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Flashcards in Disorders of the Liver Deck (14):
1

Hepatitis B
When to treat acute HBV?

1. Acute liver failure;
2. Chronic infection with an elevated ALT and an HBV DNA >10,000 IU/mL or;
3. Receiving immunosuppresive therapy

2

Hepatitis B
Which agent?

Entecavir or Tenofovir

3

Hepatitis B
When to treat chronic HBV?

Always;
Unless seroconversion of HbeAg or HbSAg is observed.

4

Hepatitis B
When to use Pegylated interferon?

No cirrhosis who have high ALT, relatively low HBV DNA levels and ability to tolerate SEs of pegylated interferon

5

Hepatitis B
What is the treatment goal?

Normalization of the ALT and decline in HBV DNA level to <50IU/mL

6

Hepatitis B
When to monitor with SONO or other image every 6 month?

1. Cirrhosis;
2. Asian male>40 yo;
3. Asian female>50 yo;
4. African >20yo;
5. Persistent inflammatory activity (elevated ALT level and HBV DNA levels greater than 10,000 IU/mL for at least few years);
6.Family hx of HCC

7

Hepatitis C
When to screen?

Born between 1945-1965

8

Hepatitis C
What are the extrahepatic manifestations of HCV infection?

1. Cryoglobulinemic vasculitis;
2. Membranoproliferative glomerulonephritis;
3. Porphyria cutanea tarda

9

Hepatitis C
Monitoring of disease

DO NOT recommend serial monitoring of HCV RNA level except during HCV treatment.

10

Hepatitis C
What is the goal of treatment?

Sustained virologic response: undetectable HCV RNA 6 months after completion.

11

Hepatitis C
Rx for HCV genotype 1

Sofosbuvir and Ledipasvir

12

Hepatitis C
Rx for HCV genotype 2

Sofosbuvir and ribavirin for 12 weeks

13

Hepatitis C
Rx for HCV genotype 3

Sofosbuvir and ribavirin for 24 weeks

14

Hepatitis C
Rx for HCV genotype 4

Pegylated interferon, ribavirin and sofosbuvir