HBV-associated polyarteritis nodosa is treated with which combination?

HBV-associated polyarteritis nodosa is treated with which combination?

• A. Prednisone, interferon, lamivudine
• B. Methotrexate
• C. Calcineurin inhibitors
• D. Anticoagulation

Answer: (A)

In HBV-associated polyarteritis nodosa, you must address both the inflammatory vasculitis and the underlying hepatitis B infection. Suppressing the immune-driven inflammation with a steroid helps control the vasculitis, but doing so without tackling the HBV can fuel viral replication and liver injury. Using an antiviral strategy to lower HBV replication reduces the source of antigenic stimulation driving the vasculitis. Lamivudine directly inhibits HBV DNA synthesis, lowering viral load, while interferon-alpha provides additional antiviral effects and helps modulate the immune response. Together, these antivirals with steroids target both the vascular inflammation and the viral trigger, improving outcomes. Other approaches that don’t include antiviral therapy fail to address the root driver (HBV replication) and can risk hepatic deterioration, making them less suitable as a primary regimen for HBV-related PAN.

In HBV-associated polyarteritis nodosa, you must address both the inflammatory vasculitis and the underlying hepatitis B infection. Suppressing the immune-driven inflammation with a steroid helps control the vasculitis, but doing so without tackling the HBV can fuel viral replication and liver injury. Using an antiviral strategy to lower HBV replication reduces the source of antigenic stimulation driving the vasculitis. Lamivudine directly inhibits HBV DNA synthesis, lowering viral load, while interferon-alpha provides additional antiviral effects and helps modulate the immune response. Together, these antivirals with steroids target both the vascular inflammation and the viral trigger, improving outcomes.

Other approaches that don’t include antiviral therapy fail to address the root driver (HBV replication) and can risk hepatic deterioration, making them less suitable as a primary regimen for HBV-related PAN.