Uganda guidelines for the treatment of Hepatitis B and HIV Co-Infection
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Screening
All HIV-infected patients initiating or failing ART should be routinely screened for HBV using HBsAg. If positive: baseline CBC, LFTs (ALT, AST, albumin, bilirubin, PT-INR), and liver ultrasound to assess fibrosis. Repeat tests every 6 months (risk of hepatocellular carcinoma).
Treatment
Management
Preferably ART regimen containing: TDF 300 mg + 3TC 300 mg PO once daily for life. Evaluate for HBV treatment failure after 6 months. If jaundice, malaise, RUQ pain, or abnormal LFTs: Do HBV DNA (viral load). If HB VL >2000 IU/ml at 24 weeks, refer for evaluation.
Prevention
Counsel on sexual/needle transmission. Avoid alcohol. Screen household and sexual partners for HBsAg. Vaccinate all HIV-infected HBsAg-negative patients and all sexual contacts with HBV vaccine.
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