ITEMS IN AFP WITH KEYWORD:
Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Individualized treatment plans should take into account clinical and laboratory characteristics and risk of cirrhosis and hepatocellular carcinoma. Peginterferon alfa-2a, entecavir, and tenofovir are considered first-line treatment options. Vaccination is recommended for appropriate patients.
Glecaprevir/pibrentasvir is an effective treatment for any of six genotypes of HCV infection and has few adverse effects. It can be used to treat more genotypes over a shorter duration (eight weeks for patients without cirrhosis) and is substantially less expensive than other available treatments.
The Centers for Disease Control and Prevention encourages family physicians to treat patients with hepatitis C. Outcomes when primary care physicians prescribe direct-acting antivirals to patients with uncomplicated hepatitis C are comparable to those of subspecialists.
The American College of Physicians and Centers for Disease Control and Prevention highlights the consensus among these recommendations, with recent evidence, to develop a best practice advice statement for vaccination, screening, care, and treatment of patients at risk of or who currently have HBV infection.
Jun 1, 2017 Issue
Efficacy of Direct-Acting Antivirals Compared with Older Agents for Hepatitis C [Medicine by the Numbers]
Although they help patients achieve sustained viralogic response, expensive direct-acting antivirals have yet to show that they can succeed in meeting top-priority treatment goals.
Sofosbuvir/velpatasvir is an effective treatment for patients with HCV and has minimal adverse effects. It is the preferred treatment for patients with genotype 2 or 3. As with other curative treatments, it is very expensive.
Elbasvir/grazoprevir is a safe and effective treatment for HCV genotypes 1 and 4, with or without compensated cirrhosis or HIV-1 coinfection. Patients with renal impairment, including those on hemodialysis, can use the medication.
Jan 1, 2016 Issue
Should Family Physicians Routinely Screen Patients for Hepatitis C? No: One-time Screening Still Has Too Many Unanswered Questions [Editorials: Controversies in Family Medicine]
Given current scientific uncertainties, limited resources, and evolving guidelines, a reasonable middle ground would be to focus HCV testing and therapy on patients who are most likely to have long-term complications from the infection.
Jan 1, 2016 Issue
Should Family Physicians Routinely Screen Patients for Hepatitis C? Yes: Screening Makes Sense for High-Risk Adults [Editorials: Controversies in Family Medicine]
For patients to receive appropriate care for their chronic infection and receive curative treatment, they must first know they are infected, and it all begins with screening.
Aug 15, 2015 Issue
Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults [Putting Prevention into Practice]
P.N. is a 35-year-old man whose parents were born in southeast Asia. Although he was born in the United States, P.N. does not have any vaccination records from his childhood. During an office visit, he mentions that a relative was recently diagnosed with hepatitis B virus (HBV) infection and asks whether he should be screened.