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Chapter59
Viral Hepatitis
12
Medical
Professional
10/04/2011

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Term
Viruses that cause Viral Hepatitis?
Definition
HAV, HBV, HCV, HDV, HEV
Term
What are the virus types for HAV, HBV,HCV,HDV,HEV ?
Definition
ALL are RNA, except HBV, which is DNA
Term
Definition of undetectable serum HBV DNA, and HCV RNA
Definition
Concentration of < 15 IU/ml

this is one of the goals of therapy
Term
What Viruses are there specific vaccines for ?
Definition
A & B
Term
How long is the HAV vaccine effective ?
Definition
10 years
Term
Acute Viral Hepatitis Definition & treatment
Definition
Definition: viral hepatic infection present for <6 months

Avoid alcohol until normalization, stop all hepatotoxic drugs. If has prolonged INR >1.4 administer vitamin K. Patients often become constipated due to encephalopathy and require lactulose.

If it is HCV RNA, that has persisted for 12 weeks, consider treatment with peginterferon.
Term
If a patient has acute viral hepatitis, with HCV RNA > 12 weeks, what can be administered?
Definition
If it is HCV RNA, that has persisted for 12 weeks, consider treatment with peginterferon.
Term
Definition of Chronic Viral Hepatitis
Definition
Definition of Chronic Viral Hepatitis:

Lasting longer than 6 months
Term
DOC vs. Chronic Hepatitis B
Definition
Chronic Hepatitis B

DOC: Peginterferon alfa
Term
Other Drugs that can be used against Chronic HBV: Lamivudine, Entecavir, Adefovir

Which is associated with highest rates of resistance, but improved outcomes in patients with decompensated cirhosis?

Lowest rates of resistance?
Definition
Other Drugs that can be used against Chronic HBV: Lamivudine, Entecavir, Adefovir

Which is associated with highest rates of resistance, but improved outcomes in patients with decompensated cirhosis:
Lamivudine

Lowest rates of resistance: Entecavir
Term
Treatment of Chronic Hepatitis C

How long should treatment last for the different genotypes?
Definition
Peginterferon alfa + ribavirin (peginterferon alfa monotherapy if cannot tolerate, or contraindicated to ribavirin)

*Use peginterferon alfa for both chronic and acute HCV RNA (if acute > 12 weeks)

HCV genotype 1: 48 weeks, genotypes 2 & 3: 24 weeks
Term
Common SE of ribavirin?
Definition
Common SE of Ribavirin is Hemolytic anemia, and its often dose limiting
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