Sexual Health | Viral hepatitis | Hepatitis B: Management

Hepatitis B: Management
Session Overview
Description
This session describes the indications for treating hepatitis B, treatment options and how to monitor treatment.

Learning Objectives
By the end of this session you will be able to:

• Describe the treatment options for hepatitis B
• List the complications of treatment
• Explain which treatment is used for acute and chronic hepatitis B infection
• Identify which patients with hepatitis B need treatment
• Summarise information needed to make a decision to start treatment
• Recognise the endpoints of treatment
• State tests needed to assess treatment response
• Summarise duration of therapy in e antigen negative, e antigen positive, chronic hepatitis and cirrhosis

Prerequisites
Before commencing this session you should complete the sessions:

• Module 01/Sexual History (260-0004)
• Module 02/Diagnosing Viral Hepatitis (260-0030)
• Module 07/The Presentation of Infectious Hepatitis (260-0082)
• Module 07/Hepatitis B: Natural History, Presentation and Investigation (260-0084)

Although the long term efficacy of antiviral therapy for chronic hepatitis B is unknown, up to 25% of patients with chronic infection will go on to get end stage liver disease if untreated.

Unlike HIV, nucleos(t)ide monotherapy of hepatitis B is an option with tenofovir or entecavir, although resistance does develop quite quickly with lamivudine and telbivudine when used alone. Consequently, deciding in the clinic who to treat and when to treat remains a challenge:

• How would you decide if an individual with chronic hepatitis B needed treatment?
• What drug would you use?
• How would you assess the response to therapy?
• How long would you continue the treatment for?