Chronic hepatitis B- what should we know?

Chronic hepatitis B is a challenging problem in the world more so in the south East Asia region. India has intermediate prevalence of hepatitis B. Mostly it is transmitted from mother to child at the time of birth. Even after birth horizontal transmission in the family (with in family members) is quite high. As chronic hepatitis B is usually asymptomatic (without any problems) till adulthood this condition is diagnosed at a later stage i.e. liver failure.

Once chronic hepatitis B is diagnosed it is very difficult to decide on treatment, whether patient requires treatment or not. There are many guidelines but are different slightly in their indications for treatment.

Mainly ASSLD (American association for study of liver diseases) guidelines are followed. In simple terms once patient is diagnosed to have chronic hepatitis B following tests needs to be done.

Quantitative hepatitis B DNA levels

HBe antigen and antibody

Ultrasound abdomen

Liver function test

Serum creatinine

Based on results of these tests one has to decide on treating hepatitis B. In those with HBe Ag +, DNA levels >2000 IU/L, age >30 years and In those with HBeAg  negativity, DNA levels>20,000 IU/L antiviral treatment is indicated.

In case of chronic liver disease in ultrasound or in those with decompensated chronic liver disease, treatment is indicated irrespective of e Ag status or DNA level cut-off.

At present best available antiviral for hepatitis B are Entecavir and Tenefovir.  Economy mainly determines which is to be started as both have good efficacy and high barrier for resistance. These drugs have minimal side effects, Tenefovir can cause renal tubular defect rarely. It’s advisable to check serum creatinine and calcium once a year in those who are on Tenefovir.

Once patient is on treatment it is advisable to check DNA levels once a year and SGOT and SGPT once in 3 months.

Beyond 40 years of age those with chronic hepatitis B should undergo ultrasound abdomen as a part of hepatocellular carcinoma surveillance.

Once started on antiviral for all practical purpose treatment is to be continued for life long. Except for in specific conditions like in those who attains HBsAg loss can discontinue therapy.

One more important condition where in antiviral to be started irrespective of DNA levels is in those with malignancy planning chemotherapy or in those with diseases requiring long term steroid therapy. In these cases treatment needs to be continued for 6 months after discontinuing chemotherapy or steroid. This is to prevent acute flare which may be even life threatening rarely.

 

hepatitis-s1-liver-hepatitis-virus

Likes(2)Dislikes(0)
Please follow and like us:

395 thoughts on “Chronic hepatitis B- what should we know?”

  1. Pingback: sildenafil
  2. Pingback: viagra generic
  3. Pingback: cheap ed pills
  4. Pingback: generic ed pills
  5. Pingback: cialis generic
  6. Pingback: Buy cialis online
  7. Pingback: generic vardenafil
  8. Pingback: vardenafil pills
  9. Pingback: free viagra
  10. Знаете ли вы?
    Во время немецкой оккупации Украины радио на украинском языке вещало из Саратова и Москвы.
    Ливийский диктатор пытался спасти от казни премьер-министра Пакистана.
    Российских легкоалетов могут сурово наказать за действия чиновников от спорта.
    В 1941 году в московскую «Писательскую роту» пришли добровольцами бывший вор и следователь ЧК.
    Молнию можно не только увидеть, но и съесть.

    [url=http://arbeca.net/]arbeca[/url]

    Likes(0)Dislikes(0)
  11. Pingback: online slots
  12. synthroid doses levothyroxine dosage would levothyroxine cause a blood work to show as ritalin for adults [url=https://synthroidr.com/#]cheap levothyroxine[/url] buy synthroid https://synthroidr.com/# - synthroid dosage synthroid doses

    Likes(0)Dislikes(0)
  13. 923421 where to buy viagra in europe

    [url=https://kaufenvia20.com/]viagra kaufen mit mastercard[/url]

    cialis viagra online pharmacy

    Likes(0)Dislikes(0)
  14. atorvastatin side effects atorvastatin 10 mg lipitor medication [url=https://lipitormedication.com/]atorvastatin 40 mg[/url] cheap lipitor https://lipitormedication.com/ - atorvastatin calcium atorvastatin 40mg tablets

    Likes(0)Dislikes(0)
  15. Pingback: loans online
  16. Pingback: payday advance
  17. Pingback: my borgata
  18. Pingback: fair go casino
  19. Pingback: casino real money
  20. Pingback: short term loans
  21. Beneficial forum posts. Many thanks! thesis paper
    [url=http://radiobanadir.com/ministry-of-post-telecom-inaugurates-communication-rooms-project/#comment-136361]h83afmx j41cia[/url] 2454041

    Likes(0)Dislikes(0)
  22. You explained this adequately. canadian viagra
    [url=https://eng.scaglioni.it/main/products/curtain-rods/wrought-iron-collection/oe-20/ottante-art.20i064/%28now%29/1595220483/%28error%29/form_886#back886]o873gcb o878ow[/url] c176870

