Lamivudine

Lamivudine is a synthetic cytidine analogue used in the treatment of HIV (see Chapter 51) and HBV. Its activation requires phosphorylation by cellular enzymes. Lamivudine triphosphate competitively inhibits HBV DNA polymerase and HIV reverse transcriptase and causes chain termination. It inhibits the activity of mammalian DNA polymerases with a much lower potency.

HIV-1 frequently acquires mutations in reverse transcriptase that result in resistance to lamivudine within 12 weeks of treatment. Mutations in the DNA polymerase of HBV are associated with decreased lamivudine efficacy and have been documented in patients treated with this agent for 6 months or more.

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