How is HBV-related polyarteritis nodosa (PAN) treated?

Updated: Nov 14, 2017
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Answer

PAN in the setting of HBV infection is a special situation. Standard therapies for PAN, including glucocorticoids and cyclophosphamide, enhance prognosis and control of the polyarteritis. However, they are also associated with persistent HBV infection and failure to seroconvert from hepatitis B surface antigen to hepatitis B surface antibody and from hepatitis B e antigen to hepatitis B e antibody. Thus, antiviral medications are essential in the treatment of these patients.

Guillevin and colleagues studied therapeutic strategies, including steroids, antivirals, and plasma exchange (plasmapheresis), and found the regimens below to be successful. [63]


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