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Treatment: Chronic (Long-Term) Hepatitis B

Currently there is no complete cure for chronic hepatitis B. However, there are several effective treatment options that can reduce the risk of liver damage and slow down or stop the virus from spreading. 

Did You Know?

Approximately 10 percent of the Korean population has a chronic hepatitis B infection. This affects Korean Americans as well, as the virus is commonly spread from an infected mother unknowingly.

Even if you don’t feel sick, a chronic hepatitis B infection is serious and requires medical attention. Two potential results of a chronic infection are severe liver damage (cirrhosis) and liver cancer, both which can lead to death.

The Three Phases of Infection

In order 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:

  1. 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.
  2. 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.
  3. 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 thought the disease phase is currently inactive.

Antiviral Medication

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 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 re-activation of the virus.

More about our liver transplant program

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