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Med Virology-HBV 2 - Coggle Diagram
Med Virology-HBV 2
Diagnosis
Anti-HBs
-antibody against surface antigens(positive:immune , negative>at risk
anti-HBc IgM
(acute infection) anti-HBc total(past/chronic)
HBsAg
(positive-infected)
HBeAg
-active replication
Anti-HBe-virus
not replicating
HBV DNA
-indicates virus replication(monitor treatment)
Treatment
Chronic
: Treatment used in Combination ,response rate(30-40%) , 2 main treatments>Nucleotide & nucleoside Reverse transcriptase Inhibitor(
ADV , ETV, CLV, LdT
,
3TC,FTC,TDV
)
AND
alpha interferons (reduces side effects)
Hepatocellular carcinoma(HCC):chemoterapy,resection,ablation
Acute
: supportive only
HCC+Cirrhosis>Liver transplantation
Occult HBV infection
detected by HB DNA
HBsAg not detected easily
Low virus replication
Prevention
Vaccination:
Original
-serum based from blood of infected person ,
Currrent
:from recombinant HBsAg gene in yeast produce proteins,
3rd generation
:3 proteins(
HBsAg, Pre-S1,Pre-S2
), More immunogenic
Course: Normal(0/1/6) , accelerated:(0/1/2/6) , 0/1/3/6
PEP
Adults
: since 1995, Ab(-)>test infection , Immunoglobulin+ vaccine course(0/1/2/6 , 0/1/3/6) , Ab(-)>Safe
Babies
(vaccinated at 6/10/14 weeks)
Mutants
HBsAg mutants
>inability to detect HBeAg
Pre-core mutants
>faulty HBeAg