Skip to content 
Treatment
As you can see, hepatitis B is a complex disease with many variants and forms of presentation. That’s why the workup and management of this disease are in constant revision. In any case, the treatment goal is to prevent the progression of the disease into liver failure, cirrhosis, or liver cancer.
This can be achieved by combining drugs that suppress the viral load of hepatitis B and other drugs that enhance the immune response. To prevent hepatocellular carcinoma in high-risk patients, it is also important to include antiviral treatment. As for the rest, the treatment of hepatitis B is supportive and based on the patient’s emerging condition.
According to the National Institutes of Health, treatment should include nucleos(t)ide therapy in patients with cirrhosis and acute liver failure. Other patients with a diagnosed hepatitis B virus infection should only start treatment with the DNA levels of HBV that go beyond 20,000 IU/mL, or ALT in the blood remains high for 3 to 6 months.
On the other hand, the World Health Organization recommends treatment for patients with chronic hepatitis who are 30 years or older, have persistently high levels of ALT in the blood, or have 20,000 IU/mL of HBV DNA levels, regardless of any clinical evidence of cirrhosis.
Every treatment protocol should be accompanied by counseling to prevent the transmission of the hepatitis B virus to other household members. One of the most important recommendations is to abstain from alcoholic beverages. They increase the risk of liver cancer and other complications of hepatitis B infections. Another important suggestion is to maintain healthy body weight and control dyslipidemia and diabetes very closely to prevent fatty liver disease and further worsen the liver condition.
References
Lok, A. S., & McMahon, B. J. (2009). Chronic hepatitis B: update 2009.
Liaw, Y. F., & Chu, C. M. (2009). Hepatitis B virus infection. The lancet, 373(9663), 582-592.
McMahon, B. J. (2005, February). Epidemiology and natural history of hepatitis B. In Seminars in liver disease (Vol. 25, No. S 1, pp. 3-8). Published in 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA..
Trépo, C., Chan, H. L., & Lok, A. (2014). Hepatitis B virus infection. The Lancet, 384(9959), 2053-2063.
