{"id":51121,"date":"2023-09-20T09:17:47","date_gmt":"2023-09-20T09:17:47","guid":{"rendered":"https:\/\/medsname.com\/x-vir\/"},"modified":"2026-04-30T16:19:01","modified_gmt":"2026-04-30T16:19:01","slug":"x-vir","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/x-vir\/","title":{"rendered":"X-Vir"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>X-Vir<\/strong> \u2014 Entecavir 0,5\/1 mg (Natco Pharma). \u00da\u010dinn\u00fd NRTI pro chronickou hepatitidu B. Prvn\u00ed volba peror\u00e1ln\u00ed terapie HBV spolu s tenofovirem. 0,5 mg u pacient\u016f bez p\u0159edchoz\u00ed l\u00e9\u010dby nukleos(t)idy; 1 mg u pacient\u016f s p\u0159edchoz\u00ed l\u00e9\u010dbou lamivudinem. NIKDY nepou\u017e\u00edvejte jako monoterapii HIV u nel\u00e9\u010den\u00e9 koinfekce \u2014 vede k rozvoji rezistence HIV.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>X-Vir je expedov\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, fakturace prob\u00edh\u00e1 p\u0159es regulovan\u00e9ho platebn\u00edho procesora (na v\u00fdpisu z \u00fa\u010dtu se objev\u00ed regulovan\u00fd platebn\u00ed procesor \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed 20pracovnodenn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Testov\u00e1n\u00ed na HIV je nezbytn\u00e9<\/strong><br \/>Lamivudin a entekavir jako monoterapie u nel\u00e9\u010den\u00e9 koinfekce HIV\/HBV rychle vedou k rozvoji rezistence HIV (M184V pro lamivudin; mutace integr\u00e1zy pro entekavir). P\u0159ed zah\u00e1jen\u00edm jak\u00e9koli monoterapie HBV testujte HIV. Pokud je v\u00fdsledek pozitivn\u00ed, pou\u017eijte kompletn\u00ed re\u017eim ART, kter\u00fd pokr\u00fdv\u00e1 oba viry (obvykle TDF nebo TAF + emtricitabin\/lamivudin + t\u0159et\u00ed l\u00e1tka).<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Ukon\u010den\u00ed rizika<\/strong><br \/>N\u00e1hl\u00e9 vysazen\u00ed jak\u00e9hokoli nukleosidu\/nukleotidu proti HBV m\u016f\u017ee zp\u016fsobit z\u00e1va\u017en\u00e9 akutn\u00ed vzplanut\u00ed HBV s mo\u017enou dekompenzac\u00ed. Nikdy nevysazujte bez dohledu hepatologa a n\u00e1sledn\u00e9ho monitorov\u00e1n\u00ed.<\/div>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Kdy je monoterapie vhodn\u00e1?<\/h3>\n<p>Monoterapie lamivudinem u HBV je ji\u017e v\u011bt\u0161inou zastaral\u00e1 kv\u016fli rozvoji rezistence. Entekavir a tenofovir jsou l\u00e9ky prvn\u00ed volby. Lamivudin z\u016fst\u00e1v\u00e1 mo\u017enost\u00ed v oblastech s omezen\u00fdmi zdroji, v t\u011bhotenstv\u00ed (rozs\u00e1hl\u00e1 data o bezpe\u010dnosti) nebo jako sou\u010d\u00e1st kombinovan\u00e9 terapie.<\/p>\n<h3>L\u00e9k na HBV?<\/h3>\n<p>Skute\u010dn\u00e9 vyl\u00e9\u010den\u00ed (ztr\u00e1ta HBsAg, n\u011bkdy naz\u00fdvan\u00e9 funk\u010dn\u00ed vyl\u00e9\u010den\u00ed) je u sou\u010dasn\u00e9 peror\u00e1ln\u00ed terapie vz\u00e1cn\u00e9 \u2013 typicky &lt;5 % ro\u010dn\u011b. V\u011bt\u0161ina pacient\u016f pot\u0159ebuje dlouhodobou\/do\u017eivotn\u00ed supresi. Aktivita onemocn\u011bn\u00ed, fibr\u00f3za a riziko HCC se p\u0159i d\u016fsledn\u00e9 terapii dramaticky sni\u017euj\u00ed i bez clearance HBsAg.