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The flashcards below were created by user
kyleannkelsey
on FreezingBlue Flashcards.
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An antibody to what antigen will be produced in response to Hep B vaccination?
HBsAg
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If ________ antigen is present greater than or equal to 6 months after infection is detected, a chronic infection is indicated.
HBsAg
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I f a Hep B mutant strain does not produce what antigen, would you expect treatment to be refractory?
HBeAg
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What are the symptoms of Chronic Hep B that has progressed to fulminant hepatic failure?
Jaundice, diarrhea, cola colored urine, pale stools, ascites, hepatic encephalopathy
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Aute symptoms of HBV require what treatment?
Non, self-resolving
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What are the phases of HBV?
- Incubation of weeks to months
- Prodromal symptomic phase
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What consitiutes a diagnosis of chronic infection by HBV?
- HBsAg for > 6 months
- HBV DNA > 105 copies/mL and elevated AST/ALT
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What indicated protective immunity to Hep B conferred by a vaccine?
- (+) Anti-HBs
- AND
- (-) HBsAg
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What options of prevention are available for Hep B?
Vaccination and Passive immunity (HBV immunoglobulin)
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What are the indications for Hep B treatment?
- + HBsAg for > 6 months with elevated AST/ALT enzymes
- OR
- + HBeAg with measurable HBV DNA in serum
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What are the goals of therapy for HBV treatment?
- Disspaearance of HBV DNA, HBeAg and normal AST/ALT
- Prevent progression to cirrhosis or carcinoma
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What are the drugs approved for first –line treatment of chronic Hep B?
- Interferon α2b
- Pegylated interferon α2a
- Lamivudine
- Adefovir
- Entecavir
- Tenofovir
- Telbivudine
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What are the oral drugs available for chronic Hep B?
- Nucleoside analogs:
- Lamivudine
- Entecavir
- Telbivudine
- Nucleotide analogs:
- Adefovir
- Tenofovir
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By what route are Interferon α2b and Pegylated interferon α2a administered?
SQ
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What I steh MOA of interferson treatments for Hep B (Interferon alpha2b and Pegylated interferon alpha2a)?
Inhibits viral replication and stimulates the immune system to clear infected cells
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When are Interferon alpha2b and Pegylated interferon alpha2a CI?
Don’t use in decompensated cirrhosis present
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How long does an Interferon alpha2b and Pegylated interferon alpha2a treatment take for HBV?
Duration of therapy 12-24 months
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What Preparations of interferon are available in U.S. with indications for HBV?
- Alpha-2b (Intron A)
- PEG-interferon Alpha-2a (Pegasys)
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What is the efficacy of Interferon alpha2b and Pegylated interferon alpha2a in HBV treatment?
- 30-40% have undetectable levels of HBV DNA or HBeAg
- Genotypes A&B may respond better than C&D
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What are the side effects of Interferon α2b and Pegylated interferon α2a?
Flu like illness (can pretreat), Depression/anxiety, neutropenia, thrombocytopenia, anemia
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What drugs are preferred for treatment of HBV if ALT >2xULN?
- Entecavir
- Tenofovir
- Interferon-alpha or Peginterferon-alpha
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What drugs are preferred for treatment of HBV if HBV viral load is > 2000 U/mL?
- Entecavir
- Tenofovir
- Adefovir
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What pretreatments can help alleviate side effects in interferon treatment of HBV?
- Benadryl for injection site reactions
- Tylenol for myalgias and fever associated with flu like SEs
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Which interferon is superior and why?
Pegylated interferon alpha2a because it only as to be give weekly (long t1/2)
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What is the drug regimen if detectable HBV viral load is accompanied w/Decompensated Cirrhosis in HBV?
- Lamivudine or Telbivudine
- PLUS
- Adefovir, Tenofovir, or Entecavir
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