What Is New In The Treatment Of Hepatitis B
New agents are under development to treat hepatitis B. Many of these are nucleoside/nucleotide analogues that investigators hope will be more effective than older agents. Experts also are working on treatment guidelines and the use of multi-drug therapy. Vaccination remains the key to preventing hepatitis B and holds the most promise for reducing disease burden.
Prevention And Control Of Hepatitis B
- The hepatitis B vaccine is the mainstay of hepatitis B prevention.
- WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours.
- Simple environmental procedures can limit the risk of infection to health care workers, laboratory personnel, and others. Examples of specific precautions include the following:
- Gloves should be used when handling all potentially infectious materials
- protective garments should be worn and removed before leaving the work area
- masks and eye protection should be worn whenever splashes or droplets from infectious material pose a risk
- only disposable needles should be used
- needles should be discarded directly into special containers without re-sheathing
- work surfaces should be decontaminated using a bleach solution and laboratory personnel should refrain from mouth pipetting, eating, drinking, and smoking in the work area.
- Metal objects and instruments can be disinfected by autoclaving or by exposure to ethylene oxide gas.
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Who Is At Risk For Hepatitis B
Anyone can get hepatitis B, but the risk is higher in:
- Infants born to mothers who have hepatitis B
- People who inject drugs or share needles, syringes, and other types of drug equipment
- Sex partners of people with hepatitis B, especially if they are not using latex or polyurethane condoms during sex
- Men who have sex with men
- People who live with someone who has hepatitis B, especially if they use the same razor, toothbrush, or nail clippers
- Health care and public-safety workers who are exposed to blood on the job
- Yellowish eyes and skin, called jaundice
If you have chronic hepatitis B, you may not have symptoms until complications develop. This could be decades after you were infected. For this reason, hepatitis B screening is important, even if you have no symptoms. Screening means that you are tested for a disease even though you don’t have symptoms. If you are at high risk, your health care provider may suggest screening.
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When To See A Healthcare Provider
If you develop any of the symptoms of chronic hepatitis, liver damage, or liver cancer, see your healthcare provider. It takes only a blood test to detect the presence of a hepatitis virus in your body .
A blood test also can determine which hepatitis virus youre infected with, which will determine what your treatment should be .
Hepatitis B Treatment Is There A Cure
Normally acute Hepatitis B does not require special treatment and the majority of adults clear the virus spontaneously. Early treatment may be required only in less than 1% of infected people who are immunocompromised or whose infection takes an aggressive course.
Its very important to maintain comfort, avoid alcohol, keep to a balanced diet, and replace body fluids lost from diarrhea and vomiting. On the other hand, chronic hepatitis B can be treated with medicines, including antiviral agents. Treatment can help to reduce the risk of cirrhosis and liver cancer.
Chronic Hepatitis B is usually a mild disease among children. Most of them can live full and healthy lives without visible symptoms. However, in some children the virus can cause significant liver damage. They will require medical treatment and intervention. All children suffering from chronic hepatitis B infection should be seen by a liver specialist on a regular basis. During the visits its necessary to take blood tests, physical exams and sometimes ultrasounds of the liver.
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Who Should Get The Hepatitis B Vaccine
All newborn babies should get vaccinated. You should also get the shot if you:
- Come in contact with infected blood or body fluids of friends or family members
- Use needles to take recreational drugs
- Have sex with more than one person
- Are a health care worker
- Work in a day-care center, school, or jail
The Lowdown On The Latest Hepatitis Outbreak
There’s still a lot unknown about the current hepatitis outbreak in children across the world.
So far, experts suggest two possible explanations:
COVID-19 lockdowns resulted in less mingling amongst children, which led to compromised immunity.
This allowed them to become more susceptible to adenovirus infections .
Beware of misinformation circulating online about COVID-19 vaccines as a possible cause of the outbreak. Experts have refuted this claim as most of the children infected with hepatitis of unknown origin were too young to receive the vaccine.¹
Researchers are working hard to understand more about the outbreak to guide treatment and prevent future spread. In the meantime, parents should ensure their children are up-to-date with vaccinations, continue teaching children about good hygiene, and be aware of hepatitis symptoms.
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Hepatitis B Symptoms And Treatment
Hepatitis B is part of a group of hepatitis viruses that attack the liver. It is spread through blood and bodily fluids. It is most commonly passed on via unprotected sex , from a mother to her child during birth, or through contaminated needles.
In adults, it often causes no obvious symptoms and can pass in a few months without treatment. Children are more likely to develop a long-lasting infection. Without appropriate treatment and care, children and adults with a chronic infection can become seriously ill and be at risk of liver damage or death.
Vaccines for hepatitis B are offered to infants and are available for people at high risk of the condition.
How Long Does It Last
According to the World Health Organization , the complete vaccine series induces protective antibody levels in of the infants, children, and adolescents who receive it.
Immune memory induced by the HBV vaccine can last for in healthy people. That said, studies into the duration of the protection that the vaccine offers are ongoing.
