Exam 4 - Viral Hepatitis Kleyn (ChatGPT made these) Flashcards
(104 cards)
1
Q
Which hepatitis virus has a fecal-oral transmission route?
a. hepB
b. hepC
c. hepA
d. hepE
A
c. hepA
2
Q
What is the most common risk factor for Hepatitis C transmission?
a. born to infected mother
b. injection drug use
c. sexual contact
d. contaminated food or water
A
b. injection drug use
3
Q
What serologic marker indicates immunity to Hepatitis B?
a. HBsAg
b. anti-HBs
c. IgM anti-HBc
d. total anti-HBc
A
b. anti-HBs
4
Q
What is the upper limit of normal ALT for females?
a. 45 U/L
b. 35 U/L
c. 25 U/L
d. 15 U/L
A
c. 25 U/L
5
Q
What is the clinical state of a patient with negative HBsAg, negative anti-HBs, and negative anti-HBc?
a. Immune from prior infection
b. Chronic infection
c. Susceptible, never infected
d. Resolved infection
A
c. Susceptible, never infected
6
Q
If a patient has positive anti-HBs and negative anti-HBc, what is the likely clinical state?
a. Acute infection
b. Chronic infection
c. Immune from receipt of prior vaccination
d. Interpretation unclear
A
c. Immune from receipt of prior vaccination
7
Q
What is the recommended action for a patient with negative HBsAg, positive anti-HBs, and positive anti-HBc?
a. Offer HepB vaccine
b. Link to hepatitis B care
c. Counsel about HBV reactivation risk
d. Monitor HBsAg every 6 months
A
c. Counsel about HBV reactivation risk
8
Q
Which combination of test results indicates acute Hepatitis B infection?
a. Positive HBsAg, negative anti-HBs, positive anti-HBc, positive IgM anti-HBc
b. Negative HBsAg, positive anti-HBs, positive anti-HBc
c. Negative HBsAg, negative anti-HBs, negative anti-HBc
d. Positive HBsAg, positive anti-HBs, positive anti-HBc, negative IGM anti-HBc
A
a. Positive HBsAg, negative anti-HBs, positive anti-HBc, positive IgM anti-HBc
9
Q
What action is recommended for a patient with positive HBsAg, negative anti-HBs, and positive anti-HBc?
a. Monitor ALT levels
b. Vaccinate for HBV
c. Link to hepatitis B care
d. Provide supportive care only
A
c. Link to hepatitis B care
10
Q
Which test result is a marker of immunity due to vaccination?
a. Positive HBsAg
b. Positive IgM anti-HBc
c. Positive anti-HBs
d. Positive anti-HBc
A
c. Positive anti-HBs
11
Q
What is the appropriate action for a patient with negative HBsAg, negative anti-HBs, and negative anti-HBc?
a. Perform liver biopsy
b. Test HBV DNA
c. Offer HepB vaccine
d. Initiate antiviral treatment
A
c. Offer HepB vaccine
12
Q
What combination of test results is most consistent with acute Hepatitis B infection?
a. Positive HBsAg, negative anti-HBs, negative anti-HBc
b. Negative HBsAg, positive anti-HBs, positive anti-HBc
c. Positive HBsAg, negative anti-HBs, positive anti-HBc, positive IgM anti-HBc
d. Positive HBsAg, negative anti-HBs, positive anti-HBc, negative IgM anti-HBc
A
c. Positive HBsAg, negative anti-HBs, positive anti-HBc, positive IgM anti-HBc
(positive IgM indicates recent exposure -> acute)
13
Q
In the case of unclear interpretation of test results, which action is recommended?
a. Repeat testing and monitor
b. Immediately initiate treatment
c. No action needed
d. Vaccinate for HBV
A
a. Repeat testing and monitor
14
Q
What is the average incubation period for Hepatitis A virus (HAV)?
a. 14 days
b. 28 days
c. 60 days
d. 90 days
A
b. 28 days
15
Q
Which serologic marker indicates immunity from Hepatitis B infection?