<\/p>\n<h3>Kdy mohu p\u0159estat?<\/h3>\n<p>Ukon\u010den\u00ed l\u00e9\u010dby je zva\u017eov\u00e1no po trval\u00e9 s\u00e9rokonverzi HBeAg + nedetekovateln\u00e9 HBV DNA po dobu \u226512 m\u011bs\u00edc\u016f u HBeAg-pozitivn\u00edho onemocn\u011bn\u00ed nebo po ztr\u00e1t\u011b HBsAg. Ukon\u010den\u00ed by m\u011blo b\u00fdt v\u017edy pod dohledem specialisty s pe\u010dliv\u00fdm monitorov\u00e1n\u00edm vzplanut\u00ed HBV.<\/p>\n<h3>Monitorov\u00e1n\u00ed HCC?<\/h3>\n<p>V\u0161ichni pacienti s chronickou HBV pot\u0159ebuj\u00ed 6m\u011bs\u00ed\u010dn\u00ed sledov\u00e1n\u00ed HCC pomoc\u00ed b\u0159i\u0161n\u00edho ultrazvuku \u00b1 AFP, zejm\u00e9na pokud jsou cirhoti\u010dt\u00ed, maj\u00ed rodinnou anamn\u00e9zu HCC nebo specifickou demografii (asij\u0161t\u00ed mu\u017ei nad 40 let, Afri\u010dan\u00e9 nad 20 let, p\u0159etrv\u00e1vaj\u00edc\u00ed z\u00e1n\u011bt).<\/p>\n<h3>T\u011bhotenstv\u00ed?<\/h3>\n<p>Tenofovir je preferov\u00e1n v t\u011bhotenstv\u00ed (TDF nebo TAF). Lamivudin je alternativou s rozs\u00e1hl\u00fdmi \u00fadaji o t\u011bhotenstv\u00ed. Entekavir se obecn\u011b vyh\u00fdb\u00e1 kv\u016fli omezen\u00fdm \u00fadaj\u016fm o t\u011bhotenstv\u00ed.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>N\u011bkolik v\u00fdznamn\u00fdch interakc\u00ed pro tyto ren\u00e1ln\u011b vylu\u010dovan\u00e9 l\u00e9ky. Vyhn\u011bte se kombinaci s nefrotoxick\u00fdmi l\u00e9ky (chronick\u00e9 NSAID, aminoglykosidy). Tenofovir + ledipasvir obsahuj\u00edc\u00ed re\u017eimy proti hepatitid\u011b C \u2014 sledujte ren\u00e1ln\u00ed funkci.<\/p>\n<h3>Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>Vezm\u011bte, kdy\u017e si vzpomenete, pokud je stejn\u00fd den; pokud n\u00e1sleduj\u00edc\u00ed den, vynechejte vynechanou d\u00e1vku. Ned\u00e1vejte dvojn\u00e1sobnou d\u00e1vku. Proberte probl\u00e9my s adherenc\u00ed se sv\u00fdm hepatologem \u2014 mohou b\u00fdt k dispozici alternativn\u00ed re\u017eimy nebo zjednodu\u0161en\u00e9 d\u00e1vkov\u00e1n\u00ed.<\/p>\n<h3>Vedlej\u0161\u00ed \u00fa\u010dinky?<\/h3>\n<p>Obecn\u011b dob\u0159e sn\u00e1\u0161en. Tenofovir disoproxil: ren\u00e1ln\u00ed tubulopatie, dlouhodob\u00e1 ztr\u00e1ta hustoty kost\u00ed. Tenofovir alafenamid: minim\u00e1ln\u00ed dopad na ledviny\/kosti. Entekavir: vz\u00e1cn\u011b lakt\u00e1tov\u00e1 acid\u00f3za. Lamivudin: velmi dob\u0159e sn\u00e1\u0161en.<\/p>\n<h3>Co HCC po l\u00e9\u010db\u011b?<\/h3>\n<p>Riziko HCC souvisej\u00edc\u00ed s HBV p\u0159etrv\u00e1v\u00e1 i po potla\u010den\u00ed viru \u2014 nikdy nep\u0159est\u00e1vejte s monitorov\u00e1n\u00edm jen proto, \u017ee HBV DNA je nedetekovateln\u00e1. Obzvl\u00e1\u0161t\u011b cirhoti\u010dt\u00ed pacienti pot\u0159ebuj\u00ed celo\u017eivotn\u00ed 6m\u011bs\u00ed\u010dn\u00ed USS.