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Hepatitis Treatment

Beschreibung

ID Mindmap am Hepatitis Treatment, erstellt von Emma Jones am 14/09/2013.
Emma Jones
Mindmap von Emma Jones, aktualisiert more than 1 year ago
Emma Jones
Erstellt von Emma Jones vor etwa 11 Jahre
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Zusammenfassung der Ressource

Hepatitis Treatment
  1. Hepatitis B
    1. Pegylated alpha interferon
      1. Expensive, contraindications, side effects
        1. No resistance
          1. 48 wks subcutaneous
            1. eAg+ : low response, high sustained response
              1. eAg- : high response (60%), low sustained response
                1. Flu-like, cytopaenia, depression
                2. Oral anti-virals: suppress viral replication
                  1. Examples
                    1. Lamivudine: no longer used due to low durability of response
                      1. Adefovir: poor response durability @5yrs
                        1. Entecavir
                          1. Tenofovir
                          2. Effectiveness: high response to treatment, low retained response
                            1. Side effects: few
                              1. 1/day indefinitely
                            2. Hepatitis C
                              1. Pegylated alpha interferon + Ribavirin
                                1. Duration
                                  1. Genotypes 1&4: 48 weeks, 45% success
                                    1. Genotypes 2&3: 24 weeks, 80% success
                                    2. Side effects
                                      1. Pegylated interferon: fatigue, malaise, neutropaenia, thrombocytopaenia, depression, insomnia, weight loss, alopecia
                                        1. Ribavirin: pruritis, anaemia, rash, nasal congestion
                                        2. Contraindications
                                          1. Interferon: severe depression, psychosis, cardiac failure, autoimmune disease, pregnancy
                                            1. Ribavirin: renal failure, pregnancy
                                          2. HCV N23/4A inhibitors
                                            1. Boceprevir
                                              1. Anaemia, dysuguesia
                                                1. 68% sustained response
                                                2. Telaprevir
                                                  1. Severe rash, anaemia, nausea
                                                    1. 75% sustained response
                                                    2. Clinical use
                                                      1. Genotype 1 only
                                                        1. Triple Therapy with IFN/Ribavirin: reduced tolerance due to combined side effects
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