Multaq Class Action Lawsuit News Flash
Multaq Class Action Lawsuit: People with HDV may be infected either through coinfection, meaning that they contracted both HBV and HDV simultaneously, or through superinfection, meaning that they had chronic hepatitis B first and then acquired hepatitis D, usually through persisting with high-risk behaviors. Almost all HDV patients who acquire the virus at the same time (coinfection) are able to expel both viruses from their bodies, the opposite is true of those patients who are superinfected; up to 95 percent of superinfected HDV patients develop chronic HDV.
In the United States, relatively few adult patients with acute hepatitis B develop the chronic form of this illness, and generally patients are not treated with medications. When HBV patients drink fluids and get plenty of rest, their illness usually resolves on its own. If the acute hepatitis B develops into chronic HBV, however, treatment is often prescribed. The majority of patients are treated with daily oral antiviral medications. Others are treated with interferon or sometimes with a long-acting form known as pegylated interferon. Oral antivirals. Developed in 1989, lamivudine was the first drug in this class and was originally used to treat HIV/AIDS patients. Lamivudine (brand name Epivir-HBV) is a pill with very few side effects and is generally very tolerable. Lamivudine does have two major drawbacks, however. Nearly half of patients treated with lamivudine will relapse after they stop taking the drug. Even worse, in nearly one-third of patients taking lamivudine, a new strain of HBV evolves and is resistant to lamivudine after the first year. (Lamivudine-resistant strains of HBV are known scientifically as the so-called “YMDD mutations.”) The percentage of viral resistance increases with the duration of treatment. Viral resistance increases from 60 percent to 70 percent after five years of treatment.
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Another drug effective in treating chronic HBV is adefovir (brand name Hepsera), approved by the FDA in 2002. Unlike lamivudine, adefovir does not result in YMDD mutations, but most patients, unfortunately, experience a relapse of their HBV after they stop taking adefovir. Resistance rates for adefovir are somewhat different, depending on the hepatitis Be antigen (HBeAg) status. The estimated cumulative rates of resistance are 0 percent at one year, 3 percent at two years, 11 percent at three years, 18 percent at four years, and 29 percent at five years. Entecavir (brand name Baraclude) and telbivudine (brand nameTyzeka) and tenofovir (brand name Viread) are three antiviral medications recently approved for treating chronic hepatitis B in the United States. These newer drugs have been shown to develop resistance at much lower rates than is the case with lamivudine.
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The drawback to antiviral drugs is that, eventually, some users will develop viral resistance, albeit at different rates. One of the advantages to choosing a newer agent is the lower likelihood of developing a resistance. These newer drugs also have variable degrees of potency and onset of action. The clinician choosing the medication will keep this in mind when selecting the most appropriate therapy. In addition, there can be cross-resistance between certain antivirals, so selection should be performed by a professional well versed in treating this disease.
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