Treatment of Hepatitis
The treatment of hepatitis depends largely on its underlying cause, the severity of liver inflammation, and whether the condition is acute or chronic. While some forms of hepatitis resolve without intervention, others require lifelong management or complex medical therapy. Advances in medical science have significantly improved the treatment of hepatitis, particularly for viral and autoimmune types, reducing the risk of complications such as cirrhosis, liver failure, and liver cancer.
For acute viral hepatitis, such as hepatitis A and E, treatment is usually supportive. These forms are self-limiting and typically resolve within weeks. Patients should rest, drink plenty of fluids, eat light meals, and avoid alcohol or medications that could strain the liver. They may take over-the-counter pain relief such as paracetamol, but only with medical supervision, since high doses can worsen liver damage. In most cases, full recovery occurs without the need for hospitalisation.
Treatment of Hepatitis
Hepatitis B treatment depends on whether the infection is acute or chronic. In acute hepatitis B, supportive care is generally sufficient, as most healthy adults will clear the virus naturally. However, if symptoms become severe or persist, doctors may prescribe antiviral medications such as tenofovir or entecavir. For chronic hepatitis B, long-term antiviral therapy is typically recommended—especially for patients with elevated liver enzymes, a high viral load, or signs of liver fibrosis. These medications suppress the replication of the virus and help prevent disease progression but do not offer a complete cure. Regular monitoring of liver function, viral load, and screening for liver cancer (with ultrasound and alpha-fetoprotein testing) is essential in managing chronic hepatitis B.
The landscape for hepatitis C has changed dramatically in recent years. Previously managed with interferon and ribavirin (which had limited success and significant side effects), hepatitis C is now considered curable in most cases thanks to direct-acting antiviral (DAA) therapies. These oral medications—such as sofosbuvir, ledipasvir, velpatasvir, and glecaprevir—target specific steps in the viral replication cycle. Treatment usually lasts 8 to 12 weeks and boasts cure rates of over 95%, even in people with advanced liver disease. Access to DAAs has revolutionised the treatment of hepatitis C, although cost and availability remain barriers in some regions.
Hepatitis D
Hepatitis D, which only occurs in conjunction with hepatitis B infection, is more difficult to treat. The goal is to manage both viruses simultaneously. While antiviral therapy aimed at HBV can reduce viral load, interferon-based therapies are sometimes used for HDV. Research is ongoing into more effective drugs for hepatitis D, and new agents such as bulevirtide are beginning to offer hope for improved outcomes.
In the case of autoimmune hepatitis, treatment typically involves immunosuppressive therapy to reduce immune system activity and halt liver inflammation. Corticosteroids, such as prednisolone, are often the first-line therapy, either alone or combined with azathioprine, a drug that helps prevent immune-mediated liver damage. Many patients require long-term maintenance therapy, and the goal is to induce and sustain remission. For those who cannot tolerate these medications or who fail to respond, alternatives such as mycophenolate mofetil or ciclosporin may be used. Regular liver function monitoring and careful tapering of medications help reduce the risk of relapse.
Alcoholic hepatitis requires immediate cessation of alcohol consumption, which is the most critical step in improving liver function. Supportive treatment includes nutritional support, especially with high-protein and vitamin-rich diets, and corticosteroids may be prescribed in severe cases. Abstinence from alcohol can result in significant recovery, while continued drinking significantly worsens prognosis and increases the risk of death. In advanced cases with liver failure, evaluation for liver transplantation may be necessary.
Treatment of Hepatitis
Non-alcoholic steatohepatitis (NASH), a metabolic form of hepatitis, is primarily managed through lifestyle modification. This includes weight loss, dietary changes (reducing sugar and saturated fats), increased physical activity, and the control of associated conditions such as diabetes, hypertension, and high cholesterol. There are currently no specific medications approved solely for NASH, though several are under investigation. Managing the metabolic syndrome holistically can slow or even reverse the progression of liver inflammation and fibrosis.
For drug-induced hepatitis, immediate withdrawal of the offending medication or substance is the priority. If caught early, liver inflammation typically resolves with supportive care. In cases of paracetamol overdose, the antidote N-acetylcysteine (NAC) is highly effective if administered within a few hours. NAC replenishes glutathione stores in the liver, preventing further cellular damage. Severe or fulminant hepatitis caused by toxins or drugs may require intensive care support or liver transplantation.
In cases of advanced hepatitis—regardless of cause—that progress to cirrhosis or liver failure, treatment becomes more focused on managing complications and maintaining liver function. This may include:
Diuretics for fluid retention (ascites)
Beta-blockers to reduce the risk of variceal bleeding
Lactulose for hepatic encephalopathy
Antibiotics for spontaneous bacterial peritonitis
Regular screening for hepatocellular carcinoma
For some individuals with irreversible liver damage, liver transplantation remains the only curative option. Transplantation is considered in those with decompensated cirrhosis, severe acute liver failure, or liver cancer within transplant criteria. Post-transplant care includes immunosuppressive therapy and long-term monitoring, but most recipients go on to lead normal, healthy lives.
In addition to medical management, patient education and support are crucial in the treatment of hepatitis. Individuals should be advised on:
Avoiding alcohol and hepatotoxic drugs
Vaccination against hepatitis A and B (if not already immune)
Safe sex practices and needle hygiene to prevent transmission
Dietary adjustments to support liver health
Public health measures—such as harm reduction programmes, needle exchange services, screening of blood products, and universal hepatitis B vaccination—also play a critical role in controlling the spread of hepatitis and reducing the burden of liver disease on healthcare systems.
Treatment of Hepatitis
In summary, the treatment of hepatitis varies depending on the underlying cause but typically includes a combination of antiviral medications, immunosuppression, lifestyle modification, and in some cases, liver transplantation. With early diagnosis, access to appropriate therapy, and ongoing follow-up, many forms of hepatitis are now highly treatable or even curable, giving patients a much-improved outlook and quality of life.