a. HBsAg
b. anti-HBs
c. Total anti-HBc
d. IgM anti-HBc
A
b. anti-HBs
16
Q
What is the main transmission method for Hepatitis C virus (HCV)?
a. Sexual contact
b. Contaminated water
c. Blood exposure
d. Fecal-oral route
A
c. Blood exposure
17
Q
What is the goal of therapy for chronic Hepatitis B infection?
a. Virological cure
b. Suppression of HBV replication
c. Increased liver inflammation
d. Complete eradication of HBV DNA
A
b. Suppression of HBV replication
18
Q
Which antiviral agent is associated with a warning of Hepatitis B virus reactivation risk?
a. Tenofovir DF
b. Peginterferon alfa
c. Direct Acting Antivirals (DAAs)
d. Ribavirin
A
c. Direct Acting Antivirals (DAAs)
19
Q
Hepatitis delta virus (HDV) requires coinfection with which virus for replication?
a. HAV
b. HBV
c. HCV
d. HEV
A
b. HBV
20
Q
What is the upper limit of normal ALT for males?
a. 15 U/L
b. 25 U/L
c. 35 U/L
d. 45 U/L
A
c. 35 U/L
21
Q
Which Hepatitis virus typically resolves without chronic infection?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
A
a. Hepatitis A
22
Q
Which test detects a current Hepatitis C infection?
a. anti-HCV
b. HCV RNA
c. ALT levels
d. Total anti-HAV
A
b. HCV RNA
23
Q
What is the recommended pretreatment lab for assessing liver disease severity?
a. Fibrosis staging
b. Hepatitis A vaccine titers
c. Bone density study
d. eGFR
A
a. Fibrosis staging
24
Q
Which Hepatitis B clinical phase has normal ALT and elevated HBV DNA (++++)?
a. e+ Immune-tolerant
b. e- Immune-active
c. e- Carrier phase
d. e+ Immune-reactivation
A
a. e+ Immune-tolerant
25
Which Hepatitis virus has no vaccine available?
a. HAV
b. HBV
c. HCV
d. HEV
c. HCV
26
What is a contraindication for peginterferon alfa-2a use?
a. Age over 60 years
b. Decompensated liver disease
c. Co-infection with HIV
d. Hepatitis C genotype 3
b. Decompensated liver disease
27
Which Hepatitis virus is primarily found in India, Asia, and Africa?
a. HAV
b. HBV
c. HDV
d. HEV
d. HEV
28
Which Hepatitis virus is classified as a flavivirus?
a. HAV
b. HBV
c. HCV
d. HEV
c. HCV
29
What pre-treatment testing is required before initiating elbasvir?
a. ALT level monitoring
b. NS5A genotype testing
c. Hepatitis A vaccine screening
d. HCV RNA test
b. NS5A genotype testing
30
Which drug class inhibits HCV RNA polymerase replication?
a. NS5A inhibitors
b. NS5B polymerase inhibitors
c. NS3/4A protease inhibitors
d. Ribavirin
b. NS5B polymerase inhibitors
31
Chronic HBV infection can lead to which complications?
a. Influenza-like symptoms
b. Cirrhosis and HCC
c. Liver regeneration
d. Autoimmune disorders
b. Cirrhosis and HCC
32
Which antiviral agent requires a dose reduction if co-administered with a strong CYP3A4 inducer?
a. Ledipasvir
b. Daclatasvir
c. Velpatasvir
d. Pibrentasvir
b. Daclatasvir
33
Who should receive postvaccination testing for Hepatitis B immunity?
a. Immunocompromised patients
b. Pregnant women
c. Adults aged 19 years
d. People with clotting factor disorders
a. Immunocompromised patients
34
How long should patients with chronic Hepatitis C infection wait for a sustained virological response after treatment?
a. 6 weeks
b. 8 weeks
c. 12 weeks
d. 16 weeks
c. 12 weeks
35
What are common adverse effects of grazoprevir?
a. Insomnia and weight loss
b. ALT elevations and headache
c. Myopathy and neuropathy
d. Severe depression
b. ALT elevations and headache
36
How does NS5A replication complex inhibitors prevent HCV RNA replication?
