What Is The Best Medication For Hepatitis B

What Does Treatment With The New Drugs Involve

The drugs are easy to take and are taken orally.

Treatment time is usually 12 weeks. However this may range between 8 and 24 weeks for a complete course of treatment, depending on the patients genotype, whether the patient has cirrhosis, treatment history and which of the drug combinations the prescriber chooses to use.

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How Do I Get Hepatitis B Treatment

Usually for adults, hepatitis B goes away on its own and you wont need treatment. Your doctor might tell you to rest, eat well, and get plenty of fluids. You may also get medicines to help with any symptoms you might have but be sure to talk with your doctor or nurse before taking anything.

If you have chronic hepatitis, there are medicines you can take to treat it. Your doctor will tell you about your options and help you get whatever treatment you need.

The 5 Types Of Viral Hepatitis

Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally transmitted hepatitis.

Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

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History And Physical Exam

To diagnose hepatitis, first your doctor will take your history to determine any risk factors you may have for infectious or noninfectious hepatitis.

During a physical examination, your doctor may press down gently on your abdomen to see if theres pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam.

Is There A Cure For Chronic Hepatitis B

Currently, there is no complete cure for hepatitis B. But when managed properly, those living with the virus can expect to live a normal life. Maintaining a healthy diet and avoiding alcoholic beverages and tobacco products are crucial components in managing the disease.

You should also visit a doctor familiar with hepatitis B at least annuallythough twice a year might be best to monitor your liver through blood tests and medical imaging. As with most diseases, detecting it early leads to a better outcome. If youre exposed to the virus, you should get an antibody injection within 12 hours of exposure.

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Living With Hepatitis B

If you have hepatitis, you should:

• avoid having unprotected sex, including anal and oral sex, unless you’re sure your partner has been vaccinated against hepatitis B
• avoid sharing needles used to inject drugs with other people
• take precautions to avoid the spread of infection, such as not sharing toothbrushes or razors with other people
• eat a generally healthy, balanced diet there’s no special diet for people with hepatitis B
• avoid drinking alcohol this can increase your risk of developing serious liver problems
• speak to your doctor if you’re thinking of having a baby

People with hepatitis B can usually have a healthy pregnancy, but it’s a good idea to discuss your plans with a doctor first as you may need extra care and your medications may need to be changed.

There’s a risk of pregnant women with hepatitis B passing the infection on to their child around the time of the birth, but this risk can be reduced by ensuring the baby is vaccinated shortly after they’re born.

Page last reviewed: 30 January 2019 Next review due: 30 January 2022

Treatment For Suspected Exposure

Anyone who has had potential exposure to HBV can undergo a postexposure prophylaxis protocol.

This consists of HBV vaccination and hepatitis B immunoglobin . Healthcare workers give the prophylaxis after the exposure and before an acute infection develops.

This protocol will not cure an infection that has already developed. However, it decreases the rate of acute infection.

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Treatment For Chronic Hbv Infection

For chronic HBV infection, antiviral medications are available.

This is not a cure for chronic HBV. However, it can stop the virus from replicating and prevent its progression into advanced liver disease.

A person with a chronic HBV infection can develop cirrhosis or liver cancer rapidly and without warning. If a person does not have access to adequate treatment or facilities, liver cancer can be fatal within months of diagnosis.

People with a chronic HBV infection require ongoing medical evaluation and an ultrasound of the liver

Are Alternative Medicines Available

Some people believe certain forms of alternative medicine help cure hepatitis C.

However, the National Center for Complementary and Integrative Health reports that there are no effective, research-proven forms of alternative treatment or complementary medicine for hepatitis C.

Silymarin, also known as milk thistle, is an herb commonly suggested to help cure hepatitis C liver disease. But a rigorous did not find any beneficial effects from this supplement.

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What Are The Symptoms

What happens to you when you contract hepatitis B depends largely on the age at which you first become infected and how well your immune system copes with the virus. If you are infected as an adult, you may have a brief illness with mild or moderate symptoms such as jaundice, dark urine, fatigue, abdominal discomfort, and loss of appetite. As an adult, you have a 95% chance of clearing the infection completely and developing lifelong protection against this virus. The acute infection rarely leads to severe illness that requires a liver transplant.

Most babies and children exposed to this virus never have signs and symptoms. Unfortunately, they are more likely to become carriers of hepatitis B for life because their immune system is unable to fight and clear the virus from their body. In these cases, chronic infections are often not detected or picked up until much later in life when the person becomes seriously ill with liver disease.

Chronic hepatitis B infection goes through different phases that also show how well your body is coping with the virus. Although most people with chronic hepatitis B have an inactive disease and will remain healthy, about one in four will have active disease that may lead to cirrhosis , liver failure, and liver cancer.

