Case of Hepatitis B

Had received a report of raised AST and ALT raised to approx 1000+ from a friend about his employee, who is 27 years Male, occasional alcoholic Asked him to get investigations - HBsAg, Anti HCV, USG W/A, LFT, CBC It revealed a case of Hepatitis B Chief Complaints Complaints of only pain abdomen lasting for hours and start 1 hour after food Management Started him on - Tab Usibon 300mg 1 tab BD, Tab Liv 52 HB 2 tabs BD, Glucon D 2 tbsf in glass of water thrice daily, Voveron 75 mg SR SOS Pantocar D od BBF My concern is - As HBV DNA is not done, could Tenofovir D fumarate 300mg OD be started ? If yes, then how long and how to follow up patient for HBsAg and LFT ?

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Antiviral therapy like tenofovir is to be given in chronic active hepatitis B cases. So HBc IgM to rule out chronic (neg) or active (positive) status. If negative, consider HBV DNA PCR. If higher, may start antiviral therapy. Average 18 to 24 months therapy is indicated.

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Yes tenfovir or heptavir 300mg 1bd can started for 3to 6 months Better check viral load so long quantitatively it is higher it is to be given even it may be given life long on maintenance dose

Thanx dr Vipin Bihari Jain
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Stool first HBV DNA and viral load If high then only start antiviral Rest in acute episode treat as viral hepatitis As you are doing good management

Do hbeag If positive then anti viral drug If negative check 6 monthly Hbsag Nirocil bd

CASE OF HEPATITIS B 27 YEARS OLD MALE IN SUCH CASES ONE HASVTO BE VERY CAREFUL IF ANY PROCURE.HAS TO BE UNDERTSKEN

Infective Hepatitis With Cholestatic pattern

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