International Journal of Hepatology / 2011 / Article / Tab 2

Review Article

Treatment of Hepatitis B in Decompensated Liver Cirrhosis

Table 2

General Recommendations in Decompensated HBV Cirrhosis.

Assess disease severityClinical, liver biochemistry, creatinine, INR CTP score, MELD score

Prevent further liver damageAvoid alcohol
Avoid hepatotoxic drugs
Avoid Immunosuppression. Antiviral prophylaxis if necessary
Avoid Aspirin/NSAIDS
Hepatitis A vaccination in nonimmune

Prevent and treatLaboratory and clinical assessment 3 to 6 monthly

ComplicationsEndoscopy at presentation and treat varices accordingly
Be aware of spontaneous infections and treat appropriately
Salt and fluid restriction in ascites control, TIPS
Albumin and terlipressin in hepatorenal syndrome
Antibiotics and nonabsorbable disaccharides in hepatic encephalopathy
Low-protein diet not essential
Regular AFP measurement and ultrasound examination

Antiviral therapyEntecavir
Lamivudine. Replace with entecavir monotherapy, Tenofovir monotherapy, or add on adefovir in cases of lamivudine resistance
Tenofovir
Telbivudine
Adefovir

Liver transplantationPretransplant antiviral therapy in viraemic subjects and immunoprophylaxis using HBIG after transplant

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