What Epivir-hbv?

Epivir-hbv is a type of antiretroviral drugs called nucleoside analogue (NRTI). Side effects The most common of Epivir-hbv may include nausea, headache, diarrhea, vomiting and weakness. However, it is noted that Epivir-hbv usually causes fewer side effects compared to many other antiretroviral drugs. This medication is usually taken at 300 mg once daily or 150 mg twice daily with or without food.

What Epivir-hbv?

Lamivudine, sold under the brand name Epivir-hbv (Epivir in the U.S.) is a type of antiretroviral medication (anti-HIV) or known as nucleoside analogue NRTI (nucleoside reverse transcriptase inhibitors). Epivir-hbv is used in combination with other antiretroviral drugs to treat (not cure) HIV / AIDS.

Epivir-hbv How does it work?

Before explaining the mode of action of Epivir-hbv, one must first provide a little information about HIV. When HIV infects a cell, it takes control of it. HIV then forces the cell to make many more copies of the virus. To make these copies, the cell uses proteins called enzymes. When the activity of these enzymes is reduced or blocked, production of HIV slows or stops.

Epivir-hbv belongs to a class of medications called nucleoside analogues. Epivir-hbv inhibits an enzyme called reverse transcriptase (RT) with cells infected with HIV use to make new viruses. Since Epivir-hbv inhibits or reduces the activity of this enzyme, the drug induces infected cells to produce fewer viruses.

How people living with HIV / AIDS are they using Epivir-hbv?

Epivir-hbv is used in combination with several other antiretroviral drugs, including drugs from other classes, such as protease inhibitors and / or non-nucleoside reverse transcriptase inhibitors (NNRTIs). The associations of this kind are called HAART highly active antiretroviral therapy. For more information on HAART, see CATIE publication entitled A Practical Guide to HAART for people living with HIV / AIDS at www.catie.ca / PG_HAART_f.nsf.

For many people living with HIV / AIDS (PLWHA), the use of HAART has led to an increase in their CD4 cell count and reduced the amount of HIV in their blood (viral load). These benefits help to reduce the risk of contracting a potentially fatal infection. Or Epivir-hbv or any other antiretroviral drug that cures HIV / AIDS. It is therefore important to do the following:

* Consult your doctor regularly to monitor their health;
* Continue to practice safer sex and take other precautions to avoid passing HIV to others.

Epivir-hbv is easy to use and low toxicity, so it is one of the most frequent component of HAART. Epivir-hbv is also a component of several "fixed-dose combinations" as Combivir, Trizivir and Kivexa. These contain both Epivir-hbv and other antiretrovirals in one tablet.

Lamivudine and hepatitis B

A formulation of 100 mg of lamivudine was also approved for the treatment of chronic infection with hepatitis B. This formulation is the brand name Heptovir year Epivir HBV Canada and the United States. None of them is interchangeable with Epivir-hbv. People living with HIV and hepatitis B (HBV) should use Epivir-hbv as prescribed for the treatment of HIV. (See also section "Warnings - Hepatitis B".)

Warnings

1. Lactic acidosis and hepatic steatosis

Two related conditions occurred in some individuals receiving nucleoside analogues, it is the lactic acidosis (buildup of lactic acid in the blood) and hepatic steatosis (accumulation of fat in the liver). These conditions can be very serious, even fatal. They occur mostly among women, the overweight or people who use nukes long. The symptoms of these disorders include:

* Unexpected tiredness or weakness;
* Nausea and / or vomiting;
* Persistent abdominal pain;
* Painful inflammation of the pancreas (pancreatitis).

If you experience these symptoms without apparent cause, call your nurse or doctor.

2. Hepatitis B

If a person with hepatitis B takes Epivir-hbv, hepatitis can be activated if the drug is discontinued. People with hepatitis B who Epivir-hbv should be followed closely if they stop taking the medication.

Side Effects

1. General

Overall, Epivir-hbv is better tolerated than many other antiretroviral agents but can cause some side effects. Common side effects have been reported by some users of Epivir-hbv include headache, malaise, fatigue and diarrhea. Other reported effects include nausea, vomiting, abdominal pain and cough. Epivir-hbv has rarely exacerbate the side effects caused by other antiretroviral drugs. Many people find that side effects caused by antiretroviral drugs diminish or disappear after a few weeks of treatment.

Among the side effects less frequent but more serious, there are peripheral neuropathy (numbness, tingling or burning in hands or feet), neutropenia (drop in white blood cells called neutrophils) and the anemia (fall in hemoglobin or red blood cell count).

