Therapy | Hepatitis B

Therapy

Depending on whether it is an acute or chronic infection with the hepatitis B virus, the treatment options vary. Since an acute hepatitis B infection usually heals very well on its own, there is usually no need for special (antiviral) treatment to kill the virus. In very severe (fulminant) cases of acute hepatitis B infection, which can be accompanied by a decrease in liver function, the disease should be treated with so-called hepatitis B virus DNA inhibitors (HBV-DNA inhibitors), which prevent the hepatitis B genetic material (DNA) from multiplying.

So-called nucleoside analogues (lamivudine, enteacvir, tenofovir), which also intervene at the level of the viral genome, can also be used. In any case, it is recommended to stay in bed and to eat a high-carbohydrate and low-fat diet, as well as to avoid alcohol to relieve and regenerate the liver. In chronic hepatitis B infections (> 6 months), the doubling of the hepatitis B virus in the blood (viral replication in serum/viral load), the inflammation values, liver values (serum transaminases), and the content of connective tissue within the liver due to the inflammation (fibrosis status) should be observed first, and then the appropriate virus-inhibiting (antiviral) treatment should be started if necessary.

In addition to the so-called interferon alpha/pegylated interferon alpha, which inhibits the multiplication of the hepatitis B virus, so-called nucleoside or nucleotide analogues, i.e. drugs that inhibit the multiplication of the virus at the gene level, are used as drug therapy. However, the treatment of chronic hepatitis B with the above-mentioned virus-inhibiting (antiviral) drugs also involves some risks, such as the development of many side effects that these drugs bring with them. These include flu-like symptoms, severe weight loss or a drop in the number of blood platelets (thrombocytes), which can lead to bleeding in the further course of the disease.

Resistance can also develop. This means that the drug can no longer work properly and the therapy may have to be discontinued. If the chronic hepatitis B infection leads to a complete failure of liver function, a liver transplant must be considered, as the liver is irreparably damaged.