Healthcare provider speaking to a patient about hep b treatment

Hep B Treatment: How Hepatitis B Treatment Works

Written on September 19, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Your liver is a vital organ responsible for processing nutrients, filtering the blood, and fighting infections.[1] Various things can damage or cause your liver to be inflamed, such as toxins, heavy alcohol use, or medications. The term “hepatitis” means inflammation of the liver. Hepatitis can impact the function of the liver and can also be caused by viruses. The most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

Hepatitis B virus infection, or Hep B infection, is a serious global public health issue.[1-3] The World Health Organization estimates about 296 million people were living with chronic hepatitis B infection in 2019, and there are 1.5 million new infections each year.[4] Since so many people are infected with Hep B, you might wonder if Hep B treatment is available. Continue reading to learn more about Hep B, detection and treatment options, and how to protect yourself from Hep B infection.

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Understanding Hep B

Hepatitis B infection is caused by the transmission of the hepatitis B virus from an infected person to a person who is not immune.[2] Hep B can be transmitted through unprotected sex, mucosal surface contact, or injection drug use. The hepatitis B virus can also be vertically transmitted perinatally from a mother to a newborn. In the United States, there are approximately 60,000 new cases of hepatitis B infection each year.[2] Between 580,000 to 1.17 million Americans are infected with a chronic hep B infection.[5] Approximately two in three people infected with Hep B have no idea they are infected with the virus.[1]

Hep B can last a few weeks and be a mild condition, or it can be a serious, life-long illness.[1] Hep B is categorized into acute and chronic hepatitis B virus infection.[2,3,5] Acute hepatitis B infection lasts less than six months and does not always present with symptoms.[2,5] When present, symptoms can range from mild illness to more severe illness that can require hospitalization. Signs and symptoms of acute hepatitis B may include[5]:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored stool
  • Joint pain
  • Jaundice

Chronic hepatitis B infection lasts longer than six months.[2] Most people with chronic hepatitis B virus infection are asymptomatic and have no evidence of liver disease or injury.[5] However, chronic hepatitis B, if left untreated, can progress to liver cirrhosis or cancer, and even lead to death. Chronic hepatitis B infection risk varies by age at infection and is greatest in young children.[5] Around 90% of infected infants and 30% of children infected between the ages of 1 and 5 will remain chronically infected with the virus. However, 95% of infected adults will recover and do not progress to chronic infection.

Detecting And Diagnosing Hep B

Your healthcare provider can diagnose hepatitis B infection based on patient history, physical examination, laboratory tests, and imaging.[2] Other causes of hepatitis, such as the hepatitis C virus, may be considered by your healthcare provider and be included as part of the investigation process as well.

Hepatitis B infection has multiple laboratory viral markers in the blood, or serologic markers, that are either detectable or not, depending on whether the infection is acute or chronic.[2] For example, the viral marker known as hepatitis B surface antigen (HBsAg) is detectable in the body 1 to 12 weeks after the initial infection. Serological testing for HBsAg and another marker (IgM anti-HBc) is used to diagnose acute hepatitis B virus infection.[3] A persistent serologic level of HBsAg for more than six months and the presence of IgG anti-HBc is diagnostic of chronic hepatitis B virus infection. Additionally, enzymes in the liver are typically elevated as part of the active inflammatory process.[2]

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Hep B Treatment Options

In acute hepatitis B infection, the virus is self-cleared in 95% of healthy adults.[2] People with acute hepatitis B are usually treated with supportive care to help alleviate the symptoms present.[1] Supportive care can include rest, adequate nutrition, and fluids, but no specific medication treatment is available. Chronic hepatitis B can be treated with antiviral drugs and monitored regularly for signs of liver disease progression. Pregnant patients who are positive for hepatitis B infection should be evaluated and also be provided antiviral therapy to decrease perinatal transmission.[1] There is currently no cure for Hep B infection, but the treatments can help reduce the chances of developing related severe conditions.[6] The goals of antiviral therapy are to[2]:

  • Suppress hepatitis B virus replication
  • Reduce liver inflammation
  • Prevent progression to liver cirrhosis and cancer (i.e., hepatocellular carcinoma)

Steps To Reduce Your Risk Of Hep B

The most effective way to prevent hepatitis B infection is vaccination.[3] Hep B vaccines are safe and effective in helping reduce the infection.[6] All infants, children, and adolescents younger than 19 years of age, all adults 19 to 59 years old, and adults aged 60 years and older with or without risk factors can potentially get the vaccine.[1] If you are considering getting the hep B vaccination, speak with your healthcare provider. They will consider if you have had a serious allergic reaction to a prior dose of the hep B vaccine or any component of the vaccine. Adult patients in certain care settings (such as health care, evaluation, or treatment centers) where there is a known higher risk of hepatitis B infection, should receive vaccinations.[5] These settings include[5]:

  • Sexually transmitted disease treatment facilities
  • HIV testing and treatment centers
  • Facilities for drug abuse treatment and prevention
  • Healthcare settings with services targeting people who are injection drug users
  • Correctional facilities
  • Chronic hemodialysis centers and end-stage renal disease programs
  • Institutions and nonresidential day care facilities for people with developmental disabilities

In addition to vaccination, there are other ways to help reduce your risk of contracting the hepatitis B virus. Other ways to help prevent the spread of hepatitis B infection are[7]:

  • Using condoms with sexual partners
  • Avoiding direct contact with blood and bodily fluids
  • Covering all cuts carefully
  • Not sharing sharp items such as razors, nail clippers, toothbrushes, or earrings and body rings
  • Avoiding injection drug use

How Everlywell Can Help

At Everlywell, you have the option of connecting with a healthcare provider via Virtual Care Visits. Since Hep B can be transmitted through sexual contact, you can schedule an online sexual health consult with a certified clinician in less than two hours to discuss your sexual health. Based on your conversation and the assessment by the healthcare provider, you can get treatment recommendations, information on next steps based on your symptoms and exposure history, and prescription medication sent directly to your pharmacy, if applicable. You can also discuss with the healthcare provider questions regarding other types of infections that can be transmitted through sexual contact and ways to protect yourself and lower your risk.

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References

  1. What is viral hepatitis? Centers for Disease Control and Prevention. March 9, 2023. https://www.cdc.gov/hepatitis/abc/index.htm. Accessed September 11, 2023.
  2. Tripathi N, Mousa OY. Hepatitis B.[Updated 2023]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
  3. Jeng WJ, Papatheodoridis GV, Lok ASF. Hepatitis B. Lancet. 2023;401(10381):1039-1052. doi:10.1016/S0140-6736(22)01468-4.
  4. Hepatitis B. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. Accessed September 11, 2023.
  5. Hepatitis B Information. Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm#overview. March 30, 2022. Accessed September 11, 2023.
  6. Hepatitis B basics. Office of Infectious Disease and HIV/AIDS Policy (OIDP). https://www.hhs.gov/hepatitis/learn-about-viral-hepatitis/hepatitis-b-basics/index.html. March 31, 2023. Accessed September 11, 2023.
  7. Prevention Tips for Hepatitis B. Hepatitis B Foundation. https://www.hepb.org/prevention-and-diagnosis/prevention-tips/. Accessed September 11, 2023.
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