How to Treat Hepatitis B

Medically reviewed by Raj Vuppalanchi, MD

Last Updated: March 18, 2021 Approved

Research suggests chronic hepatitis B may increase your risk of liver failure, cirrhosis of the liver, and liver cancer, so it's important to get treatment early to prevent complications. Hepatitis B, which is caused by the hepatitis B virus (HBV), causes inflammation of your liver.^{[1]
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MedlinePlus
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Go to source} Experts say hepatitis B may range from mild to severe, but you might experience symptoms like abdominal pain, dark urine, nausea, vomiting, loss of appetite, fever, joint pain, weakness, fatigue, and yellowing of your skin and eyes.^{[2]
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Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} Visit your doctor if you think you might have hepatitis or if you've exchanged fluids with someone who's infected. Try not to worry because treatment is available.

Part 1

Part 1 of 3:

Obtaining Preventative Care after Exposure

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Understand the causes of hepatitis B so that you can seek treatment immediately if you have been exposed. The hepatitis B virus is transmitted through blood, saliva, semen, or other bodily fluids.^{[3]
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Raj Vuppalanchi, MD
Academic Hepatologist

Expert Interview. 26 October 2020.} Common causes of transmission include:^{[4]
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Mayo Clinic
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- Sexual contact with an infected partner. Transmission can occur via blood, semen, vaginal secretions, and saliva.^{[5]
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- Transmission through infected needles. This includes people who may be sharing needles for intravenous drug use and it includes health care workers who may be at risk of accidental needle sticks.
- Transmission during childbirth. If the mother is infected, she may transmit it to her infant during birth. However, if the mother knows that she is infected, the infant can be vaccinated upon birth and receive Hepatitis B immune globulin to prevent infection.^{[6]
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2
Obtain preventative care if you believe you have been exposed. If you think you may have been exposed to hepatitis B, see a doctor immediately. If you receive care within 12 hours, it may prevent the infection. You doctor will likely do the following:^{[7]
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Mayo Clinic
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- Give you an injection of hepatitis B immune globulin to boost your immune response
- Vaccinate you against hepatitis B^{[8]
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  Raj Vuppalanchi, MD
  Academic Hepatologist
  
  Expert Interview. 26 October 2020.}
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3
Look for the symptoms of a hepatitis B infection. Symptoms usually start one to four months after the initial exposure. Symptoms may include:^{[9]
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Mayo Clinic
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- Abdominal pain
- Dark urine
- Fever
- Joint pain
- Not being hungry
- Vomiting and nausea
- Feeling weak and tired
- Jaundice (your skin and the whites of your eyes turn yellowish)^{[10]
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  Expert Source
  
  Raj Vuppalanchi, MD
  Academic Hepatologist
  
  Expert Interview. 26 October 2020.}
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Part 2

Part 2 of 3:

Getting Medical Care for Hepatitis B

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See a gastroenterologist or an infectious disease expert to be tested for hepatitis B. The doctor may do several tests.^{[11]
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Mayo Clinic
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- The doctor will confirm the presence of the virus with a blood test and whether it is acute or chronic.
- The doctor might also do a liver biopsy to see if you have liver damage. This involves removing a very small piece of liver tissue through a thin needle and analyzing the tissue in the lab.
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Treat acute hepatitis B. Most cases of hepatitis B are acute. Acute cases of hepatitis B, contrary to what the name might suggest, are infections that will go away on their own. 95% of cases will clear on their own and the illness illness typically goes away within a few weeks and liver function is normal within six months. ^{[12]
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Go to source}^{[13]
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Research source}Treatment is usually not indicated in the acute stage.
- Get plenty of bed rest, drink lots of fluids, and stick with healthy foods. This will help your body clear the virus efficiently.^{[14]
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- If you are in pain, discuss what painkillers your doctor recommends, even for over the counter medications (acetaminophen, aspirin, or ibuprofen) or herbal supplements. You don’t want to take anything that will be hard on your liver.^{[15]
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- Schedule follow-up blood tests with your doctor to track the natural course of the infection. These blood tests will help your doctor determine whether the virus is being cleared.
- If your liver is becoming damaged, your doctor may recommend lamivudine (Epivir).^{[16]
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3
Determine whether you need to begin treatment for chronic hepatitis B. If your body has not cleared the virus within a few months, you may have chronic hepatitis B. Your doctor is likely to prescribe medications if you show the following symptoms:^{[17]
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- High virus levels in your blood
- Decreasing liver function
- Signs of long-term liver damage and scarring (cirrhosis)
4
Discuss your treatment options with your doctor. There are several possibilities depending upon your age and circumstances.^{[18]
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Mayo Clinic
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- Antiviral medications can reduce the viral load in your body. Possibilities include lamivudine (Epivir), adefovir (Hepsera), telbivudine (Tyzeka) and entecavir (Baraclude). These medications will slow the progression of the disease and decrease your chances of sustaining liver damage.^{[19]
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- Interferon-alpha is a medication which contains a synthetic version of the protein your body makes to fight the virus. This option is often given to younger people who may want to become pregnant in the next few years and do not want to have a long treatment process. However, it has significant side effects including depression, anxiety, flu-like symptoms, breathing problems, a tight feeling in the chest, and hair loss.^{[21]
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- Nucleoside/nucleotide analogues are substances that prevent the virus from replicating. Some well known ones include adefovir (Hepsera), entecavir (Baraclude), lamivudine (Epivir-HBV, Heptovir, Heptodin), telbivudine (Tyzeka) and tenofovir (Viread). However, these medications have a serious drawback in that the virus may mutate and develop resistance to these drugs after several years of use.^{[23]
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5
Discuss a liver transplant if your liver is severely damaged and in danger of failing. If necessary a surgeon can remove your liver and replace it with a healthy one.
- Sometimes a piece of a healthy liver from a living donor may be used.
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Part 3

