Not all people infected with the hepatitis B virus need medication.1 Only your medical professional can decide that. Effective hepatitis B treatments are only available through your medical professional. You should never take any other products to treat hepatitis B, including herbs and vitamins, unless you talk to your medical professional, as some herbs and vitamins can cause liver damage.
Treatment for hepatitis B: Acute infection
Any treatment discussion or plan needs to happen with a professional doctor or nurse. When someone first becomes infected with hepatitis B a doctor may advise that a specific treatment isn’t needed.2
Many people are infected when they are very young and they or their parents may not even be aware that they have the infection. But it’s especially important to identify those who are infected at this early age because they are much more likely to go on to develop chronic infection with all its complications.3 Young children in at-risk groups should be monitored and screened – ideally they should be vaccinated as early as possible to prevent infection from occurring.
If symptoms do occur in acute hepatitis B, they are often vague and flu-like, such as fever, tiredness, muscle aches, nausea or loss of appetite. Between 30% and 50% of teenagers and adults who get acute hepatitis B develop jaundice, which can last a few days or a few weeks. Infants and young children with acute hepatitis B rarely get jaundiced.4
People with acute illness often require only simple treatment, though a discussion with a healthcare professional is needed to establish what is needed, such as rest or medicines for nausea. They will then make a gradual recovery (usually within 6 months) as their immune system clears the infection before they feel back to normal. After acute infection most adults become immune to hepatitis B (i.e. they may never be infected again).4
On occasion, acute hepatitis B infection may cause acute liver failure or fulminant hepatitis. People who develop fulminant hepatitis need expert medical support in hospital with intensive specialised treatment, and may ultimately require a liver transplant.4
Treatment for hepatitis B: Chronic infection
Many people with chronic hepatitis B do not need treatment, at least at the time the diagnosis is made, though a doctor must be consulted to establish this. Many get better over time, simply needing occasional medical check-ups. But some will need treatment to limit the activity of the virus and to prevent the progressive damage to the liver.
Treatment for chronic hepatitis B consists of drug therapies to improve quality of life and survival by preventing progression of the disease to unwanted complications such as:2
These complications are directly related to the amount of virus in the body, which is known as the viral load – up to one-third of people with very high viral loads (greater than 1 million viral copies/ml of blood) will develop cirrhosis over a decade, compared to only 4.5% of those with low viral loads (less than 300 viral copies/ml).5
Medicines can reduce the number of virus particles in the body and should reduce or delay the number of people developing cirrhosis. But there are many issues to consider with these hepatitis B treatments, such as:
- Disease stage at the start of treatment
- Patient characteristics
- When to start treatment
- Which of the treatments to give
- Treatment effectiveness
- The safety in offering treatment to the patient
- How potential adverse effects should be managed
- How long to continue to take the medication
It’s necessary to be treated by a hospital consultant with experience with hepatitis B, and your healthcare provider will usually refer you to one once you have been diagnosed. They and their team of specialized nurses and therapists will be able to help you through your treatment for hepatitis B.