a. Bind to DNA polymerase
b. Block RNA polymerase active sites
c. Compete with ribavirin binding sites
d. Inhibit NS5A protein assembly
d. Inhibit NS5A protein assembly
37
Which drug is contraindicated for patients with creatinine clearance <50 mL/min?
a. Ribavirin
b. Grazoprevir
c. Tenofovir DF
d. Entecavir
a. Ribavirin
38
Which of the following statements is TRUE about Hepatitis A virus (HAV)?
a. HAV is a DNA virus classified as a hepadnavirus.
b. The HAV vaccine is live and contraindicated in pregnancy.
c. HAV primarily spreads through the fecal-oral route.
d. Chronic infection occurs in >50% of HAV cases.
c. HAV primarily spreads through the fecal-oral route.
39
Which of the following statements is FALSE regarding Hepatitis B virus (HBV)?
a. HBV is a DNA virus classified as a hepadnavirus.
b. The HBV vaccine drastically reduced incidence of infection.
c. Chronic HBV infection can lead to cirrhosis and hepatocellular carcinoma.
d. HBV spreads only through perinatal transmission.
d. HBV spreads only through perinatal transmission.
40
Which of the following statements is TRUE regarding Hepatitis C virus (HCV)?
a. HCV has no subtypes or genotypes.
b. Direct acting antivirals (DAAs) provide a curative treatment for chronic HCV.
c. Chronic HCV infection rarely leads to complications.
d. HCV RNA cannot be used to diagnose active HCV infection.
b. Direct acting antivirals (DAAs) provide a curative treatment for chronic HCV.
41
Which of the following statements is FALSE about Hepatitis delta virus (HDV)?
a. HDV requires HBV co-infection for replication and expression.
b. HDV can spread independently of HBV.
c. HDV increases the risk of cirrhosis in HBV-infected individuals.
d. HDV is primarily associated with chronic HBV infection.
b. HDV can spread independently of HBV.
42
Which of the following statements is TRUE regarding alanine aminotransferase (ALT) levels?
a. ALT levels are unrelated to liver inflammation.
b. ALT levels are exclusively used for kidney function testing.
c. The upper limit of normal ALT for males is 45 U/L.
d. The upper limit of normal ALT for females is 25 U/L.
d. The upper limit of normal ALT for females is 25 U/L.
43
Which of the following statements is FALSE regarding Hepatitis A vaccination?
a. All available HAV vaccines are safe in pregnancy.
b. HAV vaccine series is typically given in 3 doses.
c. Postvaccination serologic testing is recommended for everyone.
d. HAV vaccine drastically reduced infection rates in the United States.
c. Postvaccination serologic testing is recommended for everyone.
44
Which of the following statements is TRUE regarding Hepatitis B clinical phases?
a. The e- inactive (carrier) phase shows elevated ALT and elevated HBV DNA (+++) levels.
b. The e+ immune-active phase shows low/undetectable HBV DNA levels.
c. The e- immune reactivation phase shows normal ALT and normal HBV DNA levels.
d. The e+ immune-tolerant phase shows normal ALT and elevated HBV DNA (++++) levels.
d. The e+ immune-tolerant phase shows normal ALT and elevated HBV DNA (++++) levels.
45
Which of the following statements is TRUE regarding antiviral therapy for chronic HBV?
a. Peginterferon alfa is contraindicated in patients with decompensated liver disease.
b. Combination therapy has shown higher response rates than monotherapy.
c. Therapy eradicates HBV and achieves virological cure.
d. ALT flares are a rare side effect when stopping nucleoside analogs.
a. Peginterferon alfa is contraindicated in patients with decompensated liver disease.
46
Which of the following statements is FALSE about Hepatitis C serologic testing?
a. Anti-HCV is used diagnostically for active HCV infection.
b. HCV RNA detection is diagnostic of current infection.
c. Anti-HCV detects past exposure to HCV.
d. HCV RNA is detectable earlier than anti-HCV after exposure.
a. Anti-HCV is used diagnostically for active HCV infection.
