatment of both HIV and HBV infections. Drug resistance to this medication is very rare.
Tenofovir alafenamide (aka TAF) is a different prodrug of tenofovir which improves its residence in the liver. As such, a lower dose of TAF is requried for equivalent antiviral effect compared to TDF. TAF is recognized to be less likely to cause reduced kidney function and bone demineralization in patients than TDF (although this is an issue in only a minority of patients taking TDF).
ETV, TDF and TAF are considered to the the most suitable for control of HBV infection and associated liver disease.