Hepatitis B

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Hepatitis B Treatment

Acute hepatitis needs no treatment other than careful monitoring of liver function, by measuring serum transaminases and prothrombin time.

In rare cases of liver failure, the patient should be monitored in an intensive care unit. Because damage to the liver decreases its ability to degrade proteins, protein intake should be restricted and oral lactulose or neomycin should be administered (to limit protein production by bacteria in the gut). Patients should be supported and monitored until they recover or until prognostic factors indicate a liver transplant is necessary. Liver transplantation is the only definitive cure in cases of liver failure.

Treatment of chronic hepatitis is geared towards reducing inflammation, symptoms, and infectivity. Recombinant alpha interferon, currently the only approved antiviral agent for hepatitis, converts 37 percent of patients from the replicative phase to non-replicative phase. However, it is ineffective in most patients, very expensive, and causes some adverse effects. These include a flu-like syndrome, fever, chills, malaise, muscle aches, and rigors ('shakes'). Currently, trials are underway in Europe for natural interferon, which has fewer side effects and is more effective. Liver transplantation is used to treat end-stage chronic hepatitis B liver disease.