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Flashcards in Hepatitis B Tx Deck (20):
1

HIV co-infection

Tenofavir plus emtricitabine or lamivudine

2

Tx of choice in decompensated liver failure?

Entacavir
Tenofavir may used used

3

Tx of choice in renal insufficiency?

Entacavir preferred with dose modifaction

4

Tx of choice in woman of child bearing age planning pregnancy in near term?

Tenofavir

5

Tx of choice in female wishing to erradicate virus prior to pregnancy>

Interferon

6

1st line Tx?

Entacavir (may be indefinite) or
Tenofavir (may be indefinite) or
PEG interferon for 48 weeks

7

What is the recommendation for a pt deisring pregnancy who is HBV infected?

Mild liver disease and low viraemia
- pregnancy before Tx
Moderate liver disease, no cirrhosis
- Tx before preg, if response, stop Tx before pregnancy
Woman with advanced liver disease
- Tx before and during pregnancy and continue Tx after delivery
Woman with mild liver disease, very high viraemia?
- Tx in last trimester with Tenofavir. Discontinue post partum.

8

HBV reactivation during CTx (HBV dna and increased ALT). Tx?

Prophylactic antiviral therapy at onset of chemotherapy or immunosuppresive therapy.
If baseline HBV DNA 2000 IU/ml, continue until target end pitns reached.

Tenofavir or entecavir preferred.

9

What is the most common cause of abnormal LFTS?

NAFLD

10

What is the main RF for NASH?

Visceral fat/obesity

11

Adiponectin is reduced in obesity and pts with heaptic steatosis or NASH. T/F

True

12

Most common cause of HCC?

Hep B

13

Which drug has resistance associated?

Entecavir and Lamivudine
When switching or adding drugs, use Tenofavir/Adepavir instead if pt has had previous resistance to Lamivudine (same class as Tenofavir)

14

E antigen associations?

Higher risk of developing HCC

Aim to:
Normalise ALT
PCR -ve
Surface antigen loss - hardest goal to reach
prevent cirrhosis

15

Risk associations if Hep B

More likely to develop chronicity.
Do not show signs of jaundice etc as too young to develop immune response to infection.

Worse prognosis than if you develop Hep B after 5 y

16

Which of the Hep drugs is more effective at clearing

Tenofavir and Entacavir
Lamivudine no longer used due to resistance (YMDD mutation)

17

Hep B screening. Who and when?

Screen every 6 months with US +/- AFP.
Screen:
Cirrhosis
Asian male

18

Interferon. Benefits and cons?

Higher rates of e-antigen loss and surface antigen loss (25%) compared with nucleotides.

Finite course, use in pts who want to clear virus

Cons:
Psychiatric illness
Do not give in cirrhosis - causes ALT flares

19

If you would like to suppress virus quickly?

Entacavir and Tenofavir if higher rates of suppressing virus quickly

20

You have to have cirrhosis to develop hcc?

No
Hep B virus is an oncogene