10 Facts Impacting Chronic Hepatitis B Treatment
For the millions of people infected with chronic Hepatitis B, there is no one standard treatment route. Each with its own strengths and drawbacks, choosing which Hepatitis B medication is best – if any at all – is a complex process. If you or someone you love is wondering how to best contend with chronic Hepatitis B infection, make sure you are aware of these 10 facts that could play a major role in how this illness is approached.
About Chronic Hepatitis B
When the virus continues to multiply in the body for more than six months, a person has chronic Hepatitis B infection. Although most people with chronic Hepatitis B have no symptoms, they can still pass the virus to others – especially to people they live with or have sex with. People with chronic Hepatitis B are at increased risk of chronic hepatitis, which can lead to complications such as cirrhosis, liver cancer, liver failure and death.
According to the World Health Organization, more than 2 billion people living today have been infected with Hepatitis B at some time in their life. Of these, about 350 million remain chronically infected and become carriers of the virus. Thus, effective Hepatitis B treatments are in high demand. However, deciding whether or not to treat chronic Hepatitis B and how to treat it can be a confusing and overwhelming journey. To help understand more about experts’ suggestions and the options available, 10 facts about chronic Hepatitis B treatment are listed below:
- Because antiviral agents, the best therapy known for chronic Hepatitis B, do not work in everyone with the virus, all people with chronic Hepatitis B do not necessarily need to be on medication.
- According to the American Association for the Study of Liver Disease (AASLD), those with chronic Hepatitis B are advised to take antiviral therapy if they have high levels of Hepatitis B virus DNA in the blood AND have either high levels of liver enzymes or liver disease.
- All of the medications currently used to treat chronic Hepatitis B are antiviral drugs that reduce the ability of the virus to reproduce in the body and give the liver a chance to heal itself. These drugs are not a cure for Hepatitis B, but they do reduce the damage caused by the virus.
- Although not recommended for those who have cirrhosis or who have had a liver transplant, interferon stops Hepatitis B viral growth in about 35 percent of people who take it. The side effects of this medicine can be severe.
- Only used for chronic Hepatitis B treatment since 2005, studies suggest that another form of interferon with less frequent dosing – pegylated interferon – works better at stopping the Hepatitis B virus than lamivudine.
- Nucleoside/nucleotide analogues (NAs) block the Hepatitis B virus from making new viral particles. Higher treatment success rates are achieved in people who do not have “Hepatitis B e antigen” – which indicates if the virus is actively multiplying.
- Despite drug resistance typically developing within one year, the NA drug, lamivudin, can be used by those with cirrhosis or a weak immune system. Lamivudine reduces liver damage in about half of the people who use it without causing many side effects.
- Also reducing liver damage in about half of the people who use it without many side effects, adefovir is an NA that poses less of a problem of drug resistance than lamivudine. However, adefovir can harm the kidneys and make HIV medicines less effective. In addition, stopping adefovir treatment can cause liver enzymes to rebound to high levels – prohibiting some to ever stop taking this drug.
- Shown to be more effective than lamivudine, entecavir is an NA that greatly reduces liver inflammation and scarring. However, entecavir is associated with some unpleasant side effects and its long-term effects are not yet known.
- Approved for use in 2006, telbivudine is another NA that appears to be more effective than lamivudine, as well as more expensive. Besides not knowing about its long-term effects, this relatively new Hepatitis B drug may have drug resistance problems similar to lamivudine.
Whether considering foregoing pharmaceutical treatment, taking an interferon-based drug regimen or a nucleoside/nucleotide analogue, there are many options for addressing chronic Hepatitis B. Typically reserved for people whose infection is likely to progress to active hepatitis or cirrhosis, antiviral therapy is not appropriate for everyone with this virus. For those who are candidates for taking antiviral medication, picking a chronic Hepatitis B therapy must be carefully chosen under the guidance of a knowledgeable physician.
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http://www.hepb.org/pdf/treatment.pdf, Hepatitis B Treatment Information, Retrieved February 18, 2011, Hepatitis B Foundation, 2011.
http://www.webmd.com/hepatitis/hepb-guide/should-i-use-antiviral-therapy-for-chronic-hepatitis-b, Should I use antiviral therapy for chronic hepatitis B?, Retrieved February 16, 2011, WebMD, LLC, 2011.
http://www.who.int/csr/disease/hepatitis/HepatitisB_whocdscsrlyo2002_2.pdf, Hepatitis B, Retrieved February 19, 2011, World Health Organization, 2011.