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Acute hepatitis B infection

Acute hepatitis B infection is not treated with antiviral medications.

• If the infected person is dehydrated from vomiting or diarrhea, a doctor may prescribe IV fluids to help them feel better. Medications may also be used to control these symptoms.
  
  
• People with mild symptoms can be cared for at home.

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 ('viral load') in the blood gives your physician a good idea of how fast the virus is multiplying. The treatments now in use are classified as antiviral drugs, because they try to 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.
  
  
• There are several antiviral agents for chronic hepatitis B approved by the U.S. Food and Drug Administration (FDA). New drugs are always being tested and treatment recommendations are subject to change.
  
  
• Antiviral therapy is not appropriate for everyone with chronic HBV infection. It is reserved for people whose infection is most likely to progress to active hepatitis or cirrhosis.
  
  
• Decisions to start medications for treatment of hepatitis B are made by the patient and health care practitioner, often in consultation with a specialist in diseases of the digestive system (gastroenterologist) or liver (hepatologist).
  
  
• The decision to treat is guided by results of liver function tests, HBV DNA tests, and, frequently, liver biopsies after a complete history and physical examination.

Treatment is usually started when blood tests indicate that liver functions are deteriorating and the amount of replicating HBV is rising. Many people never reach this point. For those who do, the interval between diagnosis and starting treatment is quite variable.

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