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Chronic Hepatitis B - Diagnosis and Management Algorithm

• Who to treat: Essentially treat the pts with
Chronic Hepatitis ... of chronic HBV ... HAV immunity; Liver ... Chronic Hepatitis ... #HepatitisB #HBV
Hepatitis B Virus Serology and Interpretation
HBsAg - Anti-HBs - Anti-HBc - HBeAg - Anti-HBe
 - Acute
Acute hepatitis ... B - Chronic hepatitis ... (about 10% of cases ... ) - Acute hepatitis ... #HBV #Serology
Hepatitis B Phases and Treatment
Phase 1 - HBeAg+ Chronic Infection
Phase 2 - HBeAg+ Chronic Hepatitis
Phase 3
Hepatitis B Phases ... Hepatitis Phase ... Seroconv Occult HBV ... #HBV #HepBV #Phases ... #Treatment #Management
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Viral infections (HAV ... , HBV, HCV, HEV, ... dechallenge • Acute ... or chronic atypical ... hepatitis fibrosis
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... severe liver injury ... liver failure ... #Indications #management ... #hepatology
Here is a quick guide on the common direct-acting antivirals (DAAs) for chronic hepatitis C virus
antivirals (DAAs) for chronic ... (HCV) infection ... DAAs #Antivirals #table ... #treatment #hcv ... #Management #Pharmacology
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... > 20x normal - Acute ... 5-10x normal - Chronic ... #LFTs #transaminitis ... #differential #
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Tests (LFTs) - ... Cirrhosis • Chronic ... Viral Hepatitis ... Hepatopathy • Acute ... Diagnosis #hepatology
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Acute Liver Injury ... - Differential ... • Infectious: HAV ... , HBV, HCV, HEV, ... EBV, HSV, CMV,
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Liver Injury - Differential ... , CMV, HSV • Toxic ... Cancer - Sophia Hayes ... #Injury #Differential ... #algorithm #hepatology