The goals of treatment are to minimize infectivity and liver inﬂammation and decrease symptoms.
Of all the agents that have been used to treat chronic type B viral hepatitis, alpha-interferon as the single modality of therapy that offers the most promise.
Two antiviral agents, lamivudine (Epivir) and adefovir(Hepsera), oral nucleoside analogs, have been approved for use in chronic hepatitis B in the United States. Studies have revealed improved seroconversion rates, loss of detectable virus, improved liver function, and reduced progression to cirrhosis with lamivudine. It can be used for patients with decompensated cirrhosis who are awaiting liver transplantation. Adefovir may be effective in people who are resistant to lamivudine.
Bed rest may be recommended, regardless of other treatment, until the symptoms of hepatitis have subsided. Activities are restricted until the hepatic enlargement and levels of serum bilirubin and liver enzymes have decreased.
Adequate nutrition should be maintained. Proteins are restricted if symptoms indicate that the liver’s ability to metabolize protein byproducts is impaired. Measures to control the dyspeptic symptoms and general malaise include the use of antacids and antiemetics, but all medications should be avoided if vomiting occurs.