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How Are Hepatitis B And C Treated
Hepatitis B: Not all patients with chronic hepatitis B infection require treatment. At Yale Medicine, specialists decide on an individual basis whether a patient is an appropriate candidate for treatment. Generally, patients require treatment when their hepatitis B virus level is high, and when laboratory tests demonstrate significant inflammation or injury to the liver.
There are currently seven approved drugs for hepatitis B, two of which are considered to be first-line treatments. These drugs are oral pills taken once daily, and while they’re very effective at suppressing the virus to very low or undetectable levels over the long term, they are not considered curative.
Therefore, the goal of treatment is to control the virus long-term and decrease the risk of hepatitis B related complications such as cirrhosis and liver cancer.
Hepatitis C: For the greater part of the last 20 years, treatment of hepatitis C required the use of a chemotherapy-like injection drug called interferon, which has been associated with serious side effects and a low cure rate. Fortunately, advances in hepatitis C treatments within the last three years now allow for the use of oral medications that are significant improvements in terms of safety and effectiveness.
Complications Of Hepatitis B
Most people do not have any lasting problems after having a hepatitis B infection.
If left untreated, chronic hepatitis B can cause liver damage and increase your risk of getting liver cancer.
It is important to take any medicine you have been prescribed and go for regular check-ups to make sure your liver is working properly.
Page last reviewed: 01 July 2022 Next review due: 01 July 2025
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How Do Doctors Treat Hepatitis B
Doctors typically dont treat hepatitis B unless it becomes chronic. Doctors may treat chronic hepatitis B with antiviral medicines that attack the virus.
Not everyone with chronic hepatitis B needs treatment. If blood tests show that hepatitis B could be damaging a persons liver, a doctor may prescribe antiviral medicines to lower the chances of liver damage and complications.
Medicines that you take by mouth include
A medicine that doctors can give as a shot is peginterferon alfa-2a .
The length of treatment varies. Hepatitis B medicines may cause side effects. Talk with your doctor about the side effects of treatment. Tell your doctor before taking any other prescription or over-the-counter medicines.
For safety reasons, you also should talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.
Transmission Of Hepatitis B
HBV is often transmitted parenterally, typically via contaminated blood or blood products. Routine screening of donor blood for hepatitis B surface antigen has nearly eliminated the previously common posttransfusion transmission, but transmission through needles shared by drug users remains common. Risk of HBV is increased for patients on dialysis and in oncology units, and for hospital personnel in contact with blood.
Infants born to infected mothers have a 70 to 90% risk of acquiring hepatitis B during delivery Infection Neonatal hepatitis B virus infection is usually acquired during delivery. It is usually asymptomatic but can cause chronic subclinical disease in later childhood or adulthood. Symptomatic infection read more ) unless they are treated with hepatitis B immune globulin and are vaccinated Prevention Neonatal hepatitis B virus infection is usually acquired during delivery. It is usually asymptomatic but can cause chronic subclinical disease in later childhood or adulthood. Symptomatic infection read more immediately after delivery. Earlier transplacental transmission can occur but is rare. The risk of vertical transmission of HBV is also mitigated by treating actively infected pregnant women with high viral loads in their third trimester with tenofovir.
The virus may be spread through mucosal contact with other body fluids , but infectivity is far lower than that of hepatitis A virus, and the means of transmission is often unknown.
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How You Can Get Hepatitis B
You can get hepatitis B from:
- injecting drugs using shared needles
- being injured by a used needle
- having a tattoo or piercing with unsterilised equipment
- having a blood transfusion in a country that does not check blood for hepatitis B. Blood transfusions in the UK are checked for hepatitis B.
If you’re pregnant and have hepatitis B, you can also pass it onto your baby during pregnancy or birth.
What Are Hepatitis B Causes
Hepatitis B is caused by a virus called hepatitis B virus .
The number of people who get this disease has decreased according to the CDC. Rates have dropped up to around 20,000 diagnosed individuals. People between the ages of 20 and 49 are most infected by HBV. Only 5% to 10% of adults and children older than 5 ends up with chronic Hepatitis. But the numbers for those younger than 5 and even higher for infants infected at birth arent so good.
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Chronic Hepatitis B Virus Infection
A chronic hepatitis B infection lasts for more than 6 months. Chronic infection generally happens because your bodys immune system is not able to fight with it. Chronic hepatitis B infection can last for a lifetime, leading to serious health conditions like liver cancer and cirrhosis. The risk of developing chronic hepatitis B infection increases if you get the infection early in your life, that is, newborn babies, if diagnosed with hepatitis B infection at less than 5 years of age, can lead to a higher risk of the infection becoming chronic.
What Are The Treatments For Hepatitis B
If you think you may have been exposed to hepatitis B, its important to talk with a healthcare professional as soon as possible.
A doctor or other healthcare professional may administer the first dose of the hepatitis B vaccine and a shot of hepatitis B immunoglobulin. This is a combination of antibodies that provide short-term protection against the virus.
Though both can be given up to a week after exposure, theyre most effective at preventing infection if administered within 48 hours.
