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18 Cards in this Set
- Front
- Back
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What are the main indications for intervention in acute HBV?
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failure of synthetic function of liver
-lamivudine used in RCT |
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1st thing to check in management of chronic Hep B?
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HBeAg
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If HBeAg is positive, what 2 measures could direct you to treat?
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HBV DNA >20,000 IU/ml
and ALT elevation |
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At what measures should you give no tx for HBeAg positive folks?
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HBV <20,000 IU/ml
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If someone presents with HBV DNA >20,000 IU/ml (HBeAg+) or HBV DNA >2,000IU/ml (HBeAg-) and normal ALTs, what are the next steps?
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monitor ALT levels
consider biopsy have to keep on long-term tx, so consider factors. |
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HBV DNA detectable by PCR in decompensated cirrhosis?
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treat w/ oral agents, combo therapy
no IFN |
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3 good options for suppressing chronic HBV
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entecavir
tenofovir telbivudine |
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All oral nucleosides contain a black box warning for what?
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lactic acidosis
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Patients to tx with HCV
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adults
HCV RNA detectable in serum compensated liver disease (IFN contraindicated otherwise) |
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sustained virologic response means what?
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cure of HCV
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Rapid virologic response is what?
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virus negative at week 4
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Current tx for genotype 1 in HCV
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ribavirin, IFN, protease inhibitor (telaprevir or boceprevir)
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IFN side effects
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depression
blood dyscrasias thyroid disorders fatigue/flu-like |
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RBV side effects
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anemia
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Telaprevir side effects
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rash, anorectal symptoms
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Bocepravir side effects
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anemia
dysgeusia |
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Population more at risk for anemia
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higher starting Hbg, age, reduced CrCl
RBV dose reduction, EPO therapy |
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Genetic polymorphism that demonstrates inc tx response
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IL28B
CC/CT/TT greatest in East Asians |
