Medical Treatment for Hepatitis

Treatment for hepatitis is based on the type of hepatitis present in the body and the severity of the resulting liver damage. Depending on the results of diagnostic tests, our specialists at NYU Langone may recommend antiviral medication to stop the virus from replicating and protect your liver from further damage.

Rest and Hydration

Most people with hepatitis A do not require treatment. This type of hepatitis usually clears up on its own after a few weeks or months. Your NYU Langone doctor may recommend getting lots of rest and drinking plenty of water. You should avoid alcoholic beverages, because drinking alcohol can delay recovery.

Acute hepatitis B, a short-term illness that usually lasts a few months, rarely requires treatment either and may not cause symptoms. NYU Langone doctors recommend lots of rest, adequate fluids, and a nutritious diet to help your body fight the virus. It is also important to abstain from drinking alcohol with hepatitis B. Heavy alcohol use is linked to an increased risk of liver disease.

Rarely, a person with hepatitis A or acute hepatitis B may experience severe symptoms and require medical attention. If you begin to vomit frequently or have persistent diarrhea, your doctor may recommend a brief hospitalization so that intravenous (IV) fluids can keep you hydrated.

Antiviral Medication

NYU Langone doctors may recommend antiviral medication for chronic, or long-term, hepatitis B or hepatitis C. Antiviral medications are more effective and produce fewer side effects than earlier treatments.

Your doctor considers many factors when recommending medical treatment for hepatitis B or C, including whether the viral infection is acute or chronic and the extent of liver damage.

Antiviral Medication for Hepatitis B

Doctors frequently recommend antiviral medication for people with chronic hepatitis B who have “active replication” of the hepatitis B virus. Hepatitis B is considered chronic when the virus stays in your blood for more than six months, especially if the level of virus in the body exceeds certain thresholds or if there is evidence of liver injury on laboratory tests.

Antiviral medications prevent the virus from replicating, which means creating copies of itself. They prevent and can even reverse liver damage. Current antiviral medications are safe, highly effective, and can treat hepatitis B with a low risk of serious side effects. These medications, which are taken by mouth, are usually required for years or even indefinitely.

NYU Langone hepatologists and infectious disease specialists prescribe medication when they have determined that without treatment, the hepatitis B virus poses a risk of damaging the liver over time. At NYU Langone, liver specialists are conducting clinical trials of new medications that may reduce the need to take treatment indefinitely.

There are many different types of antiviral medications available, and your doctor recommends the right type for you based on your symptoms, your overall health, and the results of diagnostic tests. A doctor may take a wait and see approach with someone who has a healthy liver and whose blood tests indicate a low viral load—the number of copies of the hepatitis B virus in their bloodstream.

Someone with HIV infection or AIDS may have a weakened immune system and is therefore more likely to develop liver damage.

If your doctor prescribes antiviral medication, you take it by mouth once daily. Your doctor monitors the effectiveness of medication using blood tests and imaging tests during follow-up visits.

Doctors recommend avoiding alcoholic beverages and high doses of acetaminophen throughout treatment, because these substances can lead to liver damage.

Antiviral Medication for Hepatitis C

For people with hepatitis C, the goal of treatment with antiviral medication is to prevent the virus from replicating, or copying itself, and to eliminate the virus from the bloodstream. If the hepatitis C virus has been in the body for more than six months, the infection is considered chronic. Without treatment, most people with acute hