Hepatitis B infection develops when bodily fluids, such as blood and semen, that contain the hepatitis B virus (HBV) enter the body of someone who isn’t already infected with HBV, and who hasn’t been vaccinated against it. The virus causes inflammation of the liver, which is also known as hepatitis. While some people don’t develop any symptoms from the inflammation, others may experience a range of them — including nausea and vomiting, jaundice, and fatigue — about one to three months after exposure to HBV. Most people recover from the infection within two to three weeks, according to the National Institutes of Health (NIH) — making it an acute infection. But if the infection lasts for 6 months or more, it’s considered chronic hepatitis B. Treatment for hepatitis B depends on the form of the disease (acute or chronic) and how severe it is.
Acute Hepatitis B Treatment
There are no medications or specific treatments available for acute hepatitis B. If you’re experiencing symptoms from acute hepatitis B, your doctor may advise general supportive care, such as:
RestingDrinking plenty of fluids, especially if you’re suffering from vomiting, diarrhea, or feverMaintaining adequate nutrition
You may also take over-the-counter pain medicines if necessary. Motrin or Advil (ibuprofen) may be safer than Tylenol (acetaminophen) for this purpose, according to the Hepatitis B Foundation. If you’re experiencing severe symptoms, you may need to be hospitalized to receive care, including intravenous (IV) fluids and stronger pain relievers.
Chronic Hepatitis B Treatment
Antiviral medications are available to treat chronic hepatitis B, but these drugs don’t get rid of the infection. Rather, they slow or stop the virus from damaging the liver, which helps prevent life-threatening hepatitis B complications — particularly liver cancer and cirrhosis (scarring of the liver). Drug treatments include Roferon-A (interferon alfa-2a) or Intron A (interferon alfa-2b). These drugs are man-made versions of naturally occurring proteins that boost the immune system’s response to viruses, bacteria, cancer cells, and other harmful substances. Long-acting forms of the drug, called Pegasys ((peginterferon alfa-2a) or PegIntron (peginterferon alfa-2b) are also available, though not all drug treatments are approved for hepatitis B in all countries. Other drugs, called nucleoside analogues, work by blocking an enzyme HBV needs to replicate (reverse transcriptase), ultimately reducing the amount of the virus in the body. These drugs include:
Hepsera (adefovir)Baraclude (entecavir)Epivir (lamivudine)Tyzeka (telbivudine)Viread (tenofovir)
Viread and Baraclude are the most effective nucleoside analogues for hepatitis B and rarely lead to drug resistance, according to the World Health Organization. In 2015, researchers found that a cancer drug called birinapant was able to completely eliminate HBV infections in animal models, according to two studies in the journal Proceedings of the National Academy of Sciences. The drug, which works by reversing the negative effects of HBV on the liver’s infection-fighting defenses, was able to clear infections twice as fast when used in combination with Baraclude. Clinical trials are needed to find out whether birinapant alone is just as effective in ridding people of HBV.
Liver Transplant for Hepatitis B
Chronic hepatitis B can cause severe liver damage and eventually liver failure, sometimes referred to as end-stage liver disease, or ESLD. Signs of severe liver damage include:
ItchingAngiomas (spider-like blood vessels that are visible under the skin)Easy bruising and slow blood clottingSwollen stomach or ankles
Your doctor will most likely recommend being placed on a donor list to receive a liver transplant if you develop severe ESLD from hepatitis B. This complex procedure, performed by a team of surgeons, aims to remove your damaged liver and replace it with a healthy one. But getting a liver transplant doesn’t necessarily put you in the clear, since your new liver may also become infected with HBV.
