Flashcards in Hepatitis B Tx Deck (20):
Tenofavir plus emtricitabine or lamivudine
Tx of choice in decompensated liver failure?
Tenofavir may used used
Tx of choice in renal insufficiency?
Entacavir preferred with dose modifaction
Tx of choice in woman of child bearing age planning pregnancy in near term?
Tx of choice in female wishing to erradicate virus prior to pregnancy>
1st line Tx?
Entacavir (may be indefinite) or
Tenofavir (may be indefinite) or
PEG interferon for 48 weeks
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.
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.
What is the most common cause of abnormal LFTS?
What is the main RF for NASH?
Adiponectin is reduced in obesity and pts with heaptic steatosis or NASH. T/F
Most common cause of HCC?
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)
E antigen associations?
Higher risk of developing HCC
Surface antigen loss - hardest goal to reach
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
Which of the Hep drugs is more effective at clearing
Tenofavir and Entacavir
Lamivudine no longer used due to resistance (YMDD mutation)
Hep B screening. Who and when?
Screen every 6 months with US +/- AFP.
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
Do not give in cirrhosis - causes ALT flares
If you would like to suppress virus quickly?
Entacavir and Tenofavir if higher rates of suppressing virus quickly