American Board of Internal Medicine (ABIM) Certification Practice Exam

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Prepare for the American Board of Internal Medicine Exam. Engage with multiple-choice questions, each offering insights and explanations. Elevate your readiness with comprehensive study tools!

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Which treatment for HBV is used less often due to resistance development?

Tacrolimus
Adefovir
Entecavir
Tenofovir

The correct answer is: Adefovir

Adefovir is a nucleotide analogue that is used in the treatment of hepatitis B virus (HBV) infections. However, its use has declined primarily due to concerns regarding the development of viral resistance. Patients receiving adefovir can develop resistance mutations, especially if it is used as a monotherapy. This leads to a reduced effectiveness over time, warranting the search for alternative antiviral therapies that demonstrate stronger efficacy and lower resistance profiles. On the other hand, entecavir and tenofovir are both more effective and have a higher barrier to resistance compared to adefovir. These agents are now preferred for treating chronic HBV infections because they maintain their antiviral potency without significant resistance development in most patients. Tacrolimus, although an immunosuppressant, is not typically employed in the direct treatment of HBV infections, making adefovir the treatment most associated with resistance issues.