Chronic Hepatitis B - Diagnosis and Management Algorithm • Who to treat: Essentially treat the pts with chronic HBV infections who have serologic evidence of hepatitis and viremia or have cirrhosis. • Keep in mind that patients transition between the above phases of chronic HBV and thus periodic monitoring is warranted. • Monitor: CBC. CMP. Quant HBV DNA. Hbe-Ag. anti-Hbe, HIV, HCV. HAV immunity; Liver fibrosis (transient elastographv, liver Bx) • Tx option: first line Entacavir, tenofovir vs interferons, Lamivudine • Tx goal: Reduce liver inflammation (decr ALT). seroconversion of HBsAg or HBeAG. • Seroconversion is very difficult and thus lifelong tx is usually warranted. • Liver is the reservoir of HBV and thus even if viremia is absent the risk of reactivation with immunosuppressive therapy is high. If your interested in learning more-Tang LSY, Covert E, Wilson E, Kottilil S. Chronic Hepatitis B Infection: A Review. JAMA. 2018;319(17):1802–1813. doi:10.1001/jama.2018.3795 #Chronic #HepatitisB #HBV #Algorithm #Diagnosis #Management #Treatment #Hepatology
