If the person with hepatitis feels unwell enough to be in bed, he or she should rest in bed. Otherwise, if there is no fever, normal activities can be continued. People with hepatitis will probably be inclined to avoid fatty foods. Otherwise they can follow a regular diet. If their appetite is poor, fruit juice and other liquids should be encouraged. Avoid alcohol and other medications that may affect the liver.
Recovery is dependent on the person's own immune response to the virus infection. Any of the different complications might require medical treatment in hospital.
Even if a person appears to make a full recovery, follow-up blood tests should be done to show whether the infection has been cleared or whether it has persisted as a chronic infection.
Acute hepatitis B infection is not treated with specific anti-viral medication since about 95% of adults’ immune system will clear the virus within six months. Anti-viral medication may be used in people with chronic hepatitis to reduce or reverse liver damage and to prevent complications. Not all people with hepatitis B need immediate treatment.
The decision to treat and the type of treatment is based on a combination of the following:
- Liver enzyme levels (e.g. ALT) in the blood
- Hepatitis B DNA levels in the blood
- Degree of liver damage and stage of the disease (if a liver biopsy was done)
- Genetic factors like race and family history of cirrhosis and liver cancer
- Potential future pregnancies in females
- Co-factors such as alcohol use, iron overload, and co-infection with HCV or HIV
- Healthcare workers who engage in exposure-prone procedures
Simultaneous (co-infection) with HBV and HIV is common, especially in South Africa, and need special consideration. HBV/HIV co-infected patients must be treated with drugs active against both HIV and HBV as part of their HIV treatment regimen, i.e. Tenofovir plus lamivudine or Emtricitabine.
Specialists with experience in the treatment of hepatitis B are best suited to manage patients with chronic active hepatitis B without HIV co-infection. A person with end-stage liver damage may require a liver transplant to save his or her life.
Symptoms of hepatitis B
Causes of hepatitis B
Diagnosing hepatitis B
Revised and reviewed by Dr Karin Richter, MMed Path (Medical Virology), FC Path(SA) Viro, Dip HIV Man (SA), Dip Obst (SA), MBChB , Clinical Virologist, Senior Lecturer, Department of Medical Virology, University of Pretoria, Faculty of Health Sciences, and Consultant Pathologist, Tshwane Academic Division, National Health Laboratory Services (NHLS) February 2015.
Previously reviewed by Dr Eftyhia Vardas BSc (Hons), MBBCh, DTM&H, DPH, FC Path (Virol), MMed (Virol), Clinical Virologist, Director HIV AIDS Vaccine Division, Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand.