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Hepato (extraheptic s/s (splenomegaly, vasculitis, aplastic aneia,…

- - - - Acute infection: anti-HAV IBM
    - - Vaccination
    - - recover within few months
      - Standard precaution
      - anti-HAV ig
      - passive immunity for 6 months
      - prophylaxis within 2 weeks post exposure
      - not required for vaccination 1 months prior to exposure
      - supportive treatment
  - - - Acute infection: HBsAg
      - lifelong HBsAb immunity develop
      - serum HBV DNA
    - - vaccination
      - supportive treatment
        
        nutrient
        
        antacid
        
        antiemetic
        
        fluid therapy for persisting vomit
      - standard preaution
      - mointor for LFT
      - Test for co exist HIV & HCV
      - fulminant hepatitis
      - antivral agents for chronic hep B
        
        refer to onenote
      - liver transplant if needed
      - education
        
        barrier protection during intercourse
        
        mointor for chronicity
        
        HBsAg
        
        anti-HBs
        
        Persistent HBsAg & HBeAg
      - Monitor for complication
        
        LFT & alpha-fetoprotein
        
        USG for cirrhosis, portal hypertension/ tumor
      - antiviral agent
        
        interferon alpha
      - nucleoside analogues
        
        lamivudine
        
        adefovir
    - - sponteanous reactivation
      - flare due to immune sppression,
      - induced by antiviral therapy
      - superimposed infection
      - alcohol, meds, drugs
  - - - significant fibrosis
        
        cirrhosis
- - - - ALT/SGPT ; AST/SGOT
      - AP Akaline phosptase
      - GGT gamma glutamyl traspeptidase
      - bilurubin
    - - PT Prothrombin time
      - serum albumin
  - - - HBcAg
        
        core
        
        anti-HBc
      - HBsAg
        
        Surface
      - HBeAg
        
        independent protein in blood
      - HBxAg
        
        Gene of X gene HBV D