Part 3 of 3:

Living With Hepatitis B

1
Understand the limits of the treatments. Even though medications can reduce the number of viruses in the blood to nearly zero, low numbers of the virus still live in the liver and elsewhere.^{[24]
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- Monitor yourself for resurgences of the disease and if you feel the symptoms returning, go to the doctor immediately.
- Ask your doctor what he or she recommends for long-term follow up.
2
Take steps to avoid transmitting the disease to others. It won’t spread through casual contact, but it could through the exchange of bodily fluids.^{[25]
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Mayo Clinic
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- Be open with your partner and encourage him or her to get tested and vaccinated.
- Use a condom during sex to reduce the risk of transmission.
- Don’t share needles, syringes, razors or toothbrushes, all of which could have small amounts of infected blood on them.
3
Avoid ingesting substances that may further damage or burden your liver. This includes alcohol, recreational drugs, and over the counter drugs or supplements.^{[26]
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- Alcohol itself can damage the liver, so you should abstain from drinking alcohol to protect your liver while your body fights the infection.
- Avoid recreational drugs which may cause liver damage.
- Ask your doctor which over the counter medications you can take for mild conditions like a cold, flu, or headache. Even over the counter medications may burden your liver when it is in a damaged or vulnerable state.
4
Maintain your social support network. You will not infect friends through casual contact and the social support is important for your psychological and physical health.
- Seek out support groups for people with liver disease.^{[28]
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- Remind yourself that with appropriate treatment and monitoring, the prognosis for people with hepatitis B is usually very good.
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Expert Q&A

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Question

What is the main cause of hepatitis B?

Raj Vuppalanchi, MD
Academic Hepatologist
Dr. Raj Vuppalanchi is an Academic Hepatologist, a Professor of Medicine at Indiana University School of Medicine, and the Director of Clinical Hepatology at IU Health. With over ten years of experience, Dr. Vuppalanchi runs a clinical practice and provides care to patients with various liver disorders at the University Hospital in Indianapolis. He completed dual fellowships in Clinical Pharmacology and Gastroenterology-Hepatology at Indiana University School of Medicine. Dr. Raj Vuppalanchi is board certified in Internal Medicine and Gastroenterology by the American Board of Internal Medicine and is a member of the American Association for Study of Liver Diseases and the American College of Gastroenterology. His patient-oriented research is dedicated to finding new treatments for various liver disorders as well as the use of diagnostic tests for non-invasive estimation of liver fibrosis (transient elastography) and portal hypertension (spleen stiffness).

Raj Vuppalanchi, MD

Academic Hepatologist

Expert Answer

The disease is spread through direct contact with the blood or bodily fluids of someone else with hepatitis B.

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Question

What are the symptoms of Hepatitis B?

Raj Vuppalanchi, MD
Academic Hepatologist
Dr. Raj Vuppalanchi is an Academic Hepatologist, a Professor of Medicine at Indiana University School of Medicine, and the Director of Clinical Hepatology at IU Health. With over ten years of experience, Dr. Vuppalanchi runs a clinical practice and provides care to patients with various liver disorders at the University Hospital in Indianapolis. He completed dual fellowships in Clinical Pharmacology and Gastroenterology-Hepatology at Indiana University School of Medicine. Dr. Raj Vuppalanchi is board certified in Internal Medicine and Gastroenterology by the American Board of Internal Medicine and is a member of the American Association for Study of Liver Diseases and the American College of Gastroenterology. His patient-oriented research is dedicated to finding new treatments for various liver disorders as well as the use of diagnostic tests for non-invasive estimation of liver fibrosis (transient elastography) and portal hypertension (spleen stiffness).

Raj Vuppalanchi, MD

Academic Hepatologist

Expert Answer

Many people with Hepatitis B don't have any symptoms. However, some people may experience pain in the upper right side of their abdomen, yellowing of the skin, itching, nausea, vomiting, and fever.

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Question

How did I get hepatitis B?

Raj Vuppalanchi, MD
Academic Hepatologist
Dr. Raj Vuppalanchi is an Academic Hepatologist, a Professor of Medicine at Indiana University School of Medicine, and the Director of Clinical Hepatology at IU Health. With over ten years of experience, Dr. Vuppalanchi runs a clinical practice and provides care to patients with various liver disorders at the University Hospital in Indianapolis. He completed dual fellowships in Clinical Pharmacology and Gastroenterology-Hepatology at Indiana University School of Medicine. Dr. Raj Vuppalanchi is board certified in Internal Medicine and Gastroenterology by the American Board of Internal Medicine and is a member of the American Association for Study of Liver Diseases and the American College of Gastroenterology. His patient-oriented research is dedicated to finding new treatments for various liver disorders as well as the use of diagnostic tests for non-invasive estimation of liver fibrosis (transient elastography) and portal hypertension (spleen stiffness).

Raj Vuppalanchi, MD

Academic Hepatologist

Expert Answer

The most common way to contract hepatitis B is through close contact with blood or other bodily fluids.

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