47
Which of the following statements is TRUE about grazoprevir?
a. Grazoprevir belongs to the NS5A inhibitor class.
b. ALT levels must be monitored at 8 weeks during therapy.
c. Grazoprevir has a high barrier to resistance.
d. Grazoprevir is contraindicated in compensated cirrhosis.
b. ALT levels must be monitored at 8 weeks during therapy.
48
Which of the following statements is FALSE about HAV prevention?
a. HAV vaccines are inactivated and safe for pregnant women.
b. HAV vaccines are effective for children aged 12-23 months.
c. HAV infection is common in people born in high-endemic areas.
d. HAV vaccines are live attenuated.
d. HAV vaccines are live attenuated.
49
Which of the following statements is TRUE about HBV transmission?
a. HBV can spread via contaminated food or water.
b. HBV is transmitted through percutaneous or mucosal contact with blood or body fluids.
c. HBV cannot spread through sexual contact.
d. HBV transmission occurs primarily through fecal-oral routes.
b. HBV is transmitted through percutaneous or mucosal contact with blood or body fluids.
50
Which of the following statements is FALSE about HBV serologic markers?
a. anti-HBs indicates immunity to HBV infection.
b. Total anti-HBc indicates prior HBV exposure.
c. IgM anti-HBc is used to detect recent HBV infection.
d. HBsAg is a marker of immunity.
d. HBsAg is a marker of immunity.
51
Which of the following statements is TRUE about chronic HBV infection phases?
a. Elevated ALT is only observed in immune-tolerant phases.
b. e+ Immune-active phase involves elevated HBV DNA (+++) and ALT levels.
c. e- Inactive carrier phase involves elevated ALT levels.
d. e- Immune reactivation phase has low HBV DNA levels.
b. e+ Immune-active phase involves elevated HBV DNA (+++) and ALT levels.
52
Which of the following statements is TRUE regarding risk groups for HAV infection?
a. People who travel internationally are at increased risk.
b. Food handlers are at the highest risk.
c. HAV transmission occurs primarily through needle sharing.
d. HAV risk groups exclude men who have sex with men.
a. People who travel internationally are at increased risk.
53
Which of the following statements is FALSE regarding the HBV vaccine?
a. All available vaccines are inactivated and safe in pregnancy.
b. HBV vaccine is administered in three doses at 0, 1, and 6 months.
c. Postvaccination serologic testing is recommended for all vaccinated individuals.
d. HBV vaccine drastically reduced infection rates in the United States.
c. Postvaccination serologic testing is recommended for all vaccinated individuals.
54
Which of the following statements is FALSE about HCV therapy?
a. Direct-acting antivirals (DAAs) provide curative treatment for chronic HCV.
b. Combination therapy prevents drug resistance in HCV treatment.
c. Ribavirin is a first-line therapy for HCV.
d. DAAs carry a warning for risk of HBV reactivation.
c. Ribavirin is a first-line therapy for HCV.
55
Which of the following statements is TRUE about the mechanism of NS5A inhibitors?
a. NS5A inhibitors block HCV RNA replication and assembly.
b. NS5A inhibitors compete for the active site of NS5B polymerase.
c. NS5A inhibitors inhibit NS3 serine protease.
d. NS5A inhibitors are used exclusively for Hepatitis
a. NS5A inhibitors block HCV RNA replication and assembly.
56
Which of the following statements is FALSE regarding ALT monitoring?
a. ALT levels are monitored during grazoprevir therapy.
b. ALT levels are unrelated to liver inflammation.
c. ALT monitoring helps classify chronic HBV infection phases.
d. Elevated ALT levels can indicate HBV reactivation.
b. ALT levels are unrelated to liver inflammation.
57
Which of the following statements is TRUE about ribavirin treatment for HCV?
a. Ribavirin causes hemolytic anemia in 10% of cases.
b. Ribavirin is recommended for patients with renal dysfunction.
c. Ribavirin is contraindicated in pregnancy but safe for lactating mothers.
d. Ribavirin requires twice-weekly subcutaneous administration.
a. Ribavirin causes hemolytic anemia in 10% of cases.