2. Lipodystrophy syndrome

The term lipodystrophy syndrome, HIV refers to a range of symptoms that may occur over time in people with HAART. Here are some features of the syndrome:

* Loss of fat under the skin (subcutaneous fat) of the face, arms and legs;
* Bulging veins in the arms and / or legs due to the loss of subcutaneous fat;
* Fat deposits behind the neck ( "buffalo hump") or at the base of the neck ( "horse collar");
* Increase in waist or belly;
* Small deposits of fat on the abdomen;
* Increased breast size (females).

In addition to these physical changes, lipodystrophy may be associated with metabolic changes that are revealed in the results of a blood test. Among these include:

* Increased levels of triglycerides (lipids);
* Increased levels of LDL ( "bad");
* Increased blood sugar (glucose);
* Increased levels of the hormone insulin;
* Reduced sensitivity to insulin (insulin resistance);
* Lower HDL cholesterol ( "good").

The exact cause of lipodystrophy is unknown and the syndrome is difficult to explain because its manifestations vary widely from person to person. For example, some people lose fat, others are taking and others experiencing losses and gains in fat. What emerges more clearly is that the harmful changes that occur over time in rates of glucose, cholesterol and triglycerides increase the risk of diabetes and cardiovascular disease. However, until now the many benefits of HAART outweigh the increased risk of cardiovascular disease or other side effects.

Maintaining a healthy weight, eating habits, stopping smoking and regular exercise are all important to reduce the risk of diabetes, heart disease and complications. Follow-up visits and regular blood tests are also crucial for proper monitoring. If necessary, your doctor will be able to prescribe a treatment to lower lipid levels.

Researchers continue to study the lipodystrophy syndrome to assist PLWHA to avoid or mitigate this problem. To learn more about the management of various aspects of the lipodystrophy syndrome, see A Practical Guide to side effects of anti-HIV drugs in the CATIE website at www.catie.ca / sideeffects_f.nsf.

Limited data suggest that Epivir-hbv is likely to cause or contribute specifically to lipodystrophy.

Drug Interactions

No specific drug interaction was associated with Epivir-hbv. However, you should always consult your doctor and pharmacist about taking any other medicines, whether delivered on prescription or nonprescription, including herbs, supplements and recreational drugs.

Resistance and cross resistance

Gradually, as new copies of HIV are produced in the body, the virus changes its structure. We call these changes mutations, the mutations may allow HIV to resist the effects of antiretroviral drugs, which means they cease to act for you. The idea of combining Epivir-hbv at least two other antiretroviral drugs can delay the development of resistance.

To reduce the risk of drug resistance, you must take your HIV medications daily dosages according to the letter. If you miss or delay taken, or if you fail to comply with the requirements of your doctor, the rate of Epivir-hbv may fall too low. If this happens, resistant virus may emerge. If you have trouble taking your medicines regularly and follow the instructions, talk to your doctor or nurse. They can help you.

When HIV becomes resistant to one drug in a class, it can sometimes become resistant to all other drugs in this class. This cross-resistance. Please discuss your treatment options current and future with your doctor. To help you determine which therapies you can use in the future, your doctor may test a small sample of your blood under stress tests. If HIV eventually develop resistance to Epivir-hbv, your doctor may use resistance testing to help you build another combination of drugs.

Just a single mutation (known as "M184V") to allow HIV to gain a strong resistance to Epivir-hbv. However, in general, it is appropriate to continue treatment with Epivir-hbv even if this occurs because the virus mutant resistant to Epivir-hbv is:

* Less "fit" (it replicates less efficiently);
* Still controlled by the Epivir-hbv to some degree;
* More vulnerable to some other antiretrovirals, including AZT.

Dosage and formulations

Epivir-hbv is available as tablets of 150 mg and 300 mg as oral solution (10 mg / mL). The standard dose for adults is 150 mg twice daily or 300 mg once daily. Epivir-hbv can be taken with or without food.

The fixed-dose combinations Combivir and Trizivir are individual tablets which contain both Epivir-hbv and other antiretrovirals, which reduces the number of pills patients must take. Combivir contains 150 mg Epivir-hbv and 300 mg of AZT in a single tablet that is taken twice a day. Trizivir contains the same combination as Combivir, and 300 mg of abacavir (Ziagen). Kivexa contains 300 mg Epivir-hbv and 600 mg abacavir.

The formulations may change and dosages may need to be customized. All medications must always be taken exactly as prescribed by your doctor.

Accessibility

Epivir-hbv is approved in Canada for the treatment of HIV infection in adults in combination with other antiretroviral drugs. Your doctor may tell you more about accessibility and repayment of Epivir-hbv in your area. CATIE has created an electronic module entitled "Access to HIV drugs: federal, provincial and territorial access to medicines" which contains information on reimbursement of drugs in Canada.