People who are healthy with an inactive disease may still be at risk of virus reactivation, especially when their immune system is weakened by medicines such as chemotherapy or by other viral infections.

How Is Hepatitis B Diagnosed

There are three main ways to diagnose HBV infection. They include:

• Blood tests: Tests of the blood serum shows how your bodys immune system is responding to the virus. A blood test can also tell you if you are immune to HBV.
• Abdominal ultrasound: An ultrasound uses sound waves to show the size and shape of your liver and how well the blood flows through it.
• Liver biopsy: A small sample of your liver tissue is removed though a tiny incision and sent to a lab for analysis.

The blood test that is used to diagnose hepatitis B is not a test that you get routinely during a medical visit. Often, people whove become infected first learn they have hepatitis B when they go to donate blood. Blood donations are routinely scanned for the infection.

The virus can be detected within 30 to 60 days of infection. About 70% of adults with hepatitis B develop symptoms, which tend to appear an average of 90 days after initial exposure to the virus.

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What Should You Know About Pregnancy And Hepatitis B

A pregnant woman who has hepatitis B can pass the infection to her baby at delivery. This is true for both vaginal and cesarean deliveries.

You should ask your healthcare provider to test you for hepatitis B when you find out you are pregnant. However, while it is important for you and your healthcare provider to know if you do have hepatitis B, the condition should not affect the way that your pregnancy progresses.

If you do test positive, your provider may suggest that you contact another healthcare provider, a liver doctor, who is skilled in managing people with hepatitis B infections. You may have a high viral load and may need treatment during the last 3 months of your pregnancy. A viral load is the term for how much of the infection you have inside of you.

You can prevent your infant from getting hepatitis B infection by making sure that your baby gets the hepatitis B vaccine in the hours after they are born along with the hepatitis B immunoglobulin. These two shots are given in two different locations on the baby. They are the first shots needed.

Depending on the type of vaccine used, two or three more doses must be given, usually when the baby is 1 month old and then 6 months old, with the last by the time the baby is 1 year old. It is critical that all newborns get the hepatitis B vaccination, but even more important if you have hepatitis B yourself.

How Does Harvoni Work

Harvoni directly blocks the ability of the hepatitis C virus to make copies of itself in the liver. Sofosbuvir interferes with the reproduction of the genetic material of the hepatitis C virus and ledipasvir works by interfering with a protein needed by the virus. Together, they greatly reduce and then stop the production of new copies of the hepatitis C virus. Over time, these actions eliminate the hepatitis C virus from the body.

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What Do I Need To Know About Having Hepatitis B

If you have chronic hepatitis B, getting the right medical care can help you stay healthy. Taking good care of your liver is important. Talk with your doctor before you take any prescription medication, over-the-counter drugs, vitamins, or nutritional supplements to make sure they wont hurt your liver. You should also stay away from alcohol, because drinking can damage your liver.

Selection Of Randomized Control Trials

A total of 6319 studies were identified from the original literature . After screening the titles and abstracts, 1040 potentially relevant publications were retrieved for full text review . After full text review, 42 publications were selected for inclusion . Additional file is a summary of the risk of bias assessment of the included studies and Additional file describes the included study characteristics and the abbreviations for treatment strategies used in NMA. These 42 publications were for mono-infected treatment-naïve adult patients. Twenty-three publications evaluated HBeAg-positive population only and 13 publications evaluated HBeAg-negative population only . Six publications assessed both populations and were included in both networks as they reported the outcomes separately for each population. Table summarizes the included studies by interventions according to the HBeAg status. The total number of participants in each study ranged from 42 to 921. The overall number of included participants was 12,885. Participant baseline characteristics in each study are summarized in Additional file .

Table 2 Summary of included studies by treatments according to HBeAg status

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Who Should Be Vaccinated For Hepatitis B

All newborns should be vaccinated. Also, people who are under 18 who were not vaccinated at birth should also get the vaccine. Other groups who should be sure to be vaccinated are those in certain high-risk categories, such as:

• People who have more than one sexual partner.
• Men who have sex with men.
• Adults with diabetes.
• Sexual partners of infected people and people who share households with infected individuals.
• People who are exposed to blood and other bodily fluids, including healthcare and public safety professionals, and people who work in jails and other places taking care of people who cant take care of themselves.

What Are The Names Of The Medications For Treating Hepatitis C

Since 2014, multiple different antiviral treatments for hepatitis C have been developed. With the many options now available, often there is more than one good choice for a patient. Some of the treatments are recommended as first-line options, some are second-line options, and others are used less commonly in light of all the available choices.

