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Does everyone with hepatitis B need treatment?

Updated: Feb 27, 2021

Everyone deserves an honest answer to their questions, including patients

  • In answer to that question, I will set a background

  • The diagnosis of hepatitis B is made when someone has a positive HBsAg

  • HBsAg is a protein that is detected in blood of patients that are infected by a tiny germ (virus) called hepatitis B virus (HBV)

  • HBV is transmitted via blood, blood products and or sexual fluids

  • You can read more about transmission and other aspects of hepatitis B via this link HERE

  • So how do we handle the question?

  • Treatment is often understood by lay persons as taking of drugs

  • The answer, therefore, is that NOT everyone that has hepatitis B infection needs to be treated


Not everyone that has hepatitis B infection needs to be treated


  • If you have an acute infection (i.e., infection by HBV lasting less that 6 months), there is a 9 out of 10 chances that you will clear the virus without taking any medicines

  • Your body can get rid of the virus within 6 months of infection

  • Unfortunately, for some persons (especially for those that acquired the infection in childhood), persistence of the infection results

  • HBV infection lasting more than 6 months is called chronic hepatitis B infection

  • Not everyone that has chronic HBV will require treatment


Chronic hepatitis B infection does not define severity, but persistence of infection beyond 6 months


  • If you do not need to start treatment immediately, you will be monitored over time to know when hepatitis becomes more active

  • The aim of treatment is to reduce or reverse liver damage and to prevent long-term complications of hepatitis B

  • These long-term complications are called cirrhosis (when the liver becomes hard and not able to function) and liver cancer

  • The doctor looking after your liver will usually carry out some tests to determine your need for treatment

  • Once you start treatment, you will have regular blood tests to see how well the treatment is working and to detect side effects or drug resistance

  • Depending on the type of treatment, this is to be continued for a lifetime

  • There are exceptions to above rule

  • Treatment should not be stopped without discussing this with your doctor because, in some cases, the virus can come back quickly, causing severe liver injury

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