Viral Hepatitis - dr kutzer

what type of virus is hepatitis A?

nonenveloped RNA virus

who should receive a hepatitis A vaccine?

all children at 1 year old

unvaccinated children ages 2-18

traveling or working with high infection rates

persons at occupational risk

anyone who would like a HAV vaccine

what vaccines are available for hepatitis?

havrix

vaqta

twinrix

engerix-B

recombivax

heplisav

what vaccines are for hepatitis A only?

havrix

vaqta

what vaccines are for hepatitis B only?

engerix-B

recombivax

heplisav

what vaccine is for Hep A and Hep B?

twinrix

if HbsAg is negative, what can this mean?

susceptible

past HBV infection resolved

immune bc of vaccination

if HbsAg is positive, what can this mean?

acute or chronic infection

contagious

what is considered a chronic HBV infection?

HBsAg for > 6 months

if anti-HBc is positive, is management needed?

NO

unless undergoing immunosuppressive therapy or chemo

HBeAg is present during _________

acute infection

what antigen is not easily detected?

HBcAg

if a patient only has anti-HBs, what does this indicate?

vaccinated

criteria for treatment of HBV

active HBV

compensated or decompensated cirrhosis with any HBV DNA level

family history of HCC or cirrhosis

prior history of HBV treatment

extrahepatic manifestation of HBV

what is considered active HBV?

HBsAg positive, with or without HBeAg

HBV DNA > 2,000 IU/mL

ALT 2x ULN

who gets entecavir 0.5 mg daily when they have hep B?

adults who are treatment naiive

or

non-lamivudine resistant

who gets entecavir 1.0 mg daily when they have hep B?

lamivudine experienced pts

or

pts with decompensated cirrhosis

what are the advantages of tenofovir AF over DF?

smaller changes in GFR

improved bone safety

delivered directly to the hepatocyte and an improved action against HBV replication

what treatment is recommended for HepB in pregnancy?

tenofovir DF (third trimester)

what type of virus is HepC?

single stranded RNA virus

what is the ROA for DAA medication?

oral

what DAA covers all the genotypes of HepC?

glecaprevir/pibrentasvir

what is the dose of glecaprevir/pibrentasvir?

100 mg/140 mg