• Elbasvir/Grazoprevir

Second line hepatitis C medications:

• Sofosbuvir/Velpatasvir/Voxelaprevir

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Are There Any Other Precautions Or Warnings For This Medication

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Hepatitis B and HIV co-infections: The safety and effectiveness of taking tenofovir alafenamide to treat hepatitis B if you have also have HIV infection has not been determined. If you are taking tenofovir alafenamide for hepatitis B infection and an existing HIV infection is not being treated effectively, tenofovir alafenamide may increase the chance that your HIV infection will not respond to usual treatment. Therefore, it is important to be tested for HIV before starting treatment with tenofovir alafenamide and whenever there is a risk of HIV exposure during treatment.

Kidney function: This medication may affect kidney function. If you have decreased kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Tenofovir alafenamide should not be used if you have significantly decreased or worsening liver function. Report any signs of liver problems to your doctor.

Children: The safety and effectiveness of using this medication have not been established for children.

Can Hepatitis B Be Controlled By Eating Right And Exercising

It is important that people with liver disease follow a healthy, nutritious diet as outlined by Health Canada in Eating Well with Canadas Food Guide.

Alcohol can also damage the liver so it is best that people with hepatitis B do not drink. Following a healthy lifestyle may also prevent fatty liver disease, another liver disease highly prevalent in Canada.

However, hepatitis B cannot be controlled by healthy eating and exercise alone. Hepatitis B can only be controlled by currently available treatment as prescribed by your doctor. Your doctor will need to do regular blood tests to know how much of the active virus is in your blood . The viral load test is used to monitor and manage hepatitis B patients. Viral load can tell your doctor if you need treatment for hepatitis B and how well you are responding to treatment.

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How Is Hepatitis C Treated

Hepatitis C virus is treated with all-oral medications. These pills, calledantiviral medications, are usually taken once per day. These antiviral medications are extremely good at attacking the virus and preventing it from multiplying.

Antiviral medications were not the original treatment for hepatitis C. Before 2014, the only treatment for hepatitis C was called interferon and ribavirin, taken as weekly injections under the skin, plus pills. Interferon treatment caused many unpleasant side effects and was not usually successful. Then a new generation of medications became available. These antiviral treatments are extremely successful at curing the virus and have very minimal side effects.

Ribavirin is still sometimes prescribed to be taken along with the new antiviral medicines, but it has become more and more uncommon that ribavirin is needed at all. Ribavirin has some mild-moderate side effects. Ribavirin is a pill taken twice per day, as 2 or 3 pills in the morning plus 2 or 3 pills at night, depending on the patient’s body weight. Most patients do not need ribavirin.

Summary Of Drug Class Review Findings: Treatments For Chronic Hepatitis B

The Ontario Drug Policy Research Network conducted a drug class review on the effectiveness, safety, and accessibility of drugs for the treatment of chronic hepatitis B using multiple research methods. CHB treatments are categorized into two groups of treatments: oral nucleosides and injectable interferons .

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What Should You Know About Hepatitis B Before You Travel

Hepatitis B is quite common in China and other Asian countries, where as many as 1 in 12 people have the virus, though many dont know it. Before traveling to those places, you should make sure youve been vaccinated against the virus.

In addition to getting the vaccine, you can take these additional precautions to reduce your risk of contracting the virus:

• Refrain from taking illegal drugs.
• Always use latex or polyurethane condoms during sex.
• Make sure new, sterile needles are used during all piercings, tattoos and acupuncture sessions.
• Avoid direct contact with blood and bodily fluids.
• Know the HBV status of all your sexual partners.
• Ask your doctor about possible vaccination before you travel to a place where hepatitis B is common.

A note from Cleveland Clinic

Hepatitis B is a liver disease that can cause serious damage to your health. One reason that is dangerous is that it can easily go undetected for years while damaging your liver. Talk with your healthcare provider about being tested for hepatitis B if you have any reason to believe that you were not vaccinated or if you have engaged in risky behavior. If you do test positive, follow the directions from your healthcare provider so that you can live a longer, healthier and happier life.

Last reviewed by a Cleveland Clinic medical professional on 07/09/2020.

References

Combination Drug Therapy For Patients With Hepatitis C

• Study Details

During the first 6 months of the study, subjects will be asked to return to the outpatient clinic for routine check-ups and blood tests every 2 to 4 weeks. Blood tests will include tests for hepatitis C virus. If the virus test becomes negative on treatment, the therapy will be considered successful and will be continued for a full 6 or 12 months .

If the virus test does not become negative during the first six months of treatment, subjects will be considered non-responders and will stop taking interferon but will continue on ribavirin alone or an identically appearing placebo tablet. These non-responsive subjects will continue this therapy for an additional 12 months. .

Upon completion of the drug therapies, subjects will be requested to submit blood samples and undergo a liver biopsy to determine if the therapy was successful. Test results that reveal a loss of hepatitis C antibodies or normal levels of liver enzymes will be deemed successful.

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