Acute hepatitis B Treatment
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Acute hepatitis B Treatment

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MedicYatra provides the safe & best Acute Hepatitis B treatment and procedure at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, ...

MedicYatra provides the safe & best Acute Hepatitis B treatment and procedure at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified doctors are extensively trained and vastly experienced and have performed hundreds of such cases at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com

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  • Rate of progression in perinatally acquired infections is 90%, 20-50% for infections between age 1 and 5
  • Window period: The disappearance of HBsAg (hepatitis B surface antigen) is followed by the appearance of anti-HBs. In some patients, however, anti-HBs may not be detectable until after a window period of several weeks to months. At this time, when neither HBsAg nor anti-HBs can be detected, the serologic diagnosis may be made by the detection of IgM antibodies against hepatitis B core antigen (IgM anti-HBc).
  • Time course: development of encephalopathy within 8 weeks of the onset of symptoms, or within two weeks of developing jaundice. Liver failure is considered “subfulminant” if development of encephalopathy within 6 months but outside the 2 week/8 weeks. Case control study evaluated risk factors for a fulminant course in an outbreak among injection drug users. Compared with control patients, case patients were more likely to have used acetaminophen during their illness (p=.08) and had lost significantly more weight in the six months before illness, used more alcohol, and methamphetamine. Furthermore, all nine isolates were genotype D.
  • Efficacy decreases to 86% in 4 th decade, 47% in sixth decade. response rate is slightly lower in obese individuals, smokers, and men, and significantly lower in patients with cirrhosis or chronic renal failure, organ transplant recipients, children with celiac disease, and immunosuppressed patients.

Acute hepatitis B Treatment Acute hepatitis B Treatment Presentation Transcript

  • Email: enquiry@medicyatra.comAcute Hepatitis B . Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com EpidemiologyIncidence declined in US from 1990 to200570,000 acute Hepatitis B infections in USin 2005Risk factors: sexual exposure, IVDU<5% of acute infections inimmunocompetent adults progress tochronic hepatitis B Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com Clinical ManifestationsIncubation period 1-4 mosProdromal period w/ serumsickness like symptomsThen constitutional sx,anorexia, nausea, jaundiceand RUQ discomfortOnly 30% develop icterichepatitis.70% subclinical or anicterichepatitis.More severe infections inpatients coinfected w/ otherhepatitis viruses or underlyingliver disease Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com DiagnosisTo diagnose acute infection: HBSAg + IgM anti-HBc (also suggestive is +HBeAg)Recovery: Normalization of ALT, disappearanceof HBV DNA, transition from HBSAg to anti-HBsand transition from IgM anti-HBc to IGGChronic: persistence of HBSAg > 6 months Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com DiagnosisCopyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com Laboratory TestingElevated transaminases-values up to1000-2000 IU/L with ALT > ASTSerum bilirubin may be normalProthrombin time best indicator ofprognosisNormalization of transaminases within 1-4months in patients who recoverALT elevated > 6 months indicatesprogression to chronic hepatitis Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com Fulminant Hepatic Failurerapid development of severe acute liverinjury with impaired synthetic function andencephalopathy in a person whopreviously had a normal liver or had well-compensated liver diseaseunusual in Hep B infections-occurs in 0.1to 0.5% of pts due to massive immune-mediated lysis of infected hepatocytes Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com Treatmentmostly supportiveavoid interferon due to increased risk ofhepatic necroinflammationconsider antiviral therapy with lamivudine,telbivudine, adefovir, or entecavir asmonotherapy for short durationdiscontinue treatment after two consectivetests 4 weeks apart confirm patient hascleared HBSAg Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com TreatmentRCT of lamivudine to treat acute Hep B: 71 pts. 31 pts received lamivudine 100 mg daily for 3 mo (group 1), 40 received placebo (group 2) At wk 4, HBV DNA levels significantly lower in treated group (p=0.037), but thereafter levels were similar Improvement in serum bili, ALT, INR values similar in 2 groups Hepatology. 2007 Jan;45(1):97-101 Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com TreatmentAfter 1yr, 93.5% of pts in lamivudine group and96.7% of pts in placebo group lost HBsAgAfter 1yr, 21 pts (67.7%) in treatment group and34 pts (85%) in placebo developed protectiveanti-HBs titersNo deaths in either groupConclusion: No significant biochemical or clinicalimprovement with lamivudine compared toplacebo Hepatology. 2007 Jan;45(1):97-101 Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com Consider Treatment in:Pts w/ a coagulopathy (INR >1.5)Those w/ a protracted course (persistentsymptoms or marked jaundice w/ bilirubin >10mg/dl for more than four weeks)Pts with fulminant hepatitis B (to reduce thelikelihood of reinfection post-liver transplant)Immunocompromised patientsThose with concomitant infection with hepatitis Cor D virus or preexisting liver diseaseElderly patients Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com PreventionHepatitis Bvaccination!Series of three dosesat months 0, 1 to 2,and then 6 to 12In US, universalvaccination of allnewborns isrecommended Copyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com Prevention Vaccinate high risk adults:  Healthcare workers  IV drug users  Household contacts of people w/ Hep B  Pts w/ multiple sexual partners  Men who have sex with men  HD patients  Pts who require repeated transfusions of blood products  Pts w/ chronic liver diseaseCopyright @ Forever Medic Online Pvt. Ltd
  • Email: enquiry@medicyatra.com Efficacypositive immune response isdefined as development ofanti-HBs at a titer of >10 IU/L95% seroconversion in healthyadultsPost-vaccination testing inhealthcare workers/HD pts/ptswho are at risk for recurrentexposure 1-2 mos aftercompletion of vaccination.Nonresponders complete asecond 3-dose vaccinationseries Copyright @ Forever Medic Online Pvt. Ltd