Sequence repositories, databases and tools for sequence analysis should regularly review the evidence for TDF RAMs in order to highlight all sites that may be significant in mediating resistance. ii In the context of failure of viraemic suppression in a patient prescribed therapy, assessing and supporting drug compliance is crucial, ideally together with viral sequencing. iii Therapeutic failure of TFV – whether in the presence or absence of known RAMs – should lead to an expert clinical decision about switching therapy or combining agents, as long as adherence has been optimised and supported.
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Hepatitis B virus resistance to tenofovir: fact or fiction? A systematic literature review and structural analysis of drug resistance mechanisms.
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