Chronic (long term) hepatitis B
Not everyone with chronic hepatitis B requires treatment. The hepatitis B virus goes through different stages as your body recognises and reacts to the virus. Treatment is only needed (and will only work) during some of these stages. The only way to tell when treatment will be effective is through regular (usually 6 monthly) monitoring of blood and liver tests with a liver specialist. All people with chronic hepatitis B need to have regular appointments with a liver specialist, whether you are receiving treatment or not. You GP can make a referral to a specialist in your area.
Once the specialist says that it is time for treatment, most people will be treated with oral (by mouth) antiviral medication. These are just tablets taken twice a day. They are very well tolerated, and most people experience no side effects. Some people may experience mild side effects, such as stomach irritation, when they are first taking the tablets, but this goes away after a few days.
Often the hardest thing about treatment for hepatitis B is remembering to take the tablets. You may need to be on antiviral medication for 3-5 years, and some people may need to be on medication for the rest of their lives. The purpose of hepatitis B treatment is not to cure the virus, but it is to keep the virus under control to prevent liver damage from occurring.
Some people with chronic hepatitis B may go on a medication called interferon. Interferon is injected once per week and you will be taught how to do this injection yourself. Treatment with interferon is for one year only. Interferon can have a lot of side effects (flu-like symptoms, fatigue, mood changes) but can be a good option for people who want to know exactly how long they will be on treatment (such as women wanting to start a family). Your specialists will discuss all treatment options with you to help you make a decision about the best treatment to take for your circumstances.
Untreated, chronic (long term), hepatitis B can lead to serious liver disease and/or liver cancer in 1 in 4 people with hepatitis B. There is a safe and effective treatment for chronic hepatitis B, but many people with chronic hepatitis B don’t access treatment because they are either undiagnosed, or do not know they are at risk of serious liver disease.
If you do have chronic hepatitis B, regular monitoring is important to see if you will require treatment or not. Even if you feel well, you will need to be referred to a specialist for monitoring and assessment.
Acute (short term) hepatitis B
If you catch hepatitis B as an adult there is a good chance (95%) that you will have a short-term (up to 6 months) illness only before your immune system gets rid of the virus. Often adults acquire hepatitis B through unprotected sex or injecting drug use (see transmission section). If you know, or suspect, you have been exposed (and you haven’t been vaccinated) there are things you can do to reduce your risk of developing acute hepatitis B (see prevention section).
Unfortunately there is no treatment for acute hepatitis B. If you have been diagnosed with acute hepatitis B, work with your GP around managing your symptoms. As with any viral illness it is important to rest, drink plenty of fluids, and treat any pains, fevers, nausea or vomiting you may have. Avoid alcohol, and ensure that you use condoms and other safe sex practices if having sex. People you share a house with and any sexual partners should also be tested for hepatitis B, and vaccinated if not protected.
In a small number of cases, acute hepatitis B can develop into a life threatening condition called ‘fulminant hepatitis’. If you have a worsening of symptoms contact your doctor, or go a to hospital emergency department, immediately.