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. 2014 May 21;20(19):5708–5720. doi: 10.3748/wjg.v20.i19.5708

Table 1.

Guidelines for treatment of resistance

Resistant drug AASLD 2009[18] EASL 2012[16] APASL 2012[17] KASL 2012[13]
LMV Add ADV or TDF Stop LMV, switch to Truvada (TDF + FTC) Switch to TDF Add ADV (If TDF not available) Add ADV Switch to TDF Switch to IFN-based therapy Add ADV or TDF Stop LMV, switch to ADV or TDF + other nucleoside analogues Switch to TDF Stop LMV, consider to switch with Peg IFN
ADV Add LMV Stop ADV, switch to Truvada Stop ADV, switch to or add ETV NA-naïve; Switch to ETV or TDF Prior LMV-resistance; Switch to TDF + a nucleoside analogue Add LMV, LdT, or ETV Switch to TDF Switch to IFN-based therapy With prior LMV resistance, -Stop ADV, switch to TDF + other nucleoside analogues -Add ETV 1mg ADV as a first-line therapy -Stop ADV, switch to TDF + other nucleoside analogues -Add other nucleoside analogue, if rtA181T, add ETV
ETV Switch to TDF or Truvada Switch to TDF Add TDF Add ADV (If TDF not available) Add TDF or ADV Switch to IFN-based therapy Add nucleotide analogue
LdT Same treatment as LMV Switch to TDF Add TDF Add ADV (If TDF not available) Same treatment as LMV Same treatment as LMV
CLV Same treatment as LMV
TDF Add ETV, LdT, LMV or FTC (LMV-naïve; Switch to ETV/ prior LMV-resistance; Add ETV)
Multidrug-resistance Combination of a nucleoside and a nucleotide (preferably TDF) ETV + TDF Switch to IFN-based therapy TDF + ETV 1 mg ADV + ETV 1 mg
Comment Update is required especially for multidrug-resistance Recommendation about IFN-based therapy is limited Recommendation about TDF resistance is limited Recommendation about TDF resistance and IFN-based therapy is limited

KASL: Korean Association for the Study of the Liver; AASLD: American Association for the Study of Liver Diseases; APASL: Asian Pacific Association for the Study of the Liver; EASL: European Association for the Study of the Liver; LMV: Lamivudine; ADV: Adefovir; LdT: Telbivudine; CLV: Clevudine; TDF: Tenofovir; FTC: Emtricitabine; ETV: Entecavir; IFN: Interferon.