58
Which of the following statements is FALSE regarding the HAV vaccine series?
a. HAVRIX® for adults includes a two-dose series of 1,440 ELISA units.
b. VAQTA® for adults includes a two-dose series of 50 units.
c. TWINRIX® includes a three-dose series combined with HBV vaccine.
d. TWINRIX® is administered as a single-dose series for outbreak control.
d. TWINRIX® is administered as a single-dose series for outbreak control.
59
Which of the following statements is TRUE about HBV treatment principles?
a. ALT levels above 50 U/L indicate treatment eligibility for males.
b. Combination therapy is recommended for all HBV patients.
c. Treatment eligibility is based on HBV DNA and ALT levels.
d. HBV therapy is discontinued after 12 weeks.
c. Treatment eligibility is based on HBV DNA and ALT levels.
60
Which of the following statements is TRUE about sofosbuvir treatment?
a. Sofosbuvir requires ribavirin for all HCV genotypes.
b. Sofosbuvir is contraindicated in patients with hepatic impairment.
c. Sofosbuvir has pangenotypic activity and a high barrier to resistance.
d. Sofosbuvir increases the risk of symptomatic bradycardia when combined with amiodarone.
c. Sofosbuvir has pangenotypic activity and a high barrier to resistance.
61
What is the average incubation period for Hepatitis B virus?
a. 15 days
b. 45 days
c. 90 days
d. 150 days
c. 90 days
62
Which antiviral agent for chronic Hepatitis B has less impact on renal function and bone density?
a. Tenofovir disoproxil fumarate
b. Entecavir
c. Peginterferon alfa-2a
d. Tenofovir alafenamide
d. Tenofovir alafenamide
63
Which of the following is TRUE about chronic Hepatitis C infection?
a. Chronic fatigue and depression are uncommon symptoms.
b. It is defined as detectable HCV RNA for ≥6 months.
c. Only 5% of patients develop cirrhosis over 10-20 years.
d. Chronic infection rarely leads to complications.
b. It is defined as detectable HCV RNA for ≥6 months.
64
What special pretreatment test is required before initiating elbasvir therapy?
a. NS3 Q80K polymorphism testing
b. NS5A genotype testing
c. Fibrosis staging
d. Liver panel
b. NS5A genotype testing
65
which treatment eligibility for HBV is there an exception for the HBV DNA cutoff at >20,000 IU/mL instead of 2000 IU/mL?
a. e+ cirrhosis
b. e- cirrhosis
c. e+ immune reactivation
d. e+ immune-active
d. e+ immune-active
66
What is the primary goal of chronic Hepatitis C therapy?
a. Eradication of anti-HCV antibodies
b. Reduction of ALT levels
c. Virological cure via sustained virological response (SVR)
d. Complete normalization of liver histology
c. Virological cure via sustained virological response (SVR)
67
Which test is required before initiating therapy with elbasvir for HCV?
a. ALT level monitoring
b. HBV serologic testing
c. NS5A genotype resistance testing
d. HCV RNA quantification
c. NS5A genotype resistance testing
68
What is the treatment duration for most direct-acting antivirals (DAAs) in HCV therapy?
a. 4 weeks
b. 8 weeks
c. 12 weeks
d. 24 weeks
c. 12 weeks
69
What is a common adverse effect of grazoprevir therapy?
a. ALT elevations
b. Hyperglycemia
c. Skin rash
d. Neuropathy
a. ALT elevations
70
What is the primary mechanism of action for NS3/4A protease inhibitors?
a. Inhibiting HCV RNA replication and assembly
b. Preventing cleavage of HCV-encoded polyproteins
c. Stimulating immune response against HCV
d. Competing with ribavirin binding sites
b. Preventing cleavage of HCV-encoded polyproteins
71
Which treatment for chronic Hepatitis B is contraindicated in decompensated liver disease?
a. Peginterferon alfa-2a
b. Tenofovir disoproxil fumarate
c. Entecavir
d. Tenofovir alafenamide
a. Peginterferon alfa-2a
72
Which Hepatitis C genotype is most prevalent in the United States?
