Phys Vivas · infectious
Viral Hepatitis — Viva Defence
Structured DCE viva for infectious-diseases viral hepatitis: long-case defence of a man with chronic hepatitis B and fluctuating ALT — phase assignment, treat-versus-watch, antiviral selection, HCC surveillance, HDV screening and family protection.
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Prompt
Structured DCE viva for infectious-diseases viral hepatitis: long-case defence of a man with chronic hepatitis B and fluctuating ALT — phase assignment, treat-versus-watch, antiviral selection, HCC surveillance, HDV screening and family protection.
Opening statement (delivered aloud)
"Mr Tran is a 45-year-old man born in Vietnam with chronic hepatitis B, referred after his ALT fluctuated between 38 and 118 U/L over 18 months. He is HBeAg negative and his HBV DNA is 45,000 IU/mL. He feels well. My problems are assigning his phase and deciding on treatment, his liver cancer risk, screening for the infections that travel with HBV, and protecting his household." [1]
References9ShowHide
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- [2]Buti M, Gane E, Seto WK, et al. Tenofovir alafenamide versus tenofovir disoproxil fumarate for the treatment of patients with HBeAg-negative chronic hepatitis B virus infection: a randomised, double-blind, phase 3, non-inferiority trial. The lancet. Gastroenterology & hepatology, 2016.PMID 28404092
- [3]Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology (Baltimore, Md.), 2023.PMID 37199193
- [4]Zhang BH, Yang BH, Tang ZY Randomized controlled trial of screening for hepatocellular carcinoma. Journal of cancer research and clinical oncology, 2004.PMID 15042359
- [5]Pearlman B Hepatitis Delta Infection: A Clinical Review. Seminars in liver disease, 2023.PMID 37473778
- [6]Ghany MG, Morgan TR, AASLD-IDSA Hepatitis C Guidance Panel Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases-Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Hepatology (Baltimore, Md.), 2020.PMID 31816111
- [7]Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2018.PMID 29939980
- [8]Marcellin P, Gane E, Buti M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet (London, England), 2013.PMID 23234725
- [9]Centers for Disease Control and Prevention Screening and Testing for Hepatitis B CDC, 2026.Source