Table 1.

HVB-PAN: Summary of diagnosis and drug management.

	Clinical Features and Diagnosis	Medication
Mild Disease	-constitutional symptoms (fever, malaise, fatigue, anorexia and loss of weight, muscles aches) -arthritis -skin lesions -anemia -absence of significant cardiac, gastrointestinal, renal, or life-threatening manifestations	Antiviral therapy a: -Entecavir—usually, 0.5 mg/day (for patients older 16 years; dose adjustments are necessary in cases of kidney failure) -Tenofovir: tenofovir alafenamide b (25 mg/day, aged ≥12 years) or tenofovir disoproxil fumarate c (300 mg/day, aged ≥12 years) -Short-term therapy with glucocorticoids and plasma exchange—can be instituted for patients with severe symptoms of if the disease progresses
Moderate and severe Disease	-any degree of renal failure -new or worsened hypertension secondary to PAN -symptomatic arterial stenosis -aneurysm -any ischemic diseases (e.g.: limb, cardiac, gastrointestinal, and cerebral	Antiviral therapy: -entecavir or tenofovir d -Glucocorticoids: prednisone: 0.7–1 mg/kgc/day tapered in 4 to 6 months -Plasmapheresis: 2.5–4 L/session for 6–10 sessions, daily on alternate days, over 2–3 weeks

^a duration of the treatment is typically for at least 12 months after HBeAg seroconversion, several years, or indefinitely; the main objective is to suppress viral replication and reduce liver inflammation caused by the hepatitis B virus. ^b should be avoided in pregnant women; should be avoided if the patient’s creatinine clearance (CrCl) is less than 15 mL/min and they are not on dialysis. ^c should be avoided if the patient’s CrCl are less than 60 mL/min. ^d in moderate/severe cases of HVB-PAN, the antiviral therapy is similar to the approach used in mild cases of HVB-PAN.