When do hepatitis B carriers need antiviral treatment?

Apr 12, 2023 Source: Cainiu Health

Dr. Jiang Weimin

Introduction

In general, antiviral therapy is required for hepatitis B carriers when there is abnormal hepatitis B virus activity, pregnancy, immunosuppression, abnormal liver function, liver fibrosis, or cirrhosis. In short, if any of the above conditions occur, antiviral medications such as entecavir dispersible tablets or lamivudine tablets can be taken under a doctor's guidance to control disease progression.

In general, antiviral therapy is required for individuals who are hepatitis B carriers under certain conditions, including abnormal hepatitis B virus activity, pregnancy, immunosuppression, abnormal liver function, liver fibrosis, or cirrhosis. A detailed analysis is as follows:

1. Abnormal Hepatitis B Virus Activity

The serum levels of hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg), and related viral markers such as hepatitis B DNA can reflect the activity of the hepatitis B virus. If there is high viral activity—indicated by positive HBsAg, positive HBeAg, and elevated hepatitis B DNA levels—antiviral treatment should be considered.

2. Pregnant Women and Immunosuppressed Individuals

For pregnant women and immunosuppressed individuals, such as organ transplant recipients or patients with HIV/AIDS, antiviral therapy may be recommended even if viral activity is low, in order to reduce the risk of mother-to-child transmission during pregnancy or prevent disease progression in immunocompromised patients.

3. Abnormal Liver Function

If liver function tests show abnormalities, this indicates significant liver cell damage and a weakened immune system, which may lead to active viral replication. This condition can worsen the disease, so timely antiviral treatment is necessary.

4. Liver Fibrosis

Even if liver function tests are normal, if imaging examinations such as liver ultrasound reveal signs of fibrosis, this suggests progressive liver damage, and antiviral therapy should be initiated promptly.

5. Liver Cirrhosis

If cirrhosis has already developed, it indicates severe degeneration and necrosis of liver cells and represents a serious stage of disease. Antiviral treatment is urgently needed and must be continued for life.

In summary, if any of the above conditions occur, patients may take antiviral medications such as entecavir dispersible tablets or lamivudine tablets under medical supervision to control disease progression. Patients should also pay attention to dietary management, maintain a positive and optimistic mindset, and actively cooperate with their physicians in treatment.

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Can short-acting interferon be used again after having been administered for 4 years and then discontinued for 4 years?

If the underlying disease (e.g., chronic hepatitis B or C) is currently in an active phase, with abnormal liver function or elevated viral load, and no severe baseline conditions (e.g., cirrhosis) have occurred during the 4-year period off treatment, the patient may be eligible for re-treatment—provided a physician evaluates them as having good overall tolerance and no contraindications to interferon use (such as severe cardiac or renal disease, or psychiatric history). An individualized dosing regimen would then be required.