Saturday, March 26, 2011

Hepatitis B Treatment


Acute hepatitis B usually resolves on its own and does not require medical treatment. If very severe, symptoms such as vomiting or diarrhea are present, the affected person may require treatment to restore fluids and electrolytes. There are no medications that can prevent acute hepatitis B from becoming chronic.
If a person has chronic hepatitis B, they should see their health care provider regularly.

Self-Care at Home

The goals of self-care are to relieve symptoms and prevent worsening of the disease.
  • Drink plenty of fluids to prevent dehydration. Although, broth, sports drinks, gelatin, frozen ice treats (such as Popsicles), and fruit juices may be better because they also provide calories.
  • Ask your physician before taking any medications, even those that are over-the-counter. Some medications depend on the liver, and liver damage may impair the body's ability to metabolize these drugs. If you are on prescription medications, check with your physician to see if the doses should be adjusted or if the medication should be temporarily discontinued.
  • Avoid drinking alcohol until your health care practitioner allows it. Individuals with chronic HBV should avoid alcohol for the rest of their lives.
  • Try to eat a diet that provides adequate nutrition. Take it easy. It may take some time for your energy level to return to normal.
  • Avoid prolonged, vigorous exercise until symptoms start to improve.
  • Call your health care practitioner for advice if your condition worsens or new symptoms appear.
  • Avoid any activity that may spread the infection to other people (sexual intercourse, sharing needles, etc).

Medical Treatment

Acute hepatitis B infection
Acute hepatitis B infection is not treated with antiviral medications.
  • If the infected person is dehydrated from vomiting or diarrhea, a doctor may prescribe IV fluids to help them feel better. Medications may also be used to control these symptoms.
  • People with mild symptoms can be cared for at home.
Chronic hepatitis B infection
The degree of liver damage is related to the amount of active, replicating (multiplying) virus in the blood and liver. Regularly measuring the amount of HBV DNA ('viral load') in the blood gives your physician a good idea of how fast the virus is multiplying. The treatments now in use are classified as antiviral drugs, because they try to stop the virus from multiplying.
  • Antiviral agents, while the best therapy known for chronic hepatitis B, do not work in all individuals with the disease.
  • There are several antiviral agents for chronic hepatitis B approved by the U.S. Food and Drug Administration (FDA). New drugs are always being tested and treatment recommendations are subject to change.
  • Antiviral therapy is not appropriate for everyone with chronic HBV infection. It is reserved for people whose infection is most likely to progress to active hepatitis or cirrhosis.
  • Decisions to start medications for treatment of hepatitis B are made by the patient and health care practitioner, often in consultation with a specialist in diseases of the digestive system (gastroenterologist) or liver (hepatologist).
  • The decision to treat is guided by results of liver function tests, HBV DNA tests, and, frequently, liver biopsies after a complete history and physical examination.
Treatment is usually started when blood tests indicate that liver functions are deteriorating and the amount of replicating HBV is rising. Many people never reach this point. For those who do, the interval between diagnosis and starting treatment is quite variable.

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