NUCs need to be considered and discussed with the patient (Table 6).
If the HBV DNA levels are >2 000 IU/ml at 48 weeks, ongoing treatment with NUCs is required.
This is only possible with potent NUCs such as entecavir and tenofovir which have a high genetic barrier to resistance.
Patients with HBeAg-negative chronic hepatitis B and those with cirrhosis require lifelong treatment with NUCs.
NUCs are well tolerated and a potent NUC with a high genetic barrier to resistance should be used, e.
Interferon-based therapy is contraindicated and only NUCs should be used.
NUCs require dosage adjustments in the setting of renal impairment.
Consider stopping NUCs 48 weeks after HBeAg seroconversion; however, this must be carefully considered and if it is stopped, the patient must be monitored closely.
Customer Service - 1,000 ; NUD - 250; IB 100; IT 150 - NUCS
- IT mainly in Norwich, small number in London - approx 100 - Life - IT ; operations & healthcare - approx 700 - Company believe they can absorb approx 80-90% through expansion of business, attrition, VR & redeployment - Aviva confirmed this was the total offshoring for 2004 but could not confirm 2005 nor any other job losses for other reasons in 2004