If you receive a diagnosis of acute hepatitis B, a doctor may refer you to a specialist. They may advise you to get regular blood tests to ensure you dont develop chronic hepatitis.
Many people with acute hepatitis B dont experience serious symptoms. But if you do, it can help to:
- get plenty of rest
- take over-the-counter pain mediation, like naproxen, when needed
Other lifestyle changes may also be needed to manage your infection, such as:
- eating a nutritious, balanced diet
- avoiding substances that can harm your liver, such as:
- certain herbal supplements or medications, including acetaminophen
If blood tests show you still have an active infection after 6 months, your doctor may recommend further treatment, including medications to help control the virus and prevent liver damage.
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How Are Hepatitis B And C Diagnosed
Hepatitis B is diagnosed by a series of blood tests. The test may show an ongoing infection or antibodies that indicate that the patient is protected against hepatitis B. In patients who have a positive screening test that suggests the possibility of ongoing infection, further testing is done to determine the levels of the virus in the bloodstream.
Hepatitis C is diagnosed via a blood test called a Hepatitis C Antibody Test. A positive result means that hepatitis C antibodies are present in the blood. But a positive antibody test doesnt necessarily mean a person has hepatitis C. A further blood test is needed to confirm the diagnosis. This second blood test quantifies the amount of the virus or the viral load in the liver and the bloodstream.
What Exactly Is Hepatitis B
However, it cannot be spread to others by sneezing or coughing. Hepatitis B causes liver inflammation that can if it persists cause lasting liver damage.
For many people, hepatitis B is a short-term illness that goes away on its own after some time. For others, however, it can become a chronic condition.
Younger people, especially infants and children below the age of five, who are infected by HBV have a much higher risk of developing chronic hepatitis B.
People from certain regions in the world also carry a higher risk of developing chronic hepatitis B, including persons from Sub-Saharan Africa, the Pacific islands, the Middle East, as well as parts of Northeast and Southeast Asia.
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What Are The Symptoms Of Liver Cancer
Liver cancer and hepatitis B share some similar symptoms, such as jaundice, unexplained fatigue, and loss of appetite. Get medical attention if you notice symptoms such as:
- abdominal swelling
While acute hepatitis B treatment involves symptom relief only, chronic hepatitis B requires antiviral treatment. This can help reduce the overall viral load in the body as well as subsequent liver complications.
Antiviral treatments for hepatitis B are typically taken by mouth. Options include:
- tenofovir disoproxil fumarate
In some cases, a doctor may also prescribe antiviral shots.
Additionally, hepatitis B requires regular monitoring for cirrhosis and possible liver cancer development. A specialist may recommend blood testing with an ultrasound to check for cirrhosis or subsequent liver cancer.
If you develop liver cancer as a result of hepatitis B, a doctor may recommend a liver transplant.
What Makes Yale Medicine’s Approach To Treating Hepatitis B And C Unique
The Viral Hepatitis Program at Yale Medicine represents one of the leading viral hepatitis treatment programs in the country and is engaged in innovative research focused on advancing the care of patients with chronic hepatitis B, C and D infections.
A multidisciplinary team of faculty physicians and mid-level providers offer a coordinated approach to preparing patients for success. Services include structured hepatitis patient education classes, mindfulness-based stress reduction techniques , a formal physician-guided weight-loss program and access to clinical trials evaluating current and new therapies that are not available in routine clinical practice.
Our program is a core member of several national and international observational cohort studies which contributes to the advancement of science of hepatitis treatment around the world.
“Our team at Yale Medicine is uniquely equipped to serve patients with viral hepatitis from Connecticut and beyond and aims to offer outstanding, individualized, patient-centered care to help educate and guide patients through their treatment,” says Dr. Lim. We have specialists who have nationally recognized expertise in the management of viral hepatitis in special populations, including HCV-HIV coinfection, end-stage renal disease, cirrhosis/liver failure, post-liver transplant, and prior failure to respond to all-oral direct acting antivirals .
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Look Out For Hepatitis Symptoms
It’s also important for parents to be aware of hepatitis symptoms and to seek medical treatment immediately if their child shows any signs of illness.
They can also help prevent the spread of hepatitis viruses by teaching their children proper handwashing techniques and emphasizing the importance of covering coughs and sneezes.
Diagnosis And Treatment Of Hepatitis B
The presence of HBV in the body results in the production of antibodies against the virus. Examples of antibodies that target HBV include HBsAG , anti-HBc , and HBeAg . Different blood tests have been designed to detect the different antibodies and thus are used to diagnose hepatitis B.
In acute HBV infection, treatment typically is supportive, centred primarily on adequate rest and fluid intake. Treatment for chronic HBV infection varies. Agents such as lamivudine and interferon alfa-2b disrupt viral reproduction, enabling the liver to recover some of its function. Some patients develop resistance to lamivudine, requiring the use of a different antiviral drug, such as adefovir or entecavir, alone or in combination with lamivudine. Liver transplantation may be considered in cases of chronic liver failure.
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