a. Genotype 1a
b. Genotype 2
c. Genotype 4
d. Genotype 6
a. Genotype 1a
73
Which of the following is NOT a recommended monitoring parameter during Hepatitis C treatment?
a. ALT levels
b. Serum HBV DNA
c. LFTs (Liver Function Tests)
d. HCV RNA
b. Serum HBV DNA
74
Which Hepatitis virus has the shortest average incubation period?
a. HAV
b. HBV
c. HCV
d. HEV
a. HAV
75
Which Hepatitis B clinical phase requires indefinite treatment if ALT > 2xULN and HBV DNA > 2,000 IU/mL?
a. e+ Immune-tolerant
b. e- Immune reactivation
c. e- Inactive (carrier)
d. e+ Immune-active
b. e- Immune reactivation
76
What is the recommended duration of treatment for grazoprevir-based regimens in HCV?
a. 4 weeks
b. 8 weeks
c. 12 weeks
d. 24 weeks
c. 12 weeks
77
Which antiviral agent is preferred for HBV treatment during pregnancy?
a. Entecavir
b. Peginterferon alfa-2a
c. Tenofovir disoproxil fumarate
d. Tenofovir alafenamide
c. Tenofovir disoproxil fumarate
78
What is a contraindication to using elbasvir for HCV therapy in genotype 1a patients?
a. Presence of NS3 polymorphism
b. Resistance-associated substitutions in NS5A
c. Cirrhosis
d. Co-infection with HIV
b. Resistance-associated substitutions in NS5A
79
Which Hepatitis B vaccine offers a two-dose series at 0 and 1 months?
a. Engerix-B®
b. Recombivax HB®
c. Heplisav-B®
d. Twinrix®
c. Heplisav-B®
80
Which test is used to assess liver fibrosis without requiring a biopsy?
a. FibroTest®
b. ALT levels
c. HBV DNA quantification
d. Alpha-fetoprotein (AFP)
a. FibroTest®
81
diagnosis of acute HAV requires the detection of either: (2 things)
IgM anti-HAV in serum
OR
HAV RNA in serum or stool
82
HBsAg
a. Marker of presence of ongoing infection
b. Marker of immunity
(indistinguishable whether acquired from disease or vaccination)
c. Marker of exposure to the infection (persists for life, does not account for time since infection)
d. Marker of acute or recently acquired HBV infection
(can give false positives)
a. Marker of presence of ongoing infection
83
anti-HBs
a. Marker of presence of ongoing infection
b. Marker of immunity (indistinguishable whether acquired from disease or vaccination)
c. Marker of exposure to the infection (persists for life, does not account for time since infection)
d. Marker of acute or recently acquired HBV infection
(can give false positives)
b. Marker of immunity (indistinguishable whether acquired from disease or vaccination)
84
total anti-HBc
a. Marker of presence of ongoing infection
b. Marker of immunity
(indistinguishable whether acquired from disease or vaccination)
c. Marker of exposure to the infection (persists for life, does not account for time since infection)
d. Marker of acute or recently acquired HBV infection
(can give false positives)
c. Marker of exposure to the infection (persists for life, does not account for time since infection)
85
IgM anti-HbC
a. Marker of presence of ongoing infection
b. Marker of immunity
(indistinguishable whether acquired from disease or vaccination)
c. Marker of exposure to the infection (persists for life, does not account for time since infection)
d. Marker of acute or recently acquired HBV infection
(can give false positives)
d. Marker of acute or recently acquired HBV infection
(can give false positives)
86
HBsAg negative
anti-HBs negative
anti-HBc negative
a. susceptible, never infected (if no documentation of HepB vaccine series completion)
b. resolved infection
c. Immune from receipt of prior vaccination
d. acute infection
