The treatment of hepatitis B depends on whether it is acute or chronic. It also depends on how much the liver is affected and if there are problems like cirrhosis or liver cancer. People with acute hepatitis B usually get better without medicine. But those with chronic hepatitis B may need long-term treatment to stop liver damage. The goal of treatment is to lower the virus, protect the liver, prevent cancer, and improve life quality.
How to Treat Acute Hepatitis B
Most adults with acute hepatitis B do not need antiviral medicine. Their bodies clear the virus within six months. Care focuses on helping the body recover with:
- Rest, since people often feel very tired
- Drinking enough fluids to avoid dehydration
- Eating healthy foods with less fat
- Avoiding alcohol and certain medicines that harm the liver
- Regular blood tests to check liver health
In rare cases, people may need to stay in hospital. Doctors may give antiviral drugs like tenofovir or entecavir if the illness is very serious.
Chronic Hepatitis B Needs Special Care
Chronic hepatitis B lasts longer than six months. Doctors decide on treatment based on:
- The amount of virus in the blood (HBV DNA)
- Liver enzyme levels (ALT)
- Signs of liver scarring
- Age and family history
- Other infections like HIV
Some people do not need medicine right away. They get regular check-ups until treatment is needed.
First-Line Medicines for Hepatitis B
Doctors recommend two main medicines because they work well and are safe to use for many years:
- Tenofovir (TDF or TAF): Lowers virus levels and protects the liver. TAF is easier on the kidneys and bones.
- Entecavir: Stops the virus from growing. It is safe for long-term use.
These medicines come in tablets taken once a day. Many people need to take them for life.
Other Treatment Options
Older drugs like lamivudine and adefovir are used less often due to weaker effects. Some people may use interferon shots for a limited time, but side effects are common.
Regular Monitoring Is Important
People on treatment need regular tests to check:
- Virus levels
- Liver health
- Signs of liver cancer
- Kidney function
- Bone strength if using certain drugs
Doctors want to see very low virus levels, healthy liver tests, and sometimes the body removing virus markers like HBsAg.
Watching Without Medicine
Not everyone needs treatment. Some people have little liver damage and normal blood tests. Doctors check them every 6–12 months to catch changes early.
Treating Cirrhosis and Severe Disease
Anyone with cirrhosis needs treatment, even with low virus levels. Cirrhosis raises the risk of serious problems like:
- Swelling in the belly
- Bleeding veins in the throat
- Confusion from liver toxins
- Liver cancer
Treatment helps slow down or stop damage, and regular cancer checks are very important.
Checking for Liver Cancer
People with hepatitis B have a higher risk of liver cancer. Doctors recommend an ultrasound every six months, especially if the person:
- Has cirrhosis
- Is an Asian man over 40 or woman over 50
- Is African and over 20
- Has a family history of liver cancer
- Has high virus levels or liver inflammation
Stopping the Spread of Hepatitis B
Treatment also lowers the chance of passing hepatitis B to others. It helps prevent:
- Passing the virus from mother to baby
- Spreading it through sex
- Spreading it through blood or household contact
Doctors also teach people to practice safe sex, avoid sharing personal things, and get their family vaccinated.
Special Situations in Hepatitis B Treatment
- Pregnant women: Tenofovir is safe and used to protect babies from infection.
- Children: Doctors treat based on age, liver health, and virus levels.
- People with other infections: Those with HIV or other hepatitis viruses need special care.
In Summary
The treatment of hepatitis B depends on how serious the infection is. Most acute cases get better without medicine. Chronic cases may need long-term antiviral drugs to stop liver damage and cancer. With modern medicine, regular check-ups, and protecting family members, people with hepatitis B can live long and healthy lives
