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Viral dynamics during tenofovir therapy 203<br />

Our data demonstrate that direct comparison of the effi cacies given by different mathematical<br />

models is not always possible. As we have demonstrated, variations between<br />

the models with respect to sampling frequencies and duration of follow up result in<br />

different outcomes. In addition, our data show that tenofovir is capable of effectively<br />

blocking viral replication in patients with lamivudine-induced mutant viruses in both HBV<br />

and HBV/ HIV co-infected patients. However, for effective treatment of patients, the first<br />

goal should be to totally inactivate disease by completely blocking virion production.<br />

In terms of modelling this will mean an antiviral effi cacy ‘ε’ equivalent to 1. Our results<br />

show that, in patients with lamivudine-induced drug-resistant mutants, we can reach an<br />

effi cacy of 0.99. Therefore, despite the drug having an excellent effect, our data also<br />

show some low-grade viral replication remains. We suggest that the residual replication<br />

may present a risk for genotypic succession during tenofovir therapy.

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