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Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

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The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
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Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

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At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
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Drug Elimination: Non-Renal Routes01:23

Drug Elimination: Non-Renal Routes

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The liver plays a pivotal role in eliminating drugs and their metabolites, primarily through a process known as biliary excretion. This process involves the hepatocytes, the primary cells in the liver that generate bile. A range of transporters actively expels polar drugs or hydrophilic drug metabolites into the bile, which transports the drugs and metabolites into the small intestine. From here, they are eventually expelled from the body through feces. In some instances, the original drug or a...
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Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

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Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
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Physiological Pharmacokinetic Models: Incorporating Hepatic Transporter-Mediated Clearance01:07

Physiological Pharmacokinetic Models: Incorporating Hepatic Transporter-Mediated Clearance

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Drug transporters are critical in drug absorption, distribution, and excretion processes. They should be included in physiological-based pharmacokinetic (PBPK) models, which help predict human drug disposition. However, predicting this is challenging during drug development, especially when liver transport is involved. However, with a realistic representation of body transport processes, an accurate model may be possible.
A recent model describes pravastatin's hepatobiliary excretion,...
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Development of a Hepatitis B Virus Reporter System to Monitor the Early Stages of the Replication Cycle
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Challenges in Formulation and Implementation of Hepatitis B Elimination Programs.

Zaigham Abbas1, Minaam Abbas2

  • 1Gastroenterology and Hepatology, Dr. Ziauddin University Hospital, Karachi, PAK.

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|April 28, 2021
PubMed
Summary
This summary is machine-generated.

Hepatitis B elimination requires comprehensive strategies, including screening pregnant women and initiating antiviral therapy. Early intervention and continuous care are crucial to finding and treating the millions unaware of their infection.

Keywords:
elimination programshepatitis b(hbv)mother to child transmissionnosocomialvaccinationwho

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis B virus (HBV) infection affects nearly 257 million globally, with low diagnosis rates.
  • Mother-to-child, nosocomial, and sexual transmission are key etiological factors for HBV.
  • Identifying and managing undiagnosed HBV cases presents a significant global challenge.

Purpose of the Study:

  • To outline essential components for a hepatitis B elimination program.
  • To emphasize the importance of early detection and treatment strategies.
  • To propose integrated approaches for managing hepatitis B infection.

Main Methods:

  • Screening pregnant women and initiating antiviral therapy at 28 weeks gestation for high viral loads (HBV DNA ≥ 200,000 IU/mL) or HBeAg positivity.
  • Implementing perinatal infection prevention, including birth dose and neonatal vaccination.
  • Establishing post-vaccination monitoring for high-risk groups and carrier registration.

Main Results:

  • A continuum of care approach is vital, addressing risk factors, testing, and treatment referrals.
  • Integration of hepatitis B services with existing healthcare systems is recommended.
  • National policies for capacity building, funding, and simplified diagnostic/treatment guidelines are necessary.

Conclusions:

  • Hepatitis B elimination necessitates a multi-faceted approach including universal screening, targeted antiviral therapy, and vaccination.
  • Continuous care, public awareness, stigma reduction, and simplified guidelines are critical for success.
  • Micro-elimination strategies and robust surveillance are essential to monitor progress and impact.