    Likes(0)Dislikes(0)
  23. Pingback: viagra pills
  24. Fine tips. Kudos! viagra for sale uk
    [url=https://eng.scaglioni.it/main/products/curtain-rods/wrought-iron-collection/oe-20/ottante-art.20i064/%28now%29/1595100526/%28error%29/form_886#back886]n36amc8 l58rlq[/url] 0eb42e0

    Likes(0)Dislikes(0)
  25. You said that wonderfully! viagra no prior prescription [url=https://daleel.arza2.com/free_profession/2924/ШЇЩѓШЄЩ€Ш±-Щ…Ш­Щ…ШЇ-Ш±Ш¬ШЁ-ШЄШ®ШµШµ-ШіЩѓШ±-Щ€ШєШЇШЇ-ШµЩ…Ш§ШЎ-ШЁШ№ЩЉЩ†-ШґЩ…Ші-ШґШ§Ш±Ш№-Ш§Щ„ШµШ­Щ‡-Ш§Щ„Щ‚Ш§Щ‡Ш±Ш©-Ш№ЩЉЩ†-ШґЩ…Ші-Ш·ШЁЩ‰-Щ€Ш№Щ„Ш§Ш¬Щ‰-ШіЩѓШ±-Щ€ШєШЇШЇ-ШµЩ…Ш§ШЎ-ШіЩѓШ±-Щ€ШєШЇШЇ-ШµЩ…Ш§ШЎ-ШЇЩ„ЩЉЩ„-ШЈШ±ШІШ§Щ‚]d10mcbc b51efn[/url] 42e0824

    Likes(0)Dislikes(0)
  26. Really plenty of wonderful advice! cialis tablets
    [url=https://www.blogger.com/comment.g?blogID=7918657404122087712&postID=3894959756407577288&page=1&token=1593465923525&isPopup=true&bpli=1]t569we4 a93rou[/url] 0eb42e0

    Likes(0)Dislikes(0)
  27. Pingback: cialis internet
  28. Pingback: cialis generic
  29. Pingback: cialis 5 mg
  30. Pingback: buy cialis
  31. Pingback: buy cialis
  32. Pingback: casinos
  33. Pingback: chumba casino
  34. Hello. And Bye.
    http://www.viagra-online-withoutprescription.org/
    [url=http://www.viagra-online-withoutprescription.org/]viagra-online-withoutprescription.org[/url]

    Likes(0)Dislikes(0)
  35. Pingback: viagra dosage
  36. Pingback: viagra dosage
  37. Pingback: levitra
  38. Funky Town Tone.
    MENS WETSUITS.
    Stainless Grasshopper.
    https://cannabisgreenbook.org/spoon-pipe-reddit.html
    https://cannabisgreenbook.org/pouch-rolling-papers.html
    https://cannabisgreenbook.org/best-hemp-wraps.html
    Best Lyric: “I was gonna make love to you but then I got high/ I was gonna eat yo’ pussy too but then I got high/ Now I’m jacking off and I know why” The process of production of the transparent paper does NOT alter the chemical nature of the cellulose film and for this the process of production uses chemically inert, insoluble, infusible and innocuous material.

    Likes(0)Dislikes(0)
  39. Pingback: purchase viagra
  40. Hello. And Bye. female viagra pill walmart
    get viagra plus how to get a viagra soft tabs prescription from your doctor http://www.viagra-online-withoutprescription.org/ how much does viagra professional cost
    [url=http://www.viagra-online-withoutprescription.org/]average age of man taking viagra [/url]
    how much viagra with dapoxetine cost
    how to order viagra gold online
    generic viagra over the counter
    where can i buy viagra plus over the counter
    can you buy viagra professional without a prescription
    how to tell if a man is taking viagra

    Likes(0)Dislikes(0)
  41. Pingback: tadalafil generic
  42. Hello. And Bye. get viagra super active prescription online
    viagra super force online canadian pharmacy how much does viagra super active cost http://www.viagra-online-withoutprescription.org/ viagra pill
    [url=http://www.viagra-online-withoutprescription.org/]street value of viagra [/url]
    how to get viagra sublingual in the us
    how to buy cheap viagra super force
    los viagras
    viagra 10 0mg
    viagra with dapoxetine online without prescription
    generic viagra with fluoxetine online
    bluechew viagra

    Likes(0)Dislikes(0)
  43. Pingback: when to buy viagra
  44. You made some really good points there. I checked on the internet to find out more about the issue and found most people will go along with your views on this web site.

    Likes(0)Dislikes(0)
  45. loanmart personal loans [url=https://personalloans02.com]https://www.personalloans02.com[/url] penfed personal loans.
    free cash online casino no deposit [url=https://onlinecasinonodeposit002.com]https://onlinecasinonodeposit002.com[/url] online gambling casino real money.

    Likes(0)Dislikes(0)
  46. Pingback: casinos
  47. should i take a 50 or a 100 mg viagra pill
    buy viagra pills https://www.v1agrabuy.com/ purchase viagra online
    videos how female having sex after taking viagra

    Likes(0)Dislikes(0)
  48. Pingback: viagra buy

Leave a Reply