Medicines for Hepatitis B

What it is

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). The virus is spread through contact with infected blood and certain body fluids — for example from mother to baby around birth, through unprotected sex, through sharing needles or other equipment for injecting drugs, through contaminated blood (for example unsafe medical or dental procedures or tattooing in some settings), and through close household contact in some circumstances. It is not spread through casual contact such as hugging, sharing food, or coughing. Hepatitis B is more common in some parts of the world than others. Many people with a new (acute) hepatitis B infection have no symptoms, particularly young children; when symptoms occur, they can include flu-like symptoms, tiredness, tummy pain, feeling sick, loss of appetite, and jaundice (yellowing of the eyes and skin). In most healthy adults, the infection clears on its own within a few months, and the person becomes immune. However, in some people — and particularly in babies and young children who are infected — the virus is not cleared and becomes a long-term (chronic) infection, which can, over many years, lead to liver damage (including cirrhosis) and an increased risk of liver cancer, though many people with chronic hepatitis B remain well for a long time. A very important point is that hepatitis B is preventable by a safe and highly effective vaccine, which is included in the routine childhood immunisation programme and is also offered to people at higher risk. For those with chronic hepatitis B, monitoring and treatments are available that can control the virus and protect the liver. The key messages are that hepatitis B is preventable by vaccination, that testing is important for those at risk (as many have no symptoms), and that effective monitoring and treatment are available.

How it is treated

Hepatitis B is managed according to whether it is a new (acute) or long-term (chronic) infection, with prevention through vaccination being a central and highly effective measure. For prevention: the hepatitis B vaccine is safe and highly effective, is part of the routine childhood immunisation programme, and is offered to people at higher risk (such as certain healthcare workers, people who inject drugs, household and sexual contacts of infected people, and others); babies born to mothers with hepatitis B are given vaccination (and sometimes an injection of antibodies) at birth to protect them, which is very effective. For a new (acute) infection: most healthy adults clear the virus on their own within a few months, so treatment is usually supportive (rest, fluids, and managing symptoms), with monitoring to ensure the infection clears, and advice on avoiding passing it on. For chronic (long-term) hepatitis B: the focus is on monitoring the liver and the virus over time (with blood tests and other assessments) and, where needed, treatment with antiviral medicines that suppress the virus and reduce the risk of liver damage and its complications — these do not usually cure the infection but can control it effectively and protect the liver, and are taken under specialist guidance. Looking after the liver (for example avoiding or limiting alcohol, and being cautious with medicines that affect the liver) and being vaccinated against hepatitis A are also part of care. Testing is important, as many people with hepatitis B have no symptoms and may not know they are infected; testing allows monitoring, treatment, and steps to protect others, and is recommended for people at higher risk. The reassuring messages are that hepatitis B is preventable by a highly effective vaccine, that most healthy adults clear a new infection, and that for chronic infection, effective monitoring and treatment are available to control the virus and protect the liver — so vaccination, testing for those at risk, and specialist care where needed are the key steps.