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Suggest treatment for chronic hepatitis C infection

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Posted on Wed, 27 May 2015
Question: I need to get this case solved fully
Thanks

I've uploaded the case study, I needed a liver disease speciallist but couldn't find any
doctor
Answered by Dr. Hardik Sanghvi (1 hour later)
Brief Answer:
she may have hepatitis c or other cause.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
I will explain in detail.
1. She has history of hepatitis C and treated with interferon. Her result was negative for hepatitis c.
she may havr chronic hepatitis c occult infection which can not detected by conventional test.
Rigjt now she may have relapse of hepatitis C or reinfection or some other cause. So she should be tested for hepatitis panel.

2. Interferon alone is not effective much in treating all infection. So it can be used with ribavirin and some newer drugs like sofosbuvir or semeprevir. Sofosbuvir is effective drugs and clears most of infection of type 1,4,5 etc.

3. Tegecyclin is brode spectrum antibiotic and It should be used. Any other broad spectrum antibiotics can be used or go with culture and sensitivity test results.

4. Nsaids or opiod should not be used. Paracetamol with XXXXXXX dosage of 2 gm per day is safe and it should be used for pain management.

Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hardik Sanghvi (17 minutes later)
Hey doc
i really appreciate your fast respond
but i think you haven't answered all question or you did but in general.
The whole idea is that if it is possible to include patients presentation whether they're symptoms or result just basically anything in the answer.
I will try to help by cutting parts of the Questions

1a)What is the significance of her HBCAg levels being “largely removed”?

b)What does chronic infection with hepatitis C CAUSE in patients?



2)Interferon alpha was the treatment of choice for clearing hepatitis C from patients
with mixed success.
Indicate a more current humanised antibody treatment that
would be considered and its EFFECTIVNESS



3a)Is tigecycline the best antibiotic of choice in this case? ( Explain in terms of her current condition ( her presentation ) and liver function tests )

b) What else might be considered? Explain



4)What would you recommend for pain management in this patient?



Doctor just imagine you're answering these questions in a assignment.
Thanks
doctor
Answered by Dr. Hardik Sanghvi (1 hour later)
Brief Answer:
I will try to explain in detail.

Detailed Answer:
1. A. Her HBCAg levels being “largely removed” means by the interferon therapy most of the antigen particles are cleared from the circulation. But it does not means complete cure.

1. B. Chronic infection with hepatitis C can cause cirrhosis or hepatocellular carcinoma in the patients.

2. Interferon has mixed success. More current humanized antibody treatment like rebavirin or Sofosbuvir or semiprivir can be considered. Effectiveness of this drugs are higher then interferon. It is 70 to 90% depending on type of hepatitis c and and varies from patient to patients. Like it is more effective against type 1.

3. A. Tigecyclin is best antibiotics of choice in this case. It is broad spectrum antibiotics, very useful in skin infection, newer broad spectrum antibiotics so less chance of resistance. Liver function test is not a issue for tigecyclin in this case.

B. Other broad spectrum antibiotics like cephalosporin or vanomycin can be used.
But best thing to do is culture and sensitivity test of that wound and drug should be given according to sensitivity test.

4. For pain management I recommend paracetamol in dose less then 2 gm per day. Opiods and Other NSAIDS should not be given.

Hepatitis profile and viral load should be done in this case and then start treatment accordingly.
These all drugs are prescription based medicine so consult your doctor and take treatment accordingly.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7043 Questions

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Suggest treatment for chronic hepatitis C infection

Brief Answer: she may have hepatitis c or other cause. Detailed Answer: Hi, dear I have gone through your question. I can understand your concern. I will explain in detail. 1. She has history of hepatitis C and treated with interferon. Her result was negative for hepatitis c. she may havr chronic hepatitis c occult infection which can not detected by conventional test. Rigjt now she may have relapse of hepatitis C or reinfection or some other cause. So she should be tested for hepatitis panel. 2. Interferon alone is not effective much in treating all infection. So it can be used with ribavirin and some newer drugs like sofosbuvir or semeprevir. Sofosbuvir is effective drugs and clears most of infection of type 1,4,5 etc. 3. Tegecyclin is brode spectrum antibiotic and It should be used. Any other broad spectrum antibiotics can be used or go with culture and sensitivity test results. 4. Nsaids or opiod should not be used. Paracetamol with XXXXXXX dosage of 2 gm per day is safe and it should be used for pain management. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.