Hepatitis B: treatment (antiviral therapy) Testing and treatment
Hepatitis Queensland
Reviewed: 10 October2013 , Valid to: October 2014
Yes, there is treatment (antiviral therapy) available for hepatitis B. However, there are many factors that impact on whether you will need to start treatment. It is very important that you see your doctor or liver specialist regularly for monitoring, usually every six months (see factsheet ‘Hepatitis B: monitoring’ for more information).
How does it work? Hepatitis B treatment (antiviral therapy) works to stop the virus replicating (making copies of itself) and to reduce the amount of virus that you have in your blood to the lowest possible level. When this happens, your immune system (which protects us from infections) is able to get stronger and kill off some of the virus. The lower the amount of virus in your blood, the less damage being done to your liver and less chance you may develop cirrhosis (liver scarring) and liver cancer. The treatment aims to reduce the amount virus in your blood rather than remove it, so it is unlikely that treatment will cure your hepatitis B.
Why would I need treatment? There are a few reasons that you may need treatment for your hepatitis B. One reason is to reduce the amount of virus that you have in your body. Another is to decrease the progression of damage in your liver. Treatment may also decrease your chance of advanced liver disease and lower your risk of liver cancer. With these factors your likelihood of needing a liver transplant is also reduced. It is a big decision to
start treatment, one which your liver clinic nurse and specialist will help and support to you to make.
What medicines are used? There are currently two types of medications used for hepatitis B, pegylated interferon (injection) and antiviral medications (tablets). Pegylated interferon works to boost your body’s immune system to fight off hepatitis B. Pegylated interferon is injected once a week for 48 weeks. You will be taught how to inject yourself by your liver clinic nurse, so you can do this at home. Pegylated interferon works best when your ALTs are high and your viral load is not very high. You may see improvements in your liver function once you have stopped taking this medication. You may experience some side effects including flu-like symptoms (such as a fever or headache), fatigue (tiredness), muscle pain and mood swings. Images © istockphoto.com. Models used for illustrative purposes only.
Is there treatment available for hepatitis B?
The more commonly used antiviral medications in Australia are entecavir and tenofovir. These tablets work to slow down or stop the hepatitis B virus making copies of itself. Both entecavir and tenofovir are taken every day and generally once you start taking them you will most likely have to take them for the rest of your life. It is really important that you take this medication every day even when you start to feel better. If you stop taking your medication you may start to have problems with your liver or you may get sick.
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For more information contact Hepatitis Queensland
www.hepqld.asn.au or call the infoline 1800 648 491
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Hepatitis B: treatment (antiviral therapy) Testing and treatment
Hepatitis Queensland
Reviewed: 10 October2013 , Valid to: October 2014
What other things might influence treatment? Your liver specialist will talk with you about these things when working with you to make a decision about starting treatment: your age and if you are thinking about having children in the near future how motivated you are about treatment taking your medication when you are meant to (adherence) how it might react with other medications you might be taking (contraindications).
What if I am pregnant? If you are pregnant and have hepatitis B it is really important that your doctor and birthing team know. Treatment (antiviral therapy) can be given in the last trimester to reduce the amount of virus you have in your blood. Your baby must be given the hepatitis B immunoglobulin injection and the first hepatitis B vaccine within the first 12 hours of birth. If this happens there is a good chance that your baby will not get hepatitis B. The choice of delivery is up to you as there is no greater risk with either caesarean or vaginal birth. Mothers with hepatitis B are encouraged to breastfeed.1
Children and treatment Children rarely need treatment (antiviral therapy) for hepatitis B but it is still very important that they see a doctor or liver specialist regularly for monitoring, usually every six months. There are paediatric specialists in Queensland should your child need treatment.
Sharing medication Medicines for hepatitis B should never be shared. If anyone else you know also has hepatitis B encourage them to see their doctor or liver specialist. If you stop or don’t take your medication every day it can cause the virus to change, which will make the medication less effective. Stopping your medication might also cause the amount of virus in your body to rise suddenly. Your doctor might call this a flare.
How do I access treatment? Before you can see a liver specialist to talk about going on treatment (antiviral therapy), you will need to get a referral from your doctor. Getting a referral is as simple as making an appointment with your doctor and asking for a referral letter to be sent to your preferred clinic (see factsheet ‘Liver clinics and how to get onto hepatitis treatment’ for more information).
What is the cost of treatment? In Australia, hepatitis B medicine is free, if you have a Medicare card. The only cost you will have to pay is the dispensing fee to pick up the medication from the pharmacy. If you don’t have a Medicare card talk to your doctor as there may be other options.
Interested in finding out more? Factsheets Hepatitis B: monitoring Living with hepatitis B Chronic hepatitis B: phases Printed resources Hepatitis B: What you need to know (Hepatitis Australia)
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Chronic Hepatitis B Antenatal Management Guidelines. SSWAHS Liver and Gastroenterology Department. NSW Health
Reviewed by Jacqui Richmond, September 2013 Hepatology Nurse Consultant (Hepatitis B)
The ABC of Hepatitis Training Package is an initative of Hepatitis Queensland through funding provided by Queensland Health.
For more information contact Hepatitis Queensland
www.hepqld.asn.au or call the infoline 1800 648 491
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