Hepatitis medications
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Hepatitis medications
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Laboratory value | Result |
Hemoglobin | 12.5 g/dL |
Leukocyte count | 8000 mm3 |
Platelet count | 230,000 mm3 |
Viral profile | |
HAV IgM | Negative |
HAV IgG | Positive |
HBsAg | Positive |
HBeAg | Negative |
HBV IgG | Positive |
HCV IgG | Positive |
HCV RNA | 100,000,000 IU/ml |
External References
First Aid
2024
2023
2022
2021
Ribavirin
contraindicated in pregnancy p. 200
hepatitis p. 729
hepatitis C p. 200
purine synthesis p. 34
Teratogens p. 632
ribavirin p. 200
Transcript
Content Reviewers
Anti-hepatitis medications are a group of antiviral agents used to treat viral hepatitis, which is the inflammation of the liver caused by some sort of virus that targets and damages liver cells.
Now, viral hepatitis can be acute or chronic.
Acute hepatitis lasts for six months or less, and usually resolves on its own without any antiviral treatment.
Chronic hepatitis lasts for more than six months, sometimes even for decades.
Anti-hepatitis medications are mainly used to treat chronic hepatitis and the two main viruses are hepatitis B virus, or HBV, and hepatitis C virus, or HCV.
Alright, so, HCV is a single stranded RNA virus.
What this means is that HCV inject its RNA into the host’s cell and it can immediately use its host’s ribosomes and translate the proteins needed to make more viruses, like capsomere proteins and enzymes like RNA-dependent RNA polymerase.
This RNA-dependent RNA polymerase uses the viral RNA as a template, and uses the hepatocyte’s nucleotides to transcribe a complementary strand of RNA, which is then used to form new baby viruses!
HBV on the other hand is a double stranded DNA virus.
Once the DNA gets injected into a new cell, it enters the cell’s nucleus and is replicated by the host cell’s machinery.
It’s also transcribed into several messenger RNAs and a pregenomic RNA, and then the messenger RNAs are used to make capsomere proteins and enzymes like DNA polymerase.
DNA polymerase uses the pregenomic RNA to synthesize new copies of the viral DNA, which is combined with the capsomere proteins to assemble new viruses.
With each type of virus, whether it’s RNA or DNA, it’s turning your own cells into virus making factories and pumping out new viruses.
This process strains, damages and potentially kills the infected hepatocytes.
When these liver cells die, the liver gets inflamed and that’s called hepatitis.
The anti-hepatitis medications can be divided into two groups based on their mechanism of action; nucleoside or nucleotide analogues and interferons.
Let’s start with the nucleoside and nucleotide analogues. This group includes nucleoside analogues like ribavirin, entecavir and lamivudine; nucleotide analogues like adefovir, tenofovir, and sofosbuvir.
Summary
The medications for hepatitis can be divided into two broad categories: those that clear the virus from the body (i.e. antivirals) and those that work to protect the liver from further damage (i.e. hepatoprotectives).
Antiviral medications for hepatitis include pegylated interferon, ribavirin, and telbivudine. These medications are typically used in combination with each other and are very effective at clearing the virus from the body.
Hepatoprotective medications for hepatitis include milk thistle, ursodeoxycholic acid, and vitamin E. These medications protect the liver from further damage and can be quite effective at preventing or slowing the progression of liver disease.
Sources
- "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
- "Rang and Dale's Pharmacology" Elsevier (2019)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Is Tenofovir Alafenamide Safer than Tenofovir Disoproxil Fumarate for the Kidneys?" AIDS Rev (2016)
- "Sofosbuvir and Ribavirin Liver Pharmacokinetics in Patients Infected with Hepatitis C Virus" Antimicrobial Agents and Chemotherapy (2018)
- "Review article: long-term safety of oral anti-viral treatment for chronic hepatitis B" Alimentary Pharmacology & Therapeutics (2018)
- "Oral Direct-Acting Agent Therapy for Hepatitis C Virus Infection" Annals of Internal Medicine (2017)