Sandbox/HIV: Difference between revisions

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|+'''''HIV co infections'''''
|+'''''Recommended Treatment of Chronic Hepatitis B'''''
! style="background: #4479BA; width: 4%;" | {{fontcolor|#FFF|Coinfection}}
! style="background: #4479BA; width: 4%;" | {{fontcolor|#FFF|Coinfection}}
! style="background: #4479BA; width: 17%;" | {{fontcolor|#FFF|Epidemeology}}
! style="background: #4479BA; width: 17%;" | {{fontcolor|#FFF|Natural history}}
! style="background: #4479BA; width: 16%;" | {{fontcolor|#FFF|Clinical features}}
! style="background: #4479BA; width: 16%;" | {{fontcolor|#FFF|Treatment}}
! style="background: #4479BA; width: 63%;" | {{fontcolor|#FFF|Diagnosis}}
! style="background: #4479BA; width: 63%;" | {{fontcolor|#FFF|Prevention}}
! style="background: #4479BA; width: 4%;" | {{fontcolor|#FFF|Treatment}}
! style="background: #4479BA; width: 4%;" | {{fontcolor|#FFF|Prevention}}
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| style="padding: 5px 5px; background: #F5F5F5;" |'''Hepatitis B'''
| style="padding: 5px 5px; background: #F5F5F5;" |'''heb B'''
| style="padding: 5px 5px; background: #F5F5F5;" |''Hepatitis B virus (HBV) is the leading cause of chronic liver disease worldwide.1,2 Globally and in North
| style="padding: 5px 5px; background: #F5F5F5;" |''HBV is spread through the blood, semen, or other body fluid of a person infected with HBV. Having unprotected sex or sharing drug injection equipment (such as needles or syringes) with a person infected with HBV are the main ways people get HBV. (To prevent HBV infection, people infected with HIV receive the HBV vaccination.)''
America, approximately 10% of HIV-infected patients have evidence of chronic HBV infection.3-5
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In countries with a low prevalence of endemic chronic HBV infection, the virus is transmitted primarily
through sexual contact and injection drug use, whereas perinatal and early childhood exposures are responsible
for most HBV transmission in higher prevalence regions. Although the general modes of transmission are
similar to HIV, HBV is transmitted more efficiently than HIV.1,2,6 HBV has an average incubation period of 90
days (range 60–150 days) from exposure to onset of jaundice and 60 days (range 40–90 days) from exposure to
onset of abnormal liver enzymes. Genotypes of HBV (A–H) have been identified with different geographic
distributions. Genotype A is most common among patients in North America and Western Europe.''
| style="padding: 5px 5px; background: #F5F5F5;" |''Acute infection may be asymptomatic. Symptoms may include right upper quadrant abdominal pain, nausea, vomiting, fever, and arthralgias with or without jaundice. Most patients with chronic HBV infection are
asymptomatic or have non-specific symptoms, such as fatigue, until they develop cirrhosis and signs of
portal hypertension (i.e., ascites, variceal bleeding, coagulopathy, jaundice, or hepatic encephalopathy).
Hepatocellular carcinoma (HCC) is asymptomatic in its early stages and usually, but not always, occurs in
the setting of hepatitis-B- or hepatitis-C-related cirrhosis.''
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*All HIV-infected patients should be tested for HBV infection. Initial testing should include serologic testing ,for surface antigen (HBsAg), hepatitis B core antibody (anti-HBc total), and hepatitis B surface antibody (anti-HBs).
*Chronic HBV infection is defined as persistent HbsAg detected on 2 occasions at least 6 months apart. Patients
with chronic HBV infection should be further tested for HBV e-antigen (HBeAg), antibody to HBeAg (anti-
HBe), and HBV DNA
*The inactive chronic hepatitis B state is characterized by a
negative HBeAg, normal ALT levels, and an HBV DNA level <2,000 international units/mL.
*Patients diagnosed with chronic HBV infection should have a complete blood count, ALT, aspartate
aminotransferase (AST), albumin and bilirubin levels, and prothrombin time monitored at baseline and every
6 months thereafter to assess severity and progression of liver disease
*Liver biopsy with histologic examination remains a valuable tool for characterizing the activity and severity of
chronic hepatitis B and may provide important information in monitoring disease progression, guiding
treatment, and excluding other diseases
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Revision as of 16:42, 16 October 2014

Recommended Treatment of Chronic Hepatitis B
Coinfection Natural history Treatment Prevention
' ' '
heb B HBV is spread through the blood, semen, or other body fluid of a person infected with HBV. Having unprotected sex or sharing drug injection equipment (such as needles or syringes) with a person infected with HBV are the main ways people get HBV. (To prevent HBV infection, people infected with HIV receive the HBV vaccination.) '
' HCV is spread through the blood of a person infected with HCV. Sharing drug injection equipment with a person infected with HCV is the main way people get HCV, butHCV can also be transmitted during unprotected sex. (Before widespread screening of the blood supply began in 1992, HCV was also commonly spread through blood transfusions and organ transplants.) '
' ' '
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