Indicators for review of oral antivirals

Precautions for reviewing the indicators of oral antiviral drugs are as follows: 1. Baseline testing of relevant indicators before treatment: (1) biochemical indicators, mainly ALT, AST, bilirubin, albumin, etc.; (2) virological markers, mainly HBV DNA and Hepatitis B V; (3) according to the needs of the condition, testing of blood routine, serum creatinine and creatine kinase, etc.; (4) non-invasive liver fibrosis testing, such as liver elasticity test; (5) If conditions permit, liver puncture examination can be considered before and after treatment. 2. Pay close attention to patients’ adherence to treatment, including the dosage of medication, the method of use, whether there is any omission of medication or stopping medication, etc., to ensure that patients have understood the risks that may be caused by stopping medication arbitrarily, and to improve patients’ adherence to treatment. Prevention and treatment of rare and uncommon adverse reactions The overall safety and tolerability of NAs are good, but rare and uncommon serious adverse reactions do occur in clinical application, such as renal insufficiency (mainly seen in adefovir treatment), hypophosphatasia (mainly seen in adefovir and tenofovir treatments), myositis (mainly seen in tebivudine treatment), rhabdomyolysis (mainly seen in tebivudine), lactic acidosis, and so on. , lactic acidosis, etc. (seen with lamivudine, entecavir, and tebivudine) should be of concern. It is recommended that a careful history of relevant medical conditions be taken prior to treatment to minimize risk. For patients with markedly elevated blood creatinine, CK or lactate dehydrogenase during treatment, accompanied by corresponding clinical manifestations such as deterioration of general condition, obvious myalgia, myalgia, etc., they should be closely observed, and once the diagnosis is confirmed to be uremia, myositis, rhabdomyolysis, or lactic acidosis, etc., the medication should be stopped or switched to other medications in a timely manner, and active corresponding therapeutic interventions should be given. 4, drug resistance monitoring Drug resistance is one of the main problems facing long-term treatment of chronic hepatitis B with nucleoside analogs. Drug resistance can trigger virological breakthrough, biochemical breakthrough, virological rebound and hepatitis flare-ups, and a few patients can have liver failure, acute liver failure, or even death. 5, so, remember not to stop the drug by yourself.