Hepatitis B is a viral infection that causes liver inflammation and damage. When the infection becomes chronic, meaning it persists for more than 6 months, it can lead to serious health issues like cirrhosis and liver cancer. Fortunately, there are several effective drugs available today to treat chronic hepatitis B.
This article will provide an overview of chronic hepatitis B, the common medications used for its treatment, tips to aid the treatment process, and frequently asked questions about managing this condition.
Understanding Chronic Hepatitis B
Hepatitis B is caused by the hepatitis B virus (HBV). It is transmitted through contact with infected blood or bodily fluids. If the acute infection lasts more than 6 months, it is considered chronic. About 90-95% of healthy adult patients clear the virus spontaneously within 1 year. The remaining 5-10% develop chronic hepatitis B.
The virus continues to replicate in the liver of patients with chronic hepatitis B. This causes persistent inflammation and progresses to liver damage and scarring called fibrosis. Over time, it can lead to cirrhosis, liver failure, and liver cancer.
People at high risk of developing chronic hepatitis B include babies born to HBV-infected mothers, young children infected at an early age, immunocompromised patients, and those with HIV coinfection. Luckily, we now have vaccines to prevent hepatitis B as well as effective medications to treat it.
Common Drugs Used To Treat Chronic Hepatitis B
The goals of treatment are to suppress HBV replication and prevent the progression of liver disease. This requires long-term, sometimes lifelong treatment. The commonly used drugs include:
- Nucleoside/nucleotide analogues: These oral antiviral agents inhibit HBV replication. They include lamivudine, adefovir, entecavir, telbivudine, and tenofovir. Of these, entecavir and tenofovir are the most potent and have a high barrier to resistance.
- Pegylated interferon alfa: This injectable drug modulates the immune system response against HBV. It has a finite duration of treatment unlike nucleos(t)ide analogues which usually need lifelong treatment. However, it is less effective than oral agents.
- Combination therapy: Combining nucleoside/nucleotide analogues with interferon may improve treatment outcomes in some patients.
The choice of agent depends on the hepatitis B genotype, level of HBV DNA, severity of liver disease, and risk of resistance. Frequent monitoring of medication efficacy and safety is important during the treatment course.
Effective Tips To Aid The Treatment Of Chronic Hepatitis B
Besides medication, certain lifestyle measures can aid hepatitis B treatment. These include:
- Avoiding alcohol and tobacco: These can accelerate liver damage and are best avoided.
- Dietary changes: Eating a balanced, low-fat diet rich in vegetables, fruits, and whole grains helps maintain liver health. Avoiding raw shellfish minimizes exposure to other viral infections.
- Vaccinating against hepatitis A: Getting the hepatitis A vaccine provides protection against another virus that can infect the liver.
- Monitoring for liver cancer: Patients should undergo periodic screening for liver cancer using ultrasound or alpha-fetoprotein blood tests. Early detection improves outcomes.
- Reducing transmission: Household members should get the hepatitis B vaccine. Patients should not donate blood or share razors, nail clippers, etc. Safe sex practices lower transmission risk.
- Managing comorbidities: Controlling diabetes and obesity through diet, exercise, and medication helps reduce additional liver strain.
- Stress management: Stress management techniques like meditation, yoga, and counseling help cope with the emotional aspects of living with chronic hepatitis B. Joining a patient support group also helps.
Following the treatment regimen consistently along with the above measures provides the best chance for viral suppression and prevents the progression of chronic hepatitis B.
Chronic hepatitis B infection requires prompt and consistent medical care as well as certain lifestyle changes for optimal management. The mainstay of treatment involves oral antiviral medications like tenofovir or entecavir which can effectively suppress HBV replication. Pegylated interferon is another option for finite-duration therapy.
Along with medications, avoiding alcohol, tobacco, and hepatitis A infection plus screening for liver cancer aids the treatment process. Addressing comorbid conditions, reducing stress and transmission also improves treatment outcomes in chronic hepatitis B. With the right medical care and self-management, patients can lead full lives despite this condition.
A1. You have chronic hepatitis B if your HBV infection persists for more than 6 months based on blood tests showing detectable viral DNA and hepatitis B surface antigen. Your doctor will monitor your liver enzymes, viral load, and liver health to diagnose a chronic infection.
A2. Key blood tests include hepatitis B surface and core antibody, hepatitis B envelope antigen, hepatitis B virus DNA level, complete blood count, liver enzyme panel, serum albumin and bilirubin, and INR. These help assess liver damage and monitor treatment efficacy.
A3. Approved drugs like tenofovir and entecavir have excellent safety records for long-term use. Your doctor will monitor you for any side effects. The risks of untreated chronic hepatitis B outweigh the low risks of medication side effects for most patients.
A4. Make sure all your household members get the full hepatitis B vaccine series. Do not share razors, toothbrushes, or other personal items. Use protection during sex. Clean any blood spills with a diluted bleach solution. Get regular screenings for your family.
A5. People with chronic hepatitis B have a higher liver cancer risk. Your doctor will recommend screening every 6 months with an ultrasound and AFP blood test. Annual screening is advised if you do not have cirrhosis.