Viral Hepatitis Flashcards
HBV e(-) Immune Reactivation
- Inc ALT
- Inc HBV DNA (+++)
- Tx indefinitely IF ALT >2xULN AND HBV DNA > 2,000… if not: MONITOR
HBV e (+) immune-active
- Inc ALT
- Inc HBV DNA (+++)
- Tx IF ALT >2xULN AND HBV DNA >20,000… if not: MONITOR
ULN for ALT - Females and Males
- Females: 25 U/L
- Males: 35 U/L
Sofosbuvir AE/Tx
NS5B Polymerase-i - HCV Tx
- avoid coadmin w/ amiodarone
Peg-IFN-2a AE/Tx
Cytokine - HBV Tx
- CI: DECOMPENSATED LIVER DISEASE, psychosis, depression, neutropenia, Systemic heart disease, seizures
HBV e(-) Inactive (carrier)
- Normal ALT
- low/undetectable HBV DNA (+/-)
- MONITOR
Grazoprevir AE/Tx
NS3/4A Protease-i - HCV Tx
- Check ALT at 8 weeks… DC is ≥5xULN
- Monitor LFTs**
- CI: Child Pugh B/C
Elbasvir AE/Tx
NS5A-i - HCV Tx
- prior to use in pts w/ genotype 1a, a NS5A genotype must be performed to screen for presence of resistance associated substitutions (RAS) at positions 28, 30, 31, or 93
Hepatitis A virus (HAV)
Supportive Care (NO antivirals)
Glecaprevir AE/Tx
NS3/4A Protease-i - HCV Tx
- CI: child pugh C
Tenofovir Disoproxil Fumarate & Tenofovir alafenamide AE/Tx
Neucleoside Analogs - HBV Tx
- ALT flares on withdrawal, nephropathy, lactic acidosis
(TAF safer)
- Teratogenic
Voxilaprevir AE/Tx
NS3/4A Protease-i - HCV Tx
Ribavirin
- Teratogenic
- HCV Tx
Velpatasvir AE/Tx
NS5A-i - HCV Tx
- pior to use in compensated cirrhotic pts w/ genotype 3, a NS5A genotype must be performed to screen for the Y93H substitute
Entecavir AE/Tx
Neucleoside Analog - HBV Tx
- ALT flares on withdrawal, lactic acidosis
- Teratogenic
Ledipasvir AE/Tx
NS5A-i - HCV Tx
HBV e (+) immune-tolerance
- normal ALT
- Inc HBV DNA (++++)
- MONITOR
Pibrentasvir AE/Tx
NS5A-i - HCV Tx
HCV Tx if Y93H Present
VEL/SOF/VOX
Which two drug combos are indicated for all HCV GT’s
- PIB/GLE
- VEL/SOF
HBsAg Positive
the pt is INFECTED
Anti-HBs positive
the pt is IMMUNE
Anti-HBc positive
the pt has been EXPOSED to the virus
IgM Anti-HBc positive
pt has been exposed within the last 6 months
