Treat­ments col­lide

The Weekend Australian - Travel - - Resources -

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.’’

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