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Orv Hetil. 2015 Dec 15;156:25-36. doi: 10.1556/OH.2015.30331.

[In Process Citation].

Orvosi hetilap

[Article in Hungarian]
Gábor Horváth, Zsuzsanna Gerlei, Judit Gervain, Gabriella Lengyel, Mihály Makara, Alajos Pár, László Rókusz, Ferenc Szalay, István Tornai, Klára Werling, Béla Hunyady

Affiliations

  1. Hepatológiai Szakambulancia, Budai Hepatológiai Centrum, Budapest, Szent János Kórház és Észak-budai Egyesített Kórházak Budapest, Egry József u. 1-3. 1111.
  2. Transzplantációs és Sebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
  3. I. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
  4. II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
  5. Egyesített Szent István és Szent László Kórház Budapest.
  6. I. Belgyógyászati Klinika, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs.
  7. I. Belgyógyászati Osztály, MH Egészségügyi Központ Honvédkórház Budapest.
  8. Orvos- és Egészségtudományi Centrum, Belgyógyászati Intézet, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen.
  9. Belgyógyászati Osztály, Somogy Megyei Kaposi Mór Oktató Kórház Kaposvár.

PMID: 26667112 DOI: 10.1556/OH.2015.30331

Abstract

Diagnosis and treatment of HBV/HDV infection means for the patient to be able to maintain working capacity, to increase quality of life, to prevent cancer, and to prolong life expectancy, while society benefits from eliminating the chances of further transmission of the viruses, and decreasing the overall costs of serious complications. The guideline delineates the treatment algorithms for 2016 set by a consensus meeting of physicians involved in the treatment of these diseases. The prevalence of HBV infection in the Hungarian general population is 0.5-0.7%. The indications of treatment is based upon viral examinations (including viral nucleic acid determination), determinations of disease activity and stage (including biochemical, pathologic, and/or non-invasive methods), and excluding contraindications. To avoid unnecessary side effects and for cost-effective approach the guideline stresses the importance of quick and detailed virologic evaluations, the applicability of elastography as an acceptable alternative of liver biopsy in this regard, as well as the relevance of appropriate consistent follow up schedule for viral response during therapy. The first choice of therapy in chronic hepatitis B infection can be pegylated interferon for 48 weeks or continuous ente- cavir or tenofovir therapy. The latter two must be continued for at least 12 months after hepatitis B surface antigen seroconversion. Adefovir dipivoxil is recommended mainly in combination therapy. Lamivudine is no longer a first choice; patients currently taking lamivudine must switch if response is inadequate. Appropriate treatment of patients taking immunosuppressive medications is highly recommended. Pegylated interferon based therapy is recommended for the treatment of concomitant hepatitis D infection. Orv. Hetil., 2015, 156(Suppl. 2) 25-36.

Keywords: adefovir; cirrhosis; entecavir; hepatitis B virus; hepatitis B-vírus; hepatitis D virus; hepatitis D-vírus; interferon; lamivudin; lamivudine; liver cancer; májrák; májzsugor; pegilált interferon; pegylated interferon; tenofovir; viral hepatitis; vírushepatitis

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