Safe, Effective Hepatitis B Treatments
Hepatitis B is inflammation in the liver that is caused by the hepatitis B virus (HBV). While vaccination can help prevent you from contracting this virus, it still affects roughly 296 million people globally, many of whom are children. It contributes to around 820,000 deaths per year. (1)
Although there is no cure, hepatitis B is often treatable. If you’ve been diagnosed with this virus, you may be wondering about your treatment options.
Here are a few hepatitis B treatment options to consider
No Treatment at All
Just because you have the hepatitis B virus doesn’t automatically mean that you need treatment. Some people with an acute or short-term hepatitis B infection do get better on their own. Even those diagnosed with chronic hepatitis B don’t necessarily need to be treated. (2)
Several factors can help decide if treatment is the right decision for you.
Among them are:
- your age
- your risk of developing serious liver issues
- and what blood test results say about the level of the virus in your body. (3)
The goal of antiviral medication is to keep the hepatitis B virus from reproducing or replicating. Depending on your condition, your healthcare provider may prescribe one antiviral medication, or they may combine two medicines for a better effect. These medications tend to be strong, have a low risk of developing viral resistance, and typically have few adverse side effects. (4)
As of January 2022, the first-line antiviral drugs of choice for treating hepatitis B are: (5)
- tenofovir disoproxil fumarate
- tenofovir alafenamide
Other antiviral medications used to treat chronic hepatitis B infections include adefovir and lamivudine. (6) Several of these have a 90% or higher success rate for reducing the viral load, and they work for several years after taking the drug. (5)
Research indicates that the use of antivirals early on can reduce the risk of end-stage liver disease and even death in patients with chronic hepatitis B who also have normal alanine transaminase (ALT) levels. (7) Normal ALT levels suggest that liver damage has not yet occurred.
Achieving success with antiviral medications requires taking them as prescribed. When treatment regimens are not adhered to, their ability to work drops dramatically. (5)
Another option for taking daily medication is to treat hepatitis B with injections. Interferon is one such injection that helps protect against the virus while also modulating the body’s immune response.
Interferon-based therapy, such as pegylated interferon (Peg-IFN), has greater effectiveness when it is long-term. When taken for 48 weeks, it is found to have a 41% success rate of normalizing ALT levels, with the success rate being smaller if it is taken for shorter durations. (5)
That said, interferon therapies are not used too often because, since they are delivered via injection, they require multiple visits to your healthcare provider. Plus, interferon treatments can have a longer list of potential side effects, and these adverse effects are relatively common.
In addition, interferon treatments are not recommended for patients with hepatic decompensation, those who are immunosuppressed, have major co-occurring diseases, or are pregnant. Therefore, Peg-IFN can only be used in fewer than 5% of patients with hepatitis B. (5)
If severe liver damage has occurred, a transplant may be recommended. A majority of transplanted livers are received from deceased donors, with a smaller portion coming from donors who are still living. (6)
Antiviral therapy is required for the remainder of your life after receiving a liver transplant to help prevent complications. This therapy generally involves taking oral nucleos(t)ide analogs (NAs) and receiving hepatitis B immune globulin (HBIG) injections, although research suggests that HBIG injections may not be needed with some of the newer NAs. (8)
Alternative Hepatitis B Treatments
Some studies have found that alternative therapies may aid in the treatment of hepatitis B. For instance, a piece of research published in Frontiers in Cellular and Infection Microbiology on January 22, 2021, notes that maoto—a Traditional Chinese Medicine which is a combination of ephedra, apricot kernel, cinnamon bark, and glycyrrhiza root—appears to suppress the hepatitis B virus. (9)
Another study found that a natural polyherbal blend called Safoof akseer e jigar was as effective as a therapeutic drug for treating hepatitis B. (10) This blend is sometimes found in syrup form.
Which Hepatitis B Treatment Is Best for You?
Your healthcare provider can help determine the best treatment for you, if treatment is recommended at all. However, understanding the options that exist can help you have a more informed conversation with your provider. It also increases your awareness of what to ask, ensuring that all your hepatitis B treatment questions are answered before deciding what is right for you.
(1) Centers for Disease Control and Prevention. (2022, July 27). Fast Facts on Global Hepatitis B. Retrieved January 31, 2023, from https://www.cdc.gov/globalhealth/immunization/diseases/hepatitis-b/data/fast-facts.html
(2) National Library of Medicine: Medline Plus. (2021, March 03). Hepatitis B. Retrieved January 31, 2023, from https://medlineplus.gov/hepatitisb.html
(3) U.S. Department of Veterans Affairs. (2022, April 13). Viral Hepatitis and Liver Disease: Treatment – Hepatitis B for Patients. Retrieved January 31, 2023, from https://www.hepatitis.va.gov/hbv/patient/treat.asp
(4) Johns Hopkins Medicine. (n.d.). Hepatitis B Treatment. Retrieved January 31, 2023, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/h/hepatitis/hepatitis-b/hepatitis-b-treatment
(5) Chien, R., Liaw, Y. (2022, February 21). Current Trend in Antiviral Therapy for Chronic Hepatitis B. Viruses. doi:10.3390/v14020434
(6) Mayo Clinic. (2022, September 24). Hepatitis B. Retrieved January 31, 2023, from https://www.mayoclinic.org/diseases-conditions/hepatitis-b/diagnosis-treatment/drc-20366821
(7) Zhou, J., Wang, F., Wang, M., et al. (2021, August 30). Antiviral Therapy for Chronic HBV Infection with Persistently Normal Alanine Aminotransferase: Controversy and Consensus. Frontiers in Medicine. doi:10.3389/fmed.2021.717125
(8) Fung, J. (2015, June 08). Management of Chronic Hepatitis B Before and After Liver Transplantation. World Journal of Hepatology. doi:10.4254/wjh.v7.i10.1421
(9) Rahman, M., Ueda, K., Honda, T. (2021, January 22). A Traditional Chinese Medicine, Maoto, Suppresses Hepatitis B Virus Production. Frontiers in Cellular and Infection Microbiology. doi:10.3389/fcimb.2020.581345
(10) Iqbal, O., Nazar, H., Afzal, S., Usmanghani, K. (2017, January). Alternative Treatment in Hepatitis B by Using Polyherbal Formulation. Pakistan Journal of Pharmaceutical Science. Retrieved January 31, 2023, from https://pubmed.ncbi.nlm.nih.gov/28603112/