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MONITORING OF PATIENTS WITH CHRONIC HEPATITIS DURING AND AFTER THERAPY
Vesna ČOLIĆ-CVRLJE
; Merkur University Hospital, School of Medicine, University of Zagreb, Clinical Department of Internal Medicine, Zagreb, Croatia
RAJKO OSTOJIĆ
; School of Medicine, University of Zagreb, Zagreb University Hospital Center, Clinical Department of Internal Medicine, Department of Gastroenterology, Zagreb, Croatia
Abstract
Different effective treatments, which are today available for chronic virus hepatitis C and B, reduce the rate of adverse outcomes but HCV and HBV infections are still one of the major health and public medical problems. Screening for HCV and HBV is performed only in high-risk groups with diagnostic tests with high sensitivity and specificity. In HCV antibody positive patients, serum HCV RNA has to be determined by quantitative assay and virus genotype identified. Liver fibrosis is determined by liver biopsy or widely accepted elastography and different serum fibrosis markers. In patients with HCV cirrhosis, HCC has to be detected by expert ultrasound performer or MSCT, MR, and liver transplantation performed according to indications. The current hepatitis B vaccination policy is universal neonatal vaccination. The risk population undergo screening for HBsAg, antiHBc and antiHBs antibodies. The HBsAg, HBeAg and antiHBe positive individuals undergo quantitative testing for HBsAg and HBV DNA. According to the stage of their liver disease, patients are treated with interferon or nucleos(t)ide analogues. The optimal treatment with oral antivirals are entecavir and tenofovir, but the duration of treatment with nucleos(t)ide analogues is generally life-long. In HBV cirrhosis and HBsAg inactive carriers, detection of HCC is essential, and liver transplantation is successfully performed in these patients.
Keywords
hepatitis C; hepatitis B; screening; monitoring
Hrčak ID:
113722
URI
Publication date:
14.1.2014.
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