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Treatment
If you know you've been exposed to HBV, call your doctor
immediately. Receiving an injection of hepatitis B immune
globulin within 24 hours of coming in contact with the virus
may help protect you from developing hepatitis B. You should
also receive the first in a series of three shots of the
hepatitis B vaccine.
Once you've developed chronic hepatitis B, few treatment
options exist. In some cases — especially if you don't have
signs and symptoms or liver damage — your doctor may suggest
monitoring, rather than treating, your condition. In other
cases, your doctor may recommend treatment with antiviral
medications. When liver damage is severe, liver
transplantation may be the only option.
Drug therapies
Doctors use four drugs to treat chronic HBV infection:
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Interferon.
Your body naturally produces interferon to help protect
against invading organisms such as viruses. Giving additional
interferon that has been manufactured in a laboratory may
stimulate your body's immune response to HBV and help prevent
the virus from replicating in your cells. Not everyone is a
candidate for treatment with interferon. In a few cases,
interferon eliminates the virus completely, although the
infection can later return. Interferon has a number of side
effects — many of which resemble signs and symptoms of
hepatitis B. These include depression, fatigue, muscle pains,
body aches, fever and nausea. Signs and symptoms are usually
worse during the first two weeks of treatment and in the first
four to six hours after receiving an injection of interferon.
A more serious side effect that may occur over time is a
decreased production of red blood cells. Two interferon
medications are available, interferon alfa-2b (Intron A) and
peginterferon alfa-2a (Pegasys). Intron A is administered by
injection several times a week. Pegasys is given by injection
once a week.
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Lamivudine (Epivir-HBV).
This antiviral medication helps prevent HBV from replicating
in your cells. It's usually taken in pill form once a day.
Side effects during treatment are generally minimal, but you
may experience a severe worsening of symptoms when you stop
taking the drug. Tell your doctor if you have had any kidney
problems or history of pancreatitis before starting this
medication. If you experience worsening jaundice or any
unusual bruising, bleeding or fatigue while taking lamivudine,
call your doctor right away.
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Adefovir dipivoxil (Hepsera).
This drug, taken by pill once daily, also helps prevent HBV
from replicating in your cells. An added benefit is that it's
effective in people who are resistant to lamivudine. Like
lamivudine, side effects during treatment usually are minimal,
but symptoms may worsen when you go off the medication. And
Hepsera may cause kidney toxicity in people with underlying
kidney disease.
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Entecavir (Baraclude).
This antiviral medication, approved by the Food and Drug
Administration in March 2005, is taken once a day in pill
form. Studies comparing Baraclude with lamivudine found
Baraclude to be more effective. Baraclude may cause serious
worsening of symptoms when the drug is discontinued.
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Liver transplantation
when you’re liver has been severely damaged; a liver
transplant may be an option. The encouraging news is that
these transplants are increasingly successful. Unfortunately,
not enough donor organs are available for every person who
needs a transplant.
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