Management of Patients with Chronic Hepatitis B and Antiviral Resistance

You answered:

C Adding telbivudine (Tyzeka) 600 mg once daily would be the preferred management strategy.

This answer is incorrect. Telbivudine and lamivudine have resistance profiles that significantly overlap and thus telbivudine would not be recommended in a patient with known or suspected lamivudine resistance. In addition, telbivudine and lamivudine usually are not given together.

Choose another answer:

A It is unlikely the patient has developed resistance to lamivudine since HBV resistance to lamivudine rarely occurs in the first 2 to 3 years of lamivudine therapy.
B The patient would likely have a good response with a switch to tenofovir (Viread) 300 mg once daily.
D Entecavir (Baraclude) 0.5 mg once daily should be added to the lamivudine.

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