Hepatitis B

Medications

For people with short-term (acute) hepatitis B infection (HBV), treatment with medication is not usually recommended. Antiviral medication may be used for long-term (chronic) HBV infection if the virus is multiplying or liver damage exists or may develop.

But antiviral therapy is not recommended for everyone who has chronic hepatitis B viral infection. It is an option for people who have or appear likely to develop liver damage such as cirrhosis. Antiviral therapy may not help if you already have severe liver damage.

The American Association for the Study of Liver Disease has made recommendations on who should receive antiviral treatment for long-term (chronic) hepatitis B based on the presence of hepatitis B antigens in your blood, the level of hepatitis B virus DNA (HBV DNA) in your blood, and the levels of your liver enzymes.⁴

Medication Choices

Interferons such as interferon alfa-2b and pegylated interferon alfa-2a

Nucleoside reverse transcriptase inhibitors (NRTIs) such as adefovir, entecavir, lamivudine, and telbivudine

Should I use antiviral therapy for chronic hepatitis B?

What To Think About

• It is important to weigh the benefits of treatment against the risks. Treatment for chronic hepatitis B does not cure the disease, but does suppress it.
• Interferons are given as shots. Adefovir, entecavir, lamivudine, and telbivudine are pills.
• Interferons have common side effects, including fever, headaches, and hair loss. They may also cause or aggravate mental problems. Adefovir, entecavir, lamivudine, and telbivudine have few side effects but generally need to be taken for a longer period of time.
• After you have taken lamivudine for 1 year or longer, you can become resistant to the drug. Drug resistance means the medicine no longer works very well. If you develop resistance to lamivudine, you can take adefovir.
• If you have cirrhosis, you cannot use interferons. But you can use adefovir, entecavir, lamivudine, and telbivudine.
• After any kind of treatment for hepatitis B, the virus may return (relapse).

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Author:	Maria G. Essig, MS, ELS	Last Updated: October 15, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine W. Thomas London, MD - Hepatology
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