Hepatitis B Treatments

Individuals who knowingly have been exposed to the hepatitis B virus (HBV) should consult their healthcare providers as soon as possible. Patients who receive an injection of hepatitis B immune globulin within 24 hours of exposure to the virus may not develop HBV infection. Patients should also receive the first of three injections of the hepatitis B vaccine. There are few treatment options for patients with chronic hepatitis B. In some cases, the doctor may suggest monitoring the patient’s condition instead of treating it. In other instances, the doctor may recommend antiviral treatment. When liver damage is severe, a liver transplantation may be the only treatment option.

Read more about the hepatitis B vaccine

Alcohol avoidance

Individuals who have been diagnosed with hepatitis should avoid drinking alcohol because it speeds the progression of liver disease.

Interferon

The body naturally produces interferon to fight against invading organisms, including viruses. Administering additional synthetic interferon may stimulate the body’s immune response to HBV and help prevent the virus from spreading. Two interferon medications are available:

  1. Interferon alfa-2b (Intron A®) is administered by injection several times a week
  2. Peginterferon alfa-2a (Pegasys®) is given by injection once a week.

Not everyone is a candidate for interferon treatment. In a few cases, interferon has successfully eliminated the virus completely. However, the infection can return in the future. Several side effects are associated with interferon, including depression, fatigue, muscle pain, body aches, fever and nausea. Interferon may also cause a decreased production of red blood cells. Symptoms are usually worse during the first two weeks of treatment and in the first four to six hours after receiving an injection of interferon.

Lamivudine (Epivir-HBV®)

Lamivudine (Epivir-HBV®) is an antiviral medication that helps prevent HBV from replicating in the body’s cells. The medication is usually taken in tablet form once daily. Side effects during treatment are generally mild, but some patients may experience a severe worsening of symptoms when they stop taking the medication. Patients should tell their healthcare providers if they have had any kidney problems or history of pancreatitis before starting this medication. Patients should call their healthcare providers immediately if they experience a worsening of jaundice (yellowing of the skin and eyes) or if they experience any of the following while taking the medication:

  • unusual bruising
  • bleeding
  • fatigue

Adefovir dipivoxil (Hepsera®)

Adefovir dipivoxil (Hepsera®) is a tablet taken orally once a day to help prevent HBV from replicating inside the body’s cells. This drug is effective in patients who are resistant to lamivudine. Like lamivudine, side effects are generally mild, but symptoms may worsen when treatment is stopped. Hepsera® may cause kidney toxicity in patients with underlying kidney disease. A change in the amount of urine produced or blood in the urine may indicate kidney toxicity. Other side effects may include:

  • weakness
  • headache
  • fever
  • increased cough
  • nausea
  • vomiting
  • diarrhea or gas

Entecavir (Baraclude®)

Entecavir (Baraclude®) is an antiviral medication that was approved by the U.S. Food and Drug Administration (FDA) in March 2005. This medication is taken orally once a day. Studies comparing entecavir to lamivudine found that entecavir was more effective. Baraclude® may cause symptoms of hepatitis to worsen once medication is discontinued.

Liver transplant

When the liver has been severely damaged, a liver transplant may be the only treatment option. Liver transplants are increasingly successful. However, there are not enough donor organs available for every patient who needs a transplant, and not all patients are suitable transplant candidates.

 

Selected References

Centers for Disease Control and Prevention (CDC). Viral Hepatitis B. www.cdc.gov. Accessed March 29, 2009.

Hepatitis Foundation International. Caring for Your Liver. www.hepfi.org. Accessed March 29, 2009.

National Digestive Diseases Information Clearinghouse (NDDIC). Viral Hepatitis: A Through E and Beyond. http://digestive.niddk.nih.gov. Accessed March 29, 2009.

Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com. Copyright © 2009. Accessed March 29, 2009.

World Health Organization (WHO). Hepatitis B. www.who.int. Accessed March 29, 2009.

The Hepatitis Information Network. www.hepnet.com. Accessed March 29, 2009.