People with acute hepatitis B do not require treatment. Rest, drinking lots of fluids and maintaining adequate nutrition are usually all that is needed to manage acute hepatitis B symptoms. In severe cases, hospitalization may be necessary, but this is rare. Click here for more information on managing the common symptoms of acute hepatitis B.
Chronic hepatitis B is not curable, but it is treatable. The goal of therapy is to reduce the risk of complications, including premature death. Treatment can help to prevent cirrhosis, liver failure and liver cancer by halting HBV replication and reducing viral load. Many medications that aim to cure hepatitis B are under study.
Click here here for specific information about each type, or class, of approved HBV treatment along with information about drugs in the late stages of development.
Many factors are considered when deciding whether and when to start therapy and which treatment to use. These include, HBV viral load, hepatitis B e antigen (HBeAg) status, ALT and other liver enzyme levels, liver biopsy results (if available) and age. Other health considerations—such as the possibility of pregnancy or certain comorbidities (hepatitis D, HIV)—affect treatment choice. People with HBV and HIV coinfection should use medications that are active against both viruses, and HBV treatment should be coordinated with HIV care providers.
The American Association for the Study of Liver Diseases (AASLD) maintains basic guidelines—which were last updated in February 2018—to help patients and their health care providers figure out when to begin treatment and which medications to use:
It is important that people with chronic hepatitis B take their medications exactly as prescribed. Missing doses can cause HBV to become drug resistant. Stopping medications can also cause HBV viral load and liver enzymes to increase quickly, which can damage the liver and cause severe symptoms. It is important for people with chronic hepatitis B who are receiving treatment to be monitored regularly by a health care provider.
Last Reviewed: August 21, 2023