e. chronic infection
a. susceptible, never infected (if no documentation of HepB vaccine series completion)
87
HBsAg negative
anti-HBs positive
anti-HBc positive
a. susceptible, never infected (if no documentation of HepB vaccine series completion)
b. resolved infection
c. Immune from receipt of prior vaccination
d. acute infection
e. chronic infection
b. resolved infection
88
HBsAg negative
anti-HBs positive
anti-HBc negative
a. susceptible, never infected (if no documentation of HepB vaccine series completion)
b. resolved infection
c. Immune from receipt of prior vaccination
d. acute infection
e. chronic infection
c. Immune from receipt of prior vaccination
89
HBsAg positive
anti-HBs negative
anti-HBc positive
IgM anti-HBc positive
a. susceptible, never infected (if no documentation of HepB vaccine series completion)
b. resolved infection
c. Immune from receipt of prior vaccination
d. acute infection
e. chronic infection
d. acute infection
90
HBsAg positive
anti-HBs negative
anti-HBc positive
IgM anti-HBc negative
a. susceptible, never infected (if no documentation of HepB vaccine series completion)
b. resolved infection
c. Immune from receipt of prior vaccination
d. acute infection
e. chronic infection
e. chronic infection
91
normal ALT
elevated HBV DNA (++++)
a. e+ immune-tolerant
b. e- inactive (carrier)
c. e+ immune-active
d. e- immune reactivation
e. e+ cirrhosis
f. e- cirrhosis
a. e+ immune-tolerant
92
normal ALT
low/undetectable HBV DNA
a. e+ immune-tolerant
b. e- inactive (carrier)
c. e+ immune-active
d. e- immune reactivation
e. e+ cirrhosis
f. e- cirrhosis
b. e- inactive (carrier)
93
elevated ALT
elevated HBV DNA (+++)
(2 answers)
a. e+ immune-tolerant
b. e- inactive (carrier)
c. e+ immune-active
d. e- immune reactivation
e. e+ cirrhosis
f. e- cirrhosis
c. e+ immune-active
d. e- immune reactivation
94
elevated ALT
elevated HBV DNA (++)
low albumin, low platelets
a. e+ immune-tolerant
b. e- inactive (carrier)
c. e+ immune-active
d. e- immune reactivation
e. e+ cirrhosis
f. e- cirrhosis
e. e+ cirrhosis
f. e- cirrhosis
95
ALT ULN males vs females
males: 35 U/L
females: 25 U/L
96
criteria for treatment eligibility for HepB infection
HBV DNA > 2000 IU/mL PLUS
ALT > 2xULN or cirrhosis
97
tx:
e+ immune tolerant
e- inactive (carrier)
a. monitor
b. treat if ALT > 2xULN, HBV DNA > 20,000
c. treat indefinitely if ALT > 2xULN, HBV DNA > 2,000
d. treat indefinitely if HBV DNA > 2000
a. monitor
98
e+ immune-active
a. monitor
b. treat if ALT > 2xULN, HBV DNA > 20,000
c. treat indefinitely if ALT > 2xULN, HBV DNA > 2,000
d. treat indefinitely if HBV DNA > 2000
b. treat if ALT > 2xULN, HBV DNA > 20,000
(otherwise monitor)
99
e- immune-reactivation
a. monitor
b. treat if ALT > 2xULN, HBV DNA > 20,000
c. treat indefinitely if ALT > 2xULN, HBV DNA > 2,000
d. treat indefinitely if HBV DNA > 2000
c. treat indefinitely if ALT > 2xULN, HBV DNA > 2,000
(otherwise monitor)
100
e+ cirrhosis
e- cirrhosis
a. monitor
b. treat if ALT > 2xULN, HBV DNA > 20,000
c. treat indefinitely if ALT > 2xULN, HBV DNA > 2,000
d. treat indefinitely if HBV DNA > 2000
d. treat indefinitely if HBV DNA > 2000
(otherwise monitor)
101
first-line nucleoside analogs for HBV (3 of them)
tenofovir (TDF)
tenofovir alafenamide (TAF)
entecavir
102
first-line cytokine agent for HBV
peginterferon alfa 2a
103
anti-HCV is detectable ___-___ weeks after infection
8-11 weeks
104
grazoprevir special on-treatment monitoring parameter
ALT check at 8 weeks; d/c if > 5xULN
