Hepatitis B Care
At our clinic, you will receive the most complete care from a team of leading liver specialists, infectious disease experts, and pharmacists dedicated to the treatment and prevention of hepatitis B.
We also provide top-level care for those who are also infected with HIV, as well as patients undergoing cancer treatment.Also see Liver Disease Care
Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). For many people, hepatitis B is a short-term illness. For others, it can become a long-term, chronic infection that can lead to serious, even life-threatening conditions like cirrhosis or liver cancer.
Types of Hepatitis
Acute hepatitis B is a brief infection (6 months or less) that goes away because the body gets rid of the virus.
Chronic hepatitis B is a long-lasting infection that happens when your body can’t get rid of the virus. Chronic hepatitis B is a serious medical illness. While you may not have symptoms, a chronic infection can lead to deadly liver damage and cancer.
A hepatitis viral panel (series of blood tests) is used to diagnose a hepatitis B infection. These blood tests also establish if the infection is acute or chronic.
These tests are looking for the presence of HBsAg (hepatitis B surface antigen), a protein found on the surface of hepatitis B. The presence of HBsAg indicates a current hepatitis B infection.
Acute hepatitis B: An acute infection that shows the presence of both HBsAg and immunoglobulin M (IgM). IgM is an antibody produced by your immune system.
Chronic hepatitis B: If IgM is not present, and HBsAg has been in your body for six months or longer, it is likely that the infection is chronic.
If you have a chronic infection, your doctor may check for liver damage with liver function tests (blood), an ultrasound of the liver and newer tests such as fibroscan.
Hepatitis D Screening
If a hepatitis B infection is determined, you will then be tested for hepatitis D. Hepatitis D is seen in some areas of the Middle East, Central Asia, South Pacific islands and the Mediterranean Basin.
Hepatitis D is a serious liver disease found only in people with hepatitis B. A co-infection with hepatitis D can accelerate liver damage and worsen symptoms of hepatitis B.
Acute Hepatitis B Treatment
An acute hepatitis B infection usually doesn't require treatment or hospitalization, just close monitoring. An acute infection can last for up to six months with or without symptoms. Acute symptoms include nausea, low fever, and loss of appetite.
About 90 percent of people who get a hepatitis B infection as an adult are able to clear it naturally. But only 10 percent of infants and 40 percent of those ages 1 to 5 are able to get rid of the virus on their own.
During this time, it's recommended that you:
- Eat healthily
- Drink lots of fluids
- Get plenty of rest
It's important to note that while your infection is acute, you are still contagious and can pass the virus on to others.
Anyone who shares a home with an infected person, especially young children, should get the hepatitis B vaccine if they haven't already. Otherwise, avoid sharing things like razors and toothbrushes.
Those who are unable to clear the virus naturally from their body naturally have a chronic infection.
Chronic Hepatitis B Treatment
Currently, there is no complete cure for chronic hepatitis B. However, several effective treatment options can reduce the risk of liver damage and slow down or stop the virus from spreading.
The Three Phases of Infection
To accurately and effectively treat a chronic hepatitis B infection, our liver experts first need to determine which phase of the disease you're in. There is no single test to determine the phase of the infection. Only serial follow-up and testing can lead to an accurate assessment of the disease phase.
There are three defined phases of a chronic hepatitis B infection:
- Immune tolerant phase – Can last for a few years to more than 30 years. There is little to no liver inflammation during this phase, which is typically during childhood to early adulthood in those who are infected at birth.
- Immune active phase – Active liver inflammation is typically present during this phase, with or without scarring of the liver (fibrosis). This is the phase that requires medication therapy.
- Inactive hepatitis B phase ("inactive carrier") – Liver inflammation and scarring (fibrosis) is typically minimal or nonexistent. In some cases, liver damage may have already occurred, even though the disease phase is currently inactive.
A chronic hepatitis B infection can be treated with antiviral medications, such as peginterferon, tenofovir, entecavir and tenofovir alafenaminde. Antiviral medications help remove the virus from the blood while also reducing the risk of liver cancer and cirrhosis.
Risk of Cirrhosis
Roughly 15 to 25 percent of people with a chronic infection will get cirrhosis. If you have a chronic infection, you should see a specialist every six months.
Not everyone with a chronic hepatitis B infection will receive drug therapy. Drug therapy is usually recommended for those who enter the second phase of chronic infection (immune active phase) or if there is established advanced liver damage (cirrhosis) regardless of the current phase of infection.
You may receive antiviral medications if:
- The level of hepatitis B virus in your blood is high.
- You're showing signs of long-term liver damage.
If liver failure occurs, a liver transplant is the only treatment option.
Reinfection After Transplantation
A liver transplant does not cure a hepatitis B infection. However, thanks to improved prevention and medication control, hepatitis B reinfection occurs in only a very small percentage of people. Those who have a higher risk of reinfection include people who had resistance to antiviral drug medication prior to transplant.
All patients who undergo transplantation and have had hepatitis B will require lifelong treatment with a hepatitis B medication to prevent the re-activation of the virus.
Hepatitis B Vaccine
The hepatitis B vaccine (hepatitis B immune globulin) is given in either three or four doses, depending on the medicine brand used.
The hepatitis B virus is harder to fight off naturally the younger you are. You should get the vaccine as early as possible.
It is now recommended that all newborn babies receive the first dose of the hepatitis B vaccine before they leave the hospital. Universal hepatitis B vaccination in newborns began in the 1990s in the U.S. and is now implemented in 185 countries worldwide.