Treatment initiation should only be considered when an alternative antiviral agent w/ a higher genetic barrier to resistance is not available or appropriate. Monitor patients during initiation & maintenance of treatment in the management of chronic hepatitis B regularly. Patients may experience clinical or lab evidence of recurrent hepatitis w/ treatment discontinuation or loss of efficacy. Periodically monitor ALT & bilirubin at least 4 mth for evidence of recurrent hepatitis. Greater risk from active viral replication in transplantation recipients & patients w/ advanced liver disease; monitor for parameters associated w/ hepatitis B, liver & renal function, & antiviral response during treatment; monitor patients for at least 6 mth post cessation of treatment & those experiencing signs of hepatic insufficiency during or post-treatment frequently. Concurrent immunosuppressive regimens including cancer chemotherapy. Patients co-infected w/ HIV. Follow standard recommended procedures for HBV immunisation in infants. Patients should be advised that therapy has not been proven to reduce risk of HBV transmission. Moderate to severe renal impairment. Pregnancy & lactation.
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