There are two types of treatment for chronic hepatitis B: interferon (a drug taken by injection) and antiviral medications (oral pills usually taken once daily). This article will focus on the oral antiviral medications.

How do antiviral medications work?

While no medication can cure chronic hepatitis B, the FDA-approved oral medications have been shown to help reduce the amount of virus in the body. Antiviral pills help stop the hepatitis B virus from multiplying in your liver. They do this by blocking an enzyme (called "HBV DNA polymerase") that is necessary for the virus to replicate (make copies of itself) in the body. An enzyme is a complex protein that triggers certain reactions, like viral replication. Without the enzyme, the virus cannot replicate.

Your treatment goals

The overall goal of treatment is, of course, to keep your liver as healthy as possible for as long as possible. Chronic hepatitis B is a lifelong condition, so you and your doctor must do what’s right for your health both today and tomorrow. The long-term management of chronic hepatitis B involves the following:

• Keeping the amount of virus in your body ("viral load") as low as possible
• Normalizing the function of your liver
• Monitoring your liver for anything unusual

Working with your doctor: follow-up and tests

To achieve your treatment goals, it is important to carefully follow your doctor’s instructions on how and when to take your medication. You also need to monitor your health through regular checkups. Your doctor will determine how often you should visit. In many cases, it will be every six to 12 months. Even if you feel fine, you should still see your doctor for these checkups because the virus can silently damage your liver.

During these regular checkups, your doctor may use a variety of blood tests and other procedures to check your liver and monitor the hepatitis B virus in your body. Here are some of the tests your doctor may use to assess your health and the effectiveness of your treatment:

• Ultrasound: A quick, painless exam used to check for any abnormalities in the shape, size and appearance of your liver. More on ultrasound…
• Liver biopsy: A test in which a small tissue sample is removed from the liver to help determine the presence and extent of damage. More on liver biopsy…
• HBV DNA: A blood test that directly measures the amount of hepatitis B virus in the blood (called "viral load").
• ALT: Alanine aminotransferase, also called SGPT) is an enzyme released into the blood that can indicate liver inflammation. Your doctor measures the levels of ALT in your blood to analyze your liver function. More on ALT…
• AFP: Alpha-fetoprotein is a protein that can indicate the presence of liver cancer. Your doctor will regularly perform this blood test to screen you for liver cancer.

When you undergo regular blood tests and other procedures to monitor the health of your liver, it is helpful to track the results over time. Tracking your test results is the only way you and your doctor can know how well your treatment is working.

How to use your Treatment Tracker

To help you keep track of your treatment and the results of tests your doctor performs, we have provided an easy-to-use Treatment Tracker. One was included in the Your Liver, Your Health Starter Kit. You can also access this worksheet on this website. Use this tool to record all your lab test results, and bring it with you to each doctor’s visit. It’s an easy way to keep all your treatment and testing information organized and close at hand. This way, if you and your doctor need to make treatment decisions in the future, you can easily reference the information you need.

If you have other questions about what to expect when starting treatment, ask your doctor.

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