Hepatitis B Treatment: A Complete Guide
Infectious DiseasesHepatitis B
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Hepatitis B Treatment: A Complete Guide

Hepatitis B Treatment: A Complete Guide
Canva (2); Everyday Health
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Updated on October 31, 2024
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Hepatitis B is a viral infection caused by the hepatitis B virus (HBV), which attacks the liver and can lead to symptoms such as jaundice, nausea, abdominal pain, and liver failure in severe cases. The infection may be acute (short lasting) or chronic (long lasting).

Treatment for acute hepatitis B usually involves rest and preventing dehydration due to vomiting or diarrhea while the body clears itself of the infection. If chronic hepatitis B develops, however, treatment with medication or other approaches can help reduce the risk of severe liver disease and complications.

Around half

 of people with chronic hepatitis B need treatment due to their symptoms of liver disease. Treatment can help toward these goals:


  • Slow or stop the virus’s activity
  • Reduce liver inflammation
  • Stop the disease from progressing to cirrhosis or liver cancer

Always talk to your doctor about the treatment strategy that suits you best.

Medication

Drug therapy can help improve the outlook for chronic hepatitis B and help keep the virus from causing or furthering liver damage. People may need to stay on treatment for hepatitis B for life, although many factors affect this.

 A doctor may prescribe one or more drug types.

Immune Modulators (Interferons)

These drugs help strengthen your immune system to fight the virus. Interferon is mainly prescribed for younger people who don’t want to be on long-term treatment and whose liver still functions well with liver disease.

Two interferon drugs are approved by the U.S. Food and Drug Administration for treating chronic hepatitis B:

  • Pegylated interferon (Pegasys) is the preferred immune drug for HBV. You’ll need weekly injections.
  • Interferon alpha (Intron A) injections are needed several times per week. This treatment is used less often.

For either medication, treatment is usually 48 weeks long. Side effects for both can be severe and include depression, flu-like symptoms, and headaches.

Some people should not take interferons, including people who are pregnant, have a certain type of high blood pressure, or have more severe liver disease. Your doctor will help ensure that this medication is safe for you before prescribing it.

Antiviral Drugs for Hepatitis B

Viruses spread through the body by replicating, or producing new copies of themselves. Antiviral drugs help prevent or slow the rate of replication.

Antiviral treatments for people with chronic hepatitis B include these drugs:

  • adefovir dipivoxil (Hepsera)
  • entecavir (Baraclude)
  • lamivudine (Epivir HBV)
  • tenofovir disoproxil fumarate (Viread)
  • tenofovir alafenamide (Vemlidy)
  • telbivudine (Tyzeka, Sebivo)

In general, there are few side effects with these medications. If your doctor recommends an antiviral drug, the specific medication prescribed will depend on several factors, such as whether you’ve tried other treatments before, whether you’re pregnant, and how well your kidneys function.

Drugs in Clinical Trials

Clinical trials are the last stage of developing new drugs. To reach a clinical trial, a drug must pass through many earlier testing stages to ensure that there is little or no risk for those participating. Taking part in a trial may mean that you try new drugs before they’re widely available.


Scientists are investigating a range of drug types in the hope of finding a cure for hepatitis B.

You can search for clinical trials at ClinicalTrials.gov.

Surgery

If hepatitis B progresses to liver failure, cirrhosis, or liver cancer, surgery to remove all or part of the liver may be necessary.

If the entire liver is removed, you may need a liver transplant. After transplant surgery, you’ll need to take immunosuppressant medications so your body doesn’t reject the new healthy liver.

 You will also need to take antiviral medications after a transplant to prevent your liver from becoming reinfected.

Lifestyle Changes

Lifestyle changes can help you better manage hepatitis B and keep your liver as healthy as possible.

People with hepatitis B need to avoid substances that increase the risk of liver damage:

  • Alcohol
  • Certain medications that are processed in the liver
  • Herbal medications
  • Herbal supplements
If you have hepatitis B, be sure to check with your doctor before taking any supplements, vitamins, or over-the-counter medications. For your best health, you should also adhere to these recommendations:

  • Follow a nutritious diet.
  • Get vaccinated against hepatitis A.
  • Get screened for hepatitis C.
  • Stay physically active.
  • Maintain a body weight that’s healthy for you.

The Takeaway

Hepatitis B is a potentially severe disease that stems from infection with the hepatitis B virus. An acute infection often goes away with time, but many people who experience chronic hepatitis B will need long-term treatment with antiviral medications or immune modulators. Healthy lifestyle choices like avoiding alcohol can help keep your liver healthy if you have hepatitis B.

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Jonathan G. Stine, MD, MSc, FACP

Medical Reviewer
Castle Connolly Top Doctor

Jonathan Stine, MD, MSc, FACP, is an associate professor of medicine and public health science at Penn State in State College, Pennsylvania.

As an internationally recognized liver expert with a research and clinical focus on metabolic dysfunction–associated steatotic liver disease (MASLD) and exercise, he has authored more than 100 peer-reviewed papers, including multinational consensus guidelines.

Dr. Stine is the recipient of multiple research grants and awards from the American Association for the Study of Liver Diseases and the American Cancer Society, and has maintained continuous funding from the National Institutes of Health since 2018.

Stine is the MASLD consultant to the American College of Sports Medicine’s “Exercise is Medicine” initiative, and recently co-chaired the International Roundtable on MASLD and Physical Activity for ACSM. He serves as the Fatty Liver Program director as well as the Liver Center Research director for Penn State.

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Yvette Brazier

Author

Yvette Brazier's career has focused on language, communication, and content production, particularly in health education and information. From 2005 to 2015, she supported learning in the health science department of a higher education establishment, teaching the language of health, research, and other language application skills to paramedic, pharmacy, and medical imaging students.

From 2015 to 2023, Yvette worked as a health information editor at Medical News Today and Healthline. Yvette is now a freelance writer and editor, preparing content for Everyday Health, Medical News Today, and other health information providers.

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Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  2. Treatment Options for Hepatitis B. Hepatitis B Foundation.
  3. Approved Drugs for Adults. Hepatitis B Foundation.
  4. Clinical Trials for Hepatitis B. Hepatitis B Foundation.
  5. Peters MG et al. Chronic Hepatitis B Finite Treatment: Similar and Different Concerns With New Drug Classes. Clinical Infectious Diseases. August 2023.
  6. Surgery. Hepatitis B Foundation.
  7. Liver Transplants. Hepatitis B Foundation.
  8. Hepatitis B. University of California San Francisco.
  9. Tripathi N et al. Hepatitis B. StatPearls. July 9, 2023.
  10. Clinical Care of Hepatitis B. Centers for Disease Control and Prevention. May 2, 2024.