Chronic Hepatitis B Treatment Options

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Treatment options for chronic hepatitis B have never been as good as they are today. In 1991, the first drug for Hepatitis B was approved by the FDA. Currently, there are a number of drugs available, which means your medical team has options to choose from when selecting the drug (or combination of drugs) that works best for you.

Despite many effective treatment options for Hepatitis B, there is still no cure for the disease. The goal of medical therapy is to suppress the virus and keep symptoms at bay while protecting the liver from the disease's damaging effects. Also, it is important to keep in mind that everyone who is infected with hepatitis B patients requires (or would benefit from) taking medication.

Nevertheless, whether you begin drug therapy or not, you should be under the care of a physician. 

Pros and Cons

The medications used for managing Hepatitis B infections all have benefits and side effects that will be weighed. Your physician will work with you to select the drug that is most likely to be beneficial for your condition. To help you understand these medications a little better, here are some of their strengths and weaknesses.

Medication

Pros

Cons

Interferon (interferon alpha-2b or pegylated interferon)

Usually a good choice for young people without serious liver disease (well-compensated liver disease)

Good choice for genotype A infection

Treatment duration is relatively short (24 to 48 weeks) compared to other hepatitis B therapies.

Very serious side effects for some people

Not available for people with failing livers (decompensated liver disease)

Most expensive (regular or pegylated) compared to the other drugs

Pegylated interferon not approved for children

Lamivudine

Least expensive compared to the other hepatitis B drugs

One of the older hepatitis B drugs, so a lot is known about its safety

Might be helpful in treating HIV co-infection in combination with tenofovir

Approved for both children and adults

Often loses its effectiveness against the hepatitis B virus because of drug resistance

Because of resistance, it can be less effective than many of the newer hepatitis B drugs

Requires long-term treatment

Adefovir dipivoxil

Can be used in patients with lamivudine-resistant hepatitis B virus

Can be toxic to your kidneys at high doses

Requires long-term treatment

Entecavir

Has an extremely low rate of resistance.

Might be helpful in patients with failing livers (decompensated liver disease)

A newer drug, so it has less research available about its safety--especially in certain conditions

Known to cause cancer in rodents when given in high doses, but no human data support an increased risk in patients

Requires long-term treatment

Telbivudine

Might be a more powerful antiviral drug than lamivudine and adefovir

As likely as lamivudine to become resistant to hepatitis B virus

Requires long-term treatment

Not approved for children

Tenofovir

Excellent at treating regular and drug-resistant types of hepatitis B virus

Might be a good treatment choice when adefovir doesn't work well

Treats both HIV and the hepatitis B virus

It's a relatively new drug for treating hepatitis B, so more studies need to be completed

Not approved for children

Requires long-term treatment

Regular monitoring of kidney function is necessary

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lok AS. Personalized treatment of hepatitis B. Clin Mol Hepatol. 2015;21(1):1-6. doi:10.3350/cmh.2015.21.1.1

  2. Liu SH, Seto WK, Lai CL, Yuen MF. Hepatitis B: treatment choice and monitoring for response and resistance. Expert Rev Gastroenterol Hepatol. 2016;10(6):697-707. doi:10.1586/17474124.2016.1145547

  3. U.S. Food and Drug Administration, Hepatitis B and C Treatments, last updated October 30, 2017

Additional Reading

  • UpToDate. Basow, DS (Ed), UpToDate, Waltham, MA, 2010.