Most patients are treated at home with supportive therapy that includes bed rest and avoidance of alcohol. Most patients recover completely within three to six months from the onset of infection.
There is no cure for hepatitis B. There are two drugs used to treat patients with chronic hepatitis B infection. Both of these drugs are used to slow down the progression of hepatitis B infection and possibly prevent the onset of cirrhosis and development of liver cancer.
Lamivudine, an oral drug, is indicated for patients with chronic hepatitis B infection with evidence of viral replication (virus multiplying as a result of active infection), and active liver inflammation (evidence of active liver disease). It is usually well tolerated with few side effects. It is currently the drug of choice for persons with chronic hepatitis B who have evidence of active viral replication.
Interferon, a drug that is injected, is indicated for treatment of chronic hepatitis B infection in people 18-years-old and up. However, less than half the persons treated will respond to interferon. Furthermore, once interferon is discontinued, relapse can occur. It is given subcutaneously (under the skin into the fatty tissue) or intramuscularly (in the muscle) daily or three times per week depending upon the patients' response to the drug. Since many people find therapy hard to tolerate, premature cessation of therapy may result. Common side effects include flu-like symptoms, such as fever, chills, fatigue, muscle aches, nausea and vomiting. More serious side effects include blood disorders, depression, and thyroid disease. Because of the side effects, this drug is usually not used in persons with serious liver disease, such as patients with cirrhosis and complications.
Liver transplantation is indicated in patients with life-threatening acute liver failure. Unfortunately, the newly transplanted liver will eventually be re-infected with the hepatitis B virus because the person is unable to completely eliminate the virus even after the infected liver is removed. The time frame for re-infection varies, and drugs such as lamivudine and hepatitis B immune globulin can be taken to prevent the reoccurrence of hepatitis B after the liver transplant.
The benefit of a liver transplant is that it can prolong a person's life and decrease the complication as associated with hepatitis.
Like hepatitis B, there is no cure. In the United States, there are two different drug therapies approved for chronic hepatitis C: interferon and combination therapy with interferon and ribavirin. The combined drug regimen is the therapy of choice for persons with chronic hepatitis C virus because of a prolonged response. At present, interferon is only used as a single therapy in person who cannot tolerate ribavirin. Ribavirn is an oral drug that was recently approved by the Food and Drug Administration (FDA) to be used in combination with interferon. The main side effects of ribavirin are blood disorders such as a hemolytic anemia. Because ribavirn can cause deformity in fetuses, it should not be used during pregnancy.
More recently, a new formulation of interferon was approved. The improved formulation allows injections to be given only once per week, compared to three times per week with standard interferon. Studies using this new formulation of interferon with ribavirin are underway.
Liver transplantation is the therapy of choice in people with cirrhosis, although re-infection of the new liver is inevitable. While having a liver transplant does not provide a cure for the hepatitis C infection it does enable an individual to live longer with a better quality of life.