Treatment Of Antiviral Special Cases In Patients With Chronic Hepatitis B

Application of chemotherapy and immunosuppressive therapy:

HBsAg is routinely screened for patients treated with other diseases. If positive, lamivudine or other nucleoside analogues are taken at 1 week before treatment. HBsAg negative, anti-HBc positive patients, should be closely monitored HBV DNA and HBsAg, if there is a positive turn should be added with antiviral therapy.

HBV / HCV co-infected patients:

First determine the kind of virus dominant, and then decide how to treat. HCV RNA levels are high and can detect HCV RNA, should first use the standard dose of pegylated interferon and ribavirin treatment for 3 months, such as HBV DNA no response or elevated, then add lamivudine Or entecavir or adefovir dipivoxil.

Hepatitis B-induced primary hepatocellular carcinoma:

HBV DNA levels are one of the independent risk factors for predicting recurrence after HCC hepatectomy, and antiviral therapy can significantly prolong the survival of patients with hepatocellular carcinoma. Therefore, non-terminal HCC patients with HBV DNA positive suggest the use of nucleosides Acid) analogue antiviral therapy.

Liver transplant patients:

For patients with HBV-related diseases who are prepared to undergo liver transplantation, such as HBV DNA can be detected, preferably taking lamivudine at 1 to 3 months prior to liver transplantation, 100 mg daily orally; HBIG ; Long-term use of lamivudine and low-dose HBIG.

Child patient:

For children over 12 years of age (weight ≥ 35kg) chronic hepatitis B children, the general interferon treatment indications, efficacy and safety similar to adults, the dose of 3-6 MU / m2, the maximum dose of not more than 10MU / m2, Also available as an adult dose and treatment with lamivudine, or adefovir dipivoxil.

Pregnancy:

In the case of oral administration of antiviral drugs, if the application of lamivudine or other pregnancy class B drugs (telbivudine or tenofovir), in the full to inform the risk, weigh the pros and cons, the patient signed informed In the case of consent, treatment can continue.