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Hepatitis B - Management
Basis for recommendation
These recommendations are based on the United Kingdom national guideline on the management of the viral hepatitides A, B, and C [BASHH, 2008], guidance from the Health Protection Agency [HPA, 2010a], Immunisation against infectious disease (the 'Green Book') [DH, 2009a], information published by the British Liver Trust [British Liver Trust, 2009], and an expert review article [James-Koziel and Thio, 2009].
Treatment of pain
- The recommendations regarding analgesia are based on the opinion of CKS expert reviewers and the text book Drugs and the liver [North-Lewis, 2008].
Treatment of nausea
- Most CKS expert reviewers suggested offering metoclopramide or cyclizine in normal dosages in mild liver disease, but to exercise caution in more severe liver disease.
Treatment of itch
- The recommendation to try simple measures is based on the opinion of one CKS expert reviewer.
- The recommendation to consider offering chlorphenamine first-line is based on the opinion of CKS expert reviewers. There was a difference of opinion regarding the use of ursodeoxycholic acid, colestyramine, and corticosteroids; therefore CKS recommends seeking specialist advice.
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