Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
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 infe...
Email: enquiry@medicyatra.com        Clinical ManifestationsIncubation period 1-4 mosProdromal period w/ serumsickness lik...
Email: enquiry@medicyatra.com                  DiagnosisTo diagnose acute infection: HBSAg + IgM anti-HBc (also suggestive...
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 > ASTSeru...
Email: enquiry@medicyatra.com    Fulminant Hepatic Failurerapid development of severe acute liverinjury with impaired synt...
Email: enquiry@medicyatra.com                 Treatmentmostly supportiveavoid interferon due to increased risk ofhepatic n...
Email: enquiry@medicyatra.com                   TreatmentRCT of lamivudine to treat acute Hep B:   71 pts. 31 pts receive...
Email: enquiry@medicyatra.com                  TreatmentAfter 1yr, 93.5% of pts in lamivudine group and96.7% of pts in pla...
Email: enquiry@medicyatra.com    Consider Treatment in:Pts w/ a coagulopathy (INR >1.5)Those w/ a protracted course (persi...
Email: enquiry@medicyatra.com                  PreventionHepatitis Bvaccination!Series of three dosesat months 0, 1 to 2,a...
Email: enquiry@medicyatra.com          Prevention                            Vaccinate high risk                          ...
Email: enquiry@medicyatra.com                        Efficacypositive immune response isdefined as development ofanti-HBs ...
Upcoming SlideShare
Loading in …5
×

Acute hepatitis B Treatment

1,219 views

Published on

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

Published in: Health & Medicine
  • Be the first to comment

Acute hepatitis B Treatment

  1. 1. Email: enquiry@medicyatra.comAcute Hepatitis B . Copyright @ Forever Medic Online Pvt. Ltd
  2. 2. 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
  3. 3. 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
  4. 4. 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
  5. 5. Email: enquiry@medicyatra.com DiagnosisCopyright @ Forever Medic Online Pvt. Ltd
  6. 6. 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
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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
  13. 13. 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
  14. 14. 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

×