Download Hepatitis B and C: Management and Treatment by Thierry Poynard PDF
By Thierry Poynard
Groupe Hospitalier Pitie-Salpetriere, Paris, France. Pocket reference offers functional rationalization of the traditional heritage and administration of the sickness, and examines the advantages of the latest medications, and their impact. Illustrated with extra then 60 figures and tables.
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Additional info for Hepatitis B and C: Management and Treatment
Sample text
The safety of interferon is discussed in the hepatitis C section. 1 Serious adverse events in each year. Safety database, adapted with permission from GlaxoWellcome. 1). Adefovir was generally well tolerated. 69 40 Hepatitis B and C Management and Treatment HBV DNA (log10 copies/mL) 0 Ϫ1 Ϫ2 Ϫ3 Ϫ4 Ϫ5 BL 2 4 No. 1 Mean changes from baseline in serum HBV DNA measured by PCR during adefovir dipivoxil therapy in HIV/HBV coinfected patients. 68 First-line treatment of chronic hepatitis B: lamivudine or interferon?
Patients with HBV-DNA detectable and with symptoms, or at risk of transmission (infectivity), or with an active cirrhosis should be treated. 1. Ten key points for understanding the natural history of HBV 1. Almost all the mortality of the disease is related to complications of cirrhosis. 2. Rare cases of primary liver cancer can occur in the absence of cirrhosis. 3. One third of infected patients will probably never progress to cirrhosis or to cancer. 4. Definition of healthy carrier (normal transaminases, normal histology, no symptoms) is time dependent and a follow-up is highly recommended.
There was no difference between the two severe stages. 43 Goal of treatment in chronic hepatitis B 4 The optimal goal is to eliminate the virus completely and permanently. 1). 1 Endpoints of treatment in chronic hepatitis B. Endpoints Optimal goal Suppressive goal Seroconversion in HBsAg Seroconversion in HBeAg for wild type Serum HBV-DNA undetectable* Normalization of transaminase activity Disappearance of liver fibrosis Disappearance of necrosis and inflammation Reduction of fibrosis progression Reduction of necrosis and inflammation Improvement of quality of life Reduction of infectivity Reduction of morbidity Reduction of mortality Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No Yes Yes Yes Yes Yes Yes *HBV-DNA detection methods have a large range of sensitivity from 1000 (PCR assay) to 1 million copies per mL Efficacy of interferon 5 Biological effect Interferon-alfa was the first drug approved for the treatment of chronic hepatitis B in 1992 in the United States and Europe.