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Outlook Brightens for Chronic Hepatitis B

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Besides reducing viral load, discover how a Hepatitis B medication also appears to reverse fibrosis.

Affecting nearly one-third of the world’s total population, Hepatitis B is our planet’s most common serious liver infection. While some people can fully recover from an acute infection, those who can’t get rid of this virus develop chronic Hepatitis B – a disease capable of progressively harming the liver. The FDA has approved seven drugs for adults with chronic Hepatitis B, but they rarely provide a complete cure. Instead, these drugs significantly decrease the risk of liver damage from the virus by slowing down or stopping Hepatitis B from reproducing. However, new research demonstrates that one common Hepatitis B drug may actually reverse damage previously done by the virus.

About Hepatitis B

Caused by the Hepatitis B virus, Hepatitis B is a potentially life-threatening liver infection. In those who develop the chronic version of this illness, Hepatitis B can lead to liver failure, liver cancer, or cirrhosis – a condition that causes permanent scarring of the liver. Found in blood and infected bodily fluids, Hepatitis B is most commonly spread from a mother to her baby at birth, through unprotected sex, the sharing of unsterile needles and sharing of personal care items such as toothbrushes or razors. Besides heeding fastidious infection control practices, our best defense against Hepatitis B is the vaccine designed to prevent it.

Available since 1982, the Hepatitis B vaccine is 95 percent effective in preventing Hepatitis B infection and its chronic consequences. Thanks to widespread vaccination and Hepatitis B screening, this illness is much less common among people born in the U.S. than it was a generation ago. Nonetheless, the World Health Organization estimates that two billion people have been infected with the Hepatitis B virus worldwide.

Hepatitis B Drugs

Many people infected with the Hepatitis B virus are able to fight off the virus on their own. Though, those who develop chronic Hepatitis B may need to treat it with medications. As of September 2010, there are seven drugs approved in the U.S. to treat Hepatitis B:

  1. Interferon Alpha – Injections given several times a week for six months to a year or longer, interferon alpha can cause severe side effects.
  2. Pegylated Interferon – Injections given once a week for six months to a year or longer, pegylated interferon can also cause severe side effects.
  3. Lamivudine – A once a day pill, lamivudine is usually taken for a year or longer but has few side effects.
  4. Adefovir Dipivoxil – A once a day pill, adefovir dipivoxil is usually taken for a year or longer but has few side effects.
  5. Entecavir – A once a day pill, entecavir is usually taken for a year or longer but has few side effects.
  6. Telbivudine – A once a day pill, telbivudine is usually taken for a year or longer but has few side effects.
  7. Tenofovir – A once a day pill, tenofovir is usually taken for a year or longer but has few side effects.

The seven drugs listed above rarely cure someone of this illness, but they are reasonably effective at hampering the Hepatitis B virus’ lifecycle. Similar to HIV treatment, combining two or more of these medications is thought to be the most effective route for treating chronic Hepatitis B.

The Study Claiming an Additional Benefit

As published in the September 2010 edition of Hepatology, researchers from Taiwan found that long-term therapy with one of the Hepatitis B drugs has an additional benefit to those with this chronic liver disease. Despite being funded by Bristol-Myers Squib, the drug’s manufacturer, the study on entecavir demonstrates reasonable evidence that entecavir helps reduce liver injury in those with chronic Hepatitis B. Important details of this study include:

  • The study assessed long-term outcomes among patients with chronic Hepatitis B who took entecavir (trade name Baraclude) for a period of three to seven years.
  • Ninety-six percent of participants showed reductions in liver inflammation that leads to liver fibrosis or cirrhosis.
  • About 90 percent of participants showed improvements in liver fibrosis scores – meaning that the scarring in their liver lessened.

According to study researcher Ting-Tsung Chang of Taiwan’s National Cheng Kung University Hospital, the fact that most patients continued to improve while taking the drug confirms the value of long-term Hepatitis B treatment.

Long-term administration of entecavir not only reduces the amount of Hepatitis B virus in the blood, but also appears to help reverse the damage that this virus had caused. There is currently no successful anti-fibrotic treatment for patients with liver disease. Thus, the implications of this study are extremely important to those with Hepatitis B – and anyone interested in finding new ways to improve liver health.


http://onlinelibrary.wiley.com/doi/10.1002/hep.23785/abstract, Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B, Ting-Tsung Chang, et al, Retrieved September 12, 2010, Hepatology, September 2010.

http://www.baraclude.com/hbv.aspx, About Hepatitis B, Retrieved September 12, 2010, Bristol-Myers Squibb, 2010.

http://www.drugs.com/clinical_trials/pro-pharmaceuticals-novel-carbohydrate-compounds-reverse-liver-fibrosis-pre-clinical-studies-2285.html, Pro-Pharmaceuticals Novel Carbohydrate Compounds Reverse Liver Fibrosis in Pre-clinical Studies, Retrieved September 12, 2010, Drugs.com, 2010.

http://www.hepb.org/patients/hepatitis_b_treatment.htm, Approved Drugs for Adults, Retrieved September 12, 2010, Hepatitis B Foundation, 2010.

http://www.mayoclinic.com/health/hepatitis-b/DS00398, Hepatitis B, Retrieved September 12, 2010, Mayo Foundation for Medical Education and Research, 2010.

http://www.webmd.com/hepatitis/news/20100818/hepatitis-b-drug-fights-liver-fibrosis-cirrhosis, Hepatitis B Drug Fights Liver Fibrosis, Cirrhosis, Salynn Boyles, Retrieved September 12, 2010, WebMD, LLC, 2010.

http://www.who.int/mediacentre/factsheets/fs204/en/, Hepatitis B, Retrieved September 12, 2010, World Health Organization, 2010.

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