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Chronic Hepatitis B - Diagnosis and Management Algorithm

• Who to treat: Essentially treat the pts with
Chronic Hepatitis ... Chronic Hepatitis ... #HepatitisB #HBV ... #Management #Treatment ... #Hepatology
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... normal - Infection (EBV ... 5-10x normal - Chronic ... #Injury #hepatology ... #LFTs #transaminitis
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... non-essential drug/HDS treatments ... , HBV, HCV, HEV, ... Hepatic ischaemia ... #hepatology
Here is a quick guide on the common direct-acting antivirals (DAAs) for chronic hepatitis C virus
quick guide on the common ... antivirals (DAAs) for chronic ... Antivirals #table #treatment ... infectiousdisease #hepatology ... #Management #Pharmacology
Hepatocellular Liver Injury - Differential Diagnosis Framework:
Liver Injury → liver test abnormalities without evidence of liver
• Infections: Hepatitis ... • Vascular: Ischemic ... Differential #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Elevated Liver Enzymes ... Drugs/Toxins • Ischemia ... • Alcoholic hepatitis ... Bile Ducts • Common ... • Others #LFTs
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI)

DILI Types:
 • Intrinsic - predictable, dose dependent
Idiosyncratic - less common ... presentation • Chronic ... - ongoing ↑ LFTs ... gastroenterology #algorithm ... gastroenterology #hepatology
Autoimmune Hepatitis

Clinical Presentation
 - Highly variable clinical presentation, from subclinical disease to acute liver failure.
 -
disease to acute liver ... - Symptoms of chronic ... arthralgias) are common ... regarding need for treatment ... #Hepatology
Common Variable Immunodeficiency (CVID)

What?
CVID: Immunodeficiency disorder with hypogammaglobulinemia -> increased infection risk secondary to impaired B-cell
Autoimmunity • Chronic ... disease • Liver ... diseases and hepatitis ... Malignancies • Chronic ... #diagnosis #management