How Long Should I Take Dryan? Concerns About Duration and Resistance - Gastroenterology and Hepatology

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Hello, I previously had a GGT of over 300 and a GPT of over 500.
I have been taking Daclatasvir for 3.5 months now.
Currently, my GGT is normal and my GPT is 36, which is just slightly above the standard of 35.
I feel like I'm almost back to normal.
I read online that Daclatasvir should not be taken for more than 8 months due to concerns about drug resistance, but my doctor said I need to take it for at least a year.
I'm unsure if I should continue taking it or if 8 months would be sufficient since I am still young.
I am worried about developing drug resistance and potentially having no treatment options in the future.
Thank you, doctor, for your response.

Hua, 20~29 year old female. Ask Date: 2005/02/15

Dr. Chen Zhiping reply Gastroenterology and Hepatology


Hello, the treatment for hepatitis B is not solely based on the levels of GOT and GPT; it also requires monitoring the status of e-antigen/antibody and whether the HBV viral load (HBV-DNA) has been measured.
The goals of treatment include normalizing liver enzymes (GOT, GPT) and achieving long-term viral suppression, leading to the disappearance of e-antigen and the production of e-antibody, with undetectable HBV-DNA levels.
This is essential to ensure that the liver does not continue to be inflamed, thereby preventing the progression to cirrhosis and hepatocellular carcinoma.

There is no definitive duration for taking antiviral medication such as tenofovir; some patients may stop after a year, while others may need to continue for 2 to 3 years.
However, the longer the treatment (beyond 9 months), the greater the risk of developing drug-resistant viral strains.
Currently, it is recommended to continue treatment until the e-antigen turns negative and antibodies are produced, followed by an additional 6 months of therapy; otherwise, the virus can easily reactivate.

If drug-resistant viruses emerge during treatment, leading to abnormal liver function, another medication, entecavir, is available, but it is more expensive.
At present, there is no single medication that can completely eradicate hepatitis B without the risk of drug resistance, and further research is needed for future developments.

Sincerely, Dr.
Chen Zhiping, Internal Medicine.

Reply Date: 2005/02/15

More Info


When considering the duration of treatment with Dryan (likely referring to a medication such as an antiviral or a specific treatment for liver conditions), it is essential to understand both the rationale behind the treatment and the potential risks associated with prolonged use.
Firstly, it is crucial to recognize that the duration of any medication should be guided by the underlying condition being treated, the patient's response to the medication, and the potential for side effects or resistance. In your case, it appears that you have been on Dryan for approximately 3.5 months, and your liver enzyme levels (GOT and GPT) have shown improvement, which is a positive sign. However, the concern regarding the duration of treatment and the risk of developing drug resistance is valid.

The general recommendation for many antiviral medications or treatments for chronic conditions is to continue the therapy for a specified duration, often ranging from 6 months to a year or more, depending on the specific medication and the condition being treated. The concern about developing resistance typically arises when medications are not taken for the full recommended duration or when they are used inconsistently. Resistance can lead to treatment failure and limit future therapeutic options, which is a legitimate concern, especially for younger patients who may face long-term health implications.

Your physician's recommendation to continue treatment for at least one year may be based on clinical guidelines that suggest longer durations for optimal outcomes. It is essential to weigh the benefits of continued treatment against the risks of potential side effects or resistance. If your liver enzymes are nearing normal levels, it may be tempting to consider stopping the medication sooner; however, it is crucial to follow your doctor's advice, as they have the full context of your health status and treatment goals.

If you are concerned about the potential for resistance, it is advisable to have an open discussion with your healthcare provider. You can express your worries about the duration of treatment and the possibility of developing resistance. Your doctor may be able to provide additional insights into the specific medication you are taking, including its mechanism of action, the likelihood of resistance, and the importance of completing the prescribed course.

In addition, it may be beneficial to monitor your liver function tests regularly during treatment. This will help ensure that the medication is effectively managing your condition and that any necessary adjustments can be made promptly. If your doctor believes that you should continue treatment beyond 8 months, they may have specific reasons based on your health history and the nature of your liver condition.

In summary, while concerns about the duration of treatment and the risk of resistance are valid, it is essential to follow your healthcare provider's recommendations and maintain open communication about your treatment plan. If you have any doubts or experience side effects, do not hesitate to reach out to your doctor for further evaluation and guidance. Your health and well-being should always be the top priority in any treatment plan.

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