Hepatitis B treatment is based on the results of blood tests, age, and the degree of scarring in the liver. Hepatitis B treatment is recommended for patients with very active virus and an inflamed liver. People with chronic hepatitis B and cirrhosis also may be candidates for treatment.

Treatment involves taking an oral antiviral medication. In some cases, injections may be used.

Oral antiviral medications

There are five oral medications approved by the FDA.

• Entecavir
• Tenofovir disoproxil fumarate (TDF)
• Tenofovir alafenamide (TAF)
• Lamivudine
• Adefovir

Of these, tenofovir and entecavir are most commonly used. Uncommon adverse effects can include nausea, abdominal pain, diarrhea, headache, fatigue, and dizziness. Talk with your provider if you experience any of these adverse effects.

These medications for hepatitis B are:

• Easy to tolerate without many side effects
• Taken by mouth once per day
• Usually taken indefinitely

The virus can develop resistance to these oral hepatitis B drugs. Take your hepatitis B medicine every day to avoid this. It is important to have periodic laboratory tests to monitor HBV DNA levels and determine how well the medicine is working.

Patients who have both chronic HBV and HIV are typically on an HIV medication that includes drugs that treat HBV. If your HIV medication does not contain at least two drugs that work against HBV, your provider may prescribe an additional medication.

Injections: Interferon and pegylated interferon

Pegylated interferon is FDA-approved for HBV treatment. It is given as an injection once per week. It can be used alone or with an oral hepatitis B medication. Patients with both chronic hepatitis B and hepatitis D infection may need pegylated interferon alone or combined with an oral hepatitis B pill.

• Pegylated interferon therapy is usually given for 48 weeks.
• Pegylated interferon may cause many side effects, such as flu-like symptoms, rashes, irritability, and depression.