<\/p>\n<h3>O\u010dkov\u00e1n\u00ed?<\/h3>\n<p>V\u0161ichni \u010dlenov\u00e9 dom\u00e1cnosti a sexu\u00e1ln\u00ed partne\u0159i by m\u011bli b\u00fdt testov\u00e1ni na HBsAg a o\u010dkov\u00e1ni proti HBV, pokud jsou vn\u00edmav\u00ed. Pacient by m\u011bl tak\u00e9 dostat o\u010dkov\u00e1n\u00ed proti HAV, pneumokok\u016fm, ka\u017edoro\u010dn\u00ed ch\u0159ipce a (po obnoven\u00ed CD4, pokud je koinfekce HIV) dal\u0161\u00ed indikovan\u00e1 o\u010dkov\u00e1n\u00ed.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed antivirotika<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tenvir-l\/\">Tenvir L<\/a> \u2014 tenofovir + lamivudin \u2014 kombinovan\u00e1 NRTI z\u00e1kladna pro HIV\/HBV<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/x-vir\/\">X-Vir<\/a> \u2014 entekavir 0,5\/1 mg \u2014 prvn\u00ed linie monoterapie HBV<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lamivir-hbv\/\">Lamivir HBV<\/a> \u2014 lamivudin 100 mg \u2014 star\u0161\u00ed monoterapie HBV<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/myhep\/\">MyHep<\/a> \u2014 sofosbuvir 400 mg \u2014 pro HCV<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zimivir\/\">Zimivir<\/a> \u2014 valacyclovir 500\/1000 mg \u2014 pro HSV<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> L\u00e9\u010dba HIV je komplexn\u00ed, celo\u017eivotn\u00ed terapie. V\u00fdb\u011br l\u00e9k\u016f z\u00e1vis\u00ed na genotypu, testech rezistence, p\u0159idru\u017een\u00fdch onemocn\u011bn\u00edch a p\u0159edchoz\u00ed l\u00e9\u010db\u011b. Jakoukoli zm\u011bnu re\u017eimu konzultujte s odborn\u00edkem na HIV. Pro prevenci rezistence je nutn\u00e1 adherence &gt;95%. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby obsahuj\u00edc\u00ed tenofovir, lamivudin nebo emtricitabin testujte HBV \u2014 vysazen\u00ed m\u016f\u017ee u pacient\u016f s koinfekc\u00ed zp\u016fsobit z\u00e1va\u017en\u00e9 vzplanut\u00ed HBV.<\/div>","protected":false},"excerpt":{"rendered":"<p>X-Vir (Entecavir 0,5\/1 mg) \u2014 \u00fa\u010dinn\u00fd NRTI od Natco pro potla\u010den\u00ed chronick\u00e9ho viru hepatitidy B. Prvn\u00ed volba peror\u00e1ln\u00ed terapie HBV. P\u0159i koinfekci je nutn\u00e1 p\u0159\u00edsn\u00e1 separace od l\u00e9\u010dby HIV.<\/p>","protected":false},"featured_media":51122,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3304],"product_tag":[],"class_list":{"0":"post-51121","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-hiv-medication","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51121","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51121"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51122"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51121"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51121"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51121"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51121"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}