Treatment and Prognosis of Hepatitis B Infection

Hepatitis B is fairly common infection in many parts of the world. Unfortunately no effective antiviral antibiotic is available for treatment of hepatitis B infection and treatment is mostly based on symptomatic measures. In majority of adult’s acute hepatitis B infection usually do not need any treatment, because in most adults acute hepatitis B infection is cleared spontaneously. Only in rare cases (less than 1% of hepatitis B infections), early initiation of antiviral antibiotics may be warranted, if the patient is immunocompromized or in case the hepatitis B infection takes aggressive course known as fulminant hepatitis.

In case of chronic hepatitis B infection, most patients require treatment for reducing the risk of liver cancer development in later years and for preventing cirrhosis. Persistent elevated levels of Alanine aminotransferase, a marker of chronic hepatitis B infection and elevated HBV (hepatitis B virus) DNA levels indicate need to appropriate treatment, which lasts for 6 months to one year.

In chronic hepatitis B infection antiviral antibiotics are indicated, although no antiviral antibiotics can clear hepatitis B infection from body, but they can prevent hepatitis B virus replication, thereby reduce risk of liver damage (prevent liver cancer and cirrhosis). Currently there are several antiviral antibiotics which are available and approved by USFDA for treatment of chronic hepatitis B infection, such as lamivudin, telbivudin, adefovir, entecavir, tenofovir etc. and immune modulators such as interferon alpha-2a and PEGylated interferon alpha-2a.

Treatment of chronic hepatitis B infection with antiviral antibiotics and interferon reduce virus load by inhibiting virus replication, thereby reduce liver damage.

Prognosis of chronic hepatitis B infection treatment:

The results (seroconversion from positive to negative HBeAg) of treatment of chronic hepatitis B infection are variable and success rate range from 25% to 45%, due to difference genotype among individual patients.

In general success of treatment in children is less than treatment in adults. For example approximately 95% of adults or older children infected with hepatitis B virus recover fully after adequate treatment, but this figure is only 30% in young children and only 5% in infants infected with hepatitis B virus. Infants getting hepatitis B infection from mother during childbirth have a 40% risk of death from liver cancer (hepatocellular carcinoma) or cirrhosis of liver. Diet is very important for good prognosis of hepatitis B infection (hepatitis diet).

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