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Acute VH Definition:: Diffuse Liver Inflammation Lasting Less Than 6 Months
Acute VH Definition:: Diffuse Liver Inflammation Lasting Less Than 6 Months
Examination:
Soft tender enlarged liver Spleen is enlarged in 20 %
10% geralized lymphoadenopathy with Triangle of neck
Clinical Picture
3. Convalescence stage:
LFT:
Blood :
Stool:
Diminished stercobilinogen
Exposure to infection After 3 – 6 ms of 2nd & 3rd generation ELISA or RIBA HCV Ab
not immunity infection test
Indicate active virus After 1 – 2 weeks PCR – quantitative PCR is more HCV
accurate & assess interferon ttt RNA
• Serological gap:
Complete recovary:
Relapse:
Diet:
Improve survival and quality of life by preventing disease progression and HCC
Main endpoint
• Induction of long-term suppression of HBV DNA I 1
Valuable endpoint
• Induction of HBeAg loss (± anti-HBe seroconversion) in HBeAg-positive patients with II-1 1
chronic hepatitis B*
Additional endpoint
• ALT normalization (biochemical response) † II-1 1
Optimal endpoint
• HBsAg loss (± anti-HBs seroconversion) ‡ II-1 1
Should be treated
• Patients with HBeAg-positive or -negative chronic hepatitis B* I 1
• Patients with cirrhosis, any detectable HBV DNA, regardless of ALT level I 1
• Patients with HBV DNA >20,000 IU/mL and ALT >2x ULN, regardless of severity of
histological lesions II-2 1
May be treated
• Patients with HBeAg-positive chronic HBV infection † III 2
>30 years old, regardless of severity of liver histological lesions
Can be treated
• Patients with HBeAg-positive or -negative chronic HBV infection and family history of III 2
HCC or cirrhosis and extrahepatic manifestations ‡
*Defined by HBV DNA >2,000 IU/ml, ALT >ULN and/or at least moderate liver necroinflammation or fibrosis;
†Defined by persistently normal ALT and high HBV DNA levels;
Follow-up every 3 months for the first year and every 6 months thereafter
• HBeAg-negative chronic HBV infection, serum HBV DNA ≥2,000 IU/ml III 1
NO
Consider
Risk of HCC, risk of HBV
reactivation, extrahepatic In case of immunosuppression,
manifestations, risk of YES start oral antiviral prophylaxis
HBV transmission or monitor
• Simeprevir, Sofosbuvir
• a combination of ledipasvir and sofosbuvir
• a combination of ombitasvir, paritaprevir and ritonavir,
taken with or without dasabuvir
• a combination of sofosbuvir and velpatasvir
• a combination of sofosbuvir, velpatasvir and voxilaprevir
• a combination of glecaprevir and pibrentasvir ribavarin
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