By Thierry Poynard
Groupe Hospitalier Pitie-Salpetriere, Paris, France. Pocket reference presents functional rationalization of the traditional heritage and administration of the ailment, and examines some great benefits of the newest medicinal drugs, and their influence. Illustrated with extra then 60 figures and tables.
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Additional info for Hepatitis B and C: Management and Treatment
One possibility is to start with lamivudine and to switch to interferon if resistant mutant occurs. The development of adefovir and entecavir are also reassuring for the management of resistant mutant. 2). 1 Advantages and disadvantages of lamivudine and interferon. Advantages Disadvantages Lamivudine • Oral administration • Minimal adverse events • Useful in decompensated cirrhosis • Useful in post-transplantation • Fast efficacy on transaminases and HBV-DNA Interferon • Short course: 16–24 weeks • No drug-resistant mutants • Well-established track record • Long duration of therapy • Resistant mutants • Durability of response?
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. Who needs to be treated and how to explain the goals to the patient 5.
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. Who needs to be treated and how to explain the goals to the patient 5. Despite the risk of fibrosis a patient can be treated for extra-hepatic manifestation or to prevent transmission of the virus.
Hepatitis B and C: Management and Treatment by Thierry Poynard