Hepatitis - Symptom Management

Treatment

Treatment for Hepatitis A

Hepatitis A usually clears up on its own and does not require treatment. Patients should make sure to get plenty of rest and avoid drinking any alcohol until they are fully recovered.

Treatment for Hepatitis B

There are no medications for treating acute hepatitis B. Doctors usually recommend that patients get plenty of bed rest, drink plenty of fluids, and get adequate nutrition.

Many types of antiviral drugs are available to treat chronic hepatitis B. Not all patients with chronic hepatitis B require medication. Patients should seek the advice of an internal medicine doctor or specialist (a gastroenterologist, hepatologist, or infectious disease doctor) who has experience treating hepatitis B.

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Patients with chronic hepatitis B should receive regular monitoring to evaluate any signs of disease progression, liver damage, or liver cancer. It is also important that patients with chronic hepatitis B abstain from alcohol as it may accelerate liver damage. Patients should check with their doctors before taking any over-the-counter or prescription medications or herbal supplements. Some medications (such as high doses of acetaminophen) and herbal products (kava) can increase the risk of liver damage.

If the disease progresses to liver failure, liver transplantation may be an option. It is not foolproof, however. In patients with hepatitis B, the virus often recurs in the new liver after transplantation. However, regular, lifelong injections of hepatitis B immune globulin (HepaGam B) can reduce the risk for re-infection following liver transplantation.

Treatment for Hepatitis C

Antiviral drug therapy is used to treat both acute and chronic forms of hepatitis C. The vast majority of people infected with hepatitis C virus develop the chronic form of the disease. The standard treatment for chronic hepatitis C is combination therapy with the antiviral drugs pegylated interferon and ribavirin. Other types of drugs may also be used. Doctors will generally recommend drug treatment unless there are medical contraindications to it. (See "Candidates for Interferon Treatment" in Medications section.) Research shows that patients with chronic hepatitis C receive the best care when they are treated by a team that includes both a primary care doctor and a hepatitis specialist doctor.

Patients with chronic hepatitis C should receive genotype testing to determine the treatment approach. There are six types of hepatitis C genotypes and patients have different responses to drugs depending on their genotype. For example, patients with genotypes 2 or 3 are three times more likely to respond to treatment than patients with genotype 1. The recommended course of duration of treatment also depends on genotype. Patients with genotype 2 or 3 usually have a 24-week course of treatment whereas a 48-week course is recommended for patients with genotype 1.