Treatment

Treatment for hepatitis B depends on how long you have been infected for:

• short-term (acute) hepatitis B does not usually need specific treatment, but may require treatment to relieve the symptoms
• long-term (chronic) hepatitis B is often treated with medication to keep the virus under control

Emergency treatment can also be given soon after possible exposure to the hepatitis B virus to stop an infection developing.

Emergency hepatitis B treatment

See your GP as soon as possible if you think you may have been exposed to the hepatitis B virus.

To help stop you becoming infected, they can give you:

• a dose of the hepatitis B vaccine – you'll also need 2 further doses over the next few months to give you long-term protection
• hepatitis B immunoglobulin – a preparation of antibodies that work against the hepatitis B virus and can offer immediate but short-term protection until the vaccine starts to take effect

These are most effective if given within 48 hours after possible exposure to hepatitis B, but you can still have them up to a week after exposure.

Treatment for acute hepatitis B

If you're diagnosed with hepatitis B, your GP will usually refer you to a specialist, such as a hepatologist (liver specialist).

Many people do not have any troublesome symptoms, but if you do feel unwell, it can help to:

• get plenty of rest
• take over-the-counter painkillers, such as paracetamol or ibuprofen, for tummy pain
• maintain a cool, well-ventilated environment, wear loose clothing, and avoid hot baths or showers if itching is a problem
• take medication, such as metoclopramide, to stop you feeling sick, and chlorphenamine to reduce itching – your doctor can give you a prescription for these if necessary

Most people recover completely in a couple of months, but you'll be advised to have regular blood tests to check that you're free of the virus and have not developed chronic hepatitis B.

Treatment for chronic hepatitis B

If blood tests show that you still have hepatitis B after 6 months, your doctor may recommend medication to reduce the risk of complications of hepatitis B and regular tests to assess the health of your liver.

Treatment is usually offered if:

• your immune system is unable to control the hepatitis B by itself
• there's evidence of ongoing liver damage

Hepatitis B medications can help keep the virus under control and stop it damaging your liver, although they will not necessarily cure the infection and some people need lifelong treatment.

The main medicines for chronic hepatitis B include peginterferon alfa 2-a and antiviral medicines.

Peginterferon alfa-2a

If your liver is working fairly well, the first treatment offered is usually a medicine called peginterferon alfa 2-a.

This stimulates the immune system to attack the hepatitis B virus and regain control over it. It's usually given by injection once a week for 48 weeks.

Common side effects include flu-like symptoms, such as a fever and muscle and joint pain, after you start to take the medicine, although these should improve with time.

Tests will be carried out during treatment to see how well it's working. Alternative medicines may be recommended if it's not helping.

Antiviral medicines

If your liver is not working well, or peginterferon alpha-2a is not suitable or not working for you, your doctor may recommend trying antiviral medication instead.

This will usually be either tenofovir or entecavir, both of which are taken as tablets.

Common side effects of these medicines include feeling sick, vomiting and dizziness.

Living with hepatitis B

If you have hepatitis, you should:

• avoid having unprotected sex, including anal and oral sex, unless you're sure your partner has been vaccinated against hepatitis B
• avoid sharing needles used to inject drugs with other people
• take precautions to avoid the spread of infection, such as not sharing toothbrushes or razors with other people (close contacts, such as family members, may need to be vaccinated)
• eat a generally healthy, balanced diet – there's no special diet for people with hepatitis B
• avoid drinking alcohol – this can increase your risk of developing serious liver problems
• speak to your doctor if you're thinking of having a baby

People with hepatitis B can usually have a healthy pregnancy, but it's a good idea to discuss your plans with a doctor first as you may need extra care and your medications may need to be changed.

There's a risk of pregnant women with hepatitis B passing the infection on to their child around the time of the birth, but this risk can be reduced by ensuring the baby is vaccinated shortly after they're born.

Page last reviewed: Sun Jan 2022 Next review due: Wed Feb 2020