Hepatitis B (cont.)

Medical Treatment

Acute hepatitis B infection

The most severe effect of acute hepatitis B is dehydration from vomiting and diarrhea.

• If you are dehydrated, your doctor may prescribe IV fluid to help you feel better.
  
  
• If you are experiencing significant nausea and vomiting, you will receive medicines to control these symptoms.
  
  
• People whose symptoms are well controlled can be cared for at home.
  
  
• If dehydration or other symptoms are severe or if you are extremely confused or difficult to arouse, you may need to stay in the hospital.
  
  
• There is no treatment that can prevent acute HBV infection from becoming chronic.

Chronic hepatitis B infection

The degree of liver damage is related to the amount of active, replicating (multiplying) virus in the blood and liver. Regularly measuring the amount of HBV DNA in the blood gives a good idea of how fast the virus is multiplying. The treatments now in use are antiviral drugs, which stop the virus from multiplying.

• Antiviral agents, while the best therapy known for chronic hepatitis B, do not work in all individuals with the disease.
  
  
• Although there are several antiviral agents for chronic hepatitis B approved by the U.S. Food and Drug Administration (FDA), research is ongoing. This means that dosages and treatment recommendations are subject to change.
  
  
• Research is ongoing to find medications that work better with fewer side effects.
  

Antiviral therapy is not appropriate for everyone with chronic HBV infection. It is reserved for people whose infection is most likely to progress to chronic hepatitis B.

• Decisions to start medications for treatment of hepatitis B are made by you and your health care provider, often in consultation with a specialist in diseases of the digestive system (gastroenterologist) or liver (hepatologist).
  
  
• The decision is based on results of liver function tests, HBV DNA tests, and, frequently, liver biopsies after a complete history and physical examination.
  
  
• Depending on the results of these tests, you may decide to start therapy or to delay it until later.
  

Treatment is usually started when blood tests indicate that liver functions are deteriorating and the amount of replicating HBV is rising. The interval between diagnosis and starting treatment can be a year or two or several years. Many people may never require medication.

If you have chronic hepatitis B infection and think you might be pregnant, let your health care provider know right away. If you are pregnant and think you have been exposed to hepatitis B, let your health care provider know right away.

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