Deciding to Initiate Antiviral Treatment in Patients with Chronic Hepatitis B Virus Infection

You answered:

C If the patient has compensated cirrhosis, antiviral treatment would not be indicated because it could precipitate hepatic decompensation.

This answer is incorrect. Treatment of hepatitis B infection with lamivudine (Epivir) has not been shown to precipitate hepatic decompensation in patients with compensated cirrhosis, but has been associated with delay of progression to death or liver transplantation. Preliminary results with adefovir (Hepsera) and entecavir (Baraclude) indicate that these oral nucleosides are safe in patients with cirrhosis and may also prevent or delay transplantation.

Choose another answer:

A Current treatment guidelines suggest that treatment is indicated for this patient.
B Liver biopsy is necessary before making a decision about initiating treatment
D The patient should not be treated for hepatitis B, but should be periodically tested for spontaneous HBeAg seroconversion (loss of HBeAg and development of anti-HBe).

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