Flashcards in Disorders of the Liver Deck (14):
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
Entecavir or Tenofovir
When to treat chronic HBV?
Unless seroconversion of HbeAg or HbSAg is observed.
When to use Pegylated interferon?
No cirrhosis who have high ALT, relatively low HBV DNA levels and ability to tolerate SEs of pegylated interferon
What is the treatment goal?
Normalization of the ALT and decline in HBV DNA level to <50IU/mL
When to monitor with SONO or other image every 6 month?
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
When to screen?
Born between 1945-1965
What are the extrahepatic manifestations of HCV infection?
1. Cryoglobulinemic vasculitis;
2. Membranoproliferative glomerulonephritis;
3. Porphyria cutanea tarda
Monitoring of disease
DO NOT recommend serial monitoring of HCV RNA level except during HCV treatment.
What is the goal of treatment?
Sustained virologic response: undetectable HCV RNA 6 months after completion.
Rx for HCV genotype 1
Sofosbuvir and Ledipasvir
Rx for HCV genotype 2
Sofosbuvir and ribavirin for 12 weeks
Rx for HCV genotype 3
Sofosbuvir and ribavirin for 24 weeks