From Health cover responded well to treatment with AZT in the late 1980s, but sickened as the drug lost effectiveness.
Locarnini fears a repeat of the HIV story with emerging Hepatitis B drugs. Worse, he says that resistance to lamivudine weakens the replacement drug entecavir, which is approved in Australia, while adefovir resistance weakens tenofovir, an even newer drug approved in Europe last month and expected to be approved here later this year.
What we are really battling at the moment is the education of hepatologists’’ says Locarnini. He says this message is seldom welcomed by liver specialists, who, he says, can get very pissed off’’ in response.
Still, he’s not on his own. Experts such as Mark Sulkowski, associate professor of medicine at the Johns Hopkins School of Medicine in Baltimore, Maryland, support Locarnini’s argument.
Once you have identified resistance in a virus like hep B that cannot be eradicated, your next treatment is affected by that (resistance),’’ says Sulkowski. Clinicians need to think about resistance before they reach for the prescription pad. We are not doing that right now. We’re reaching for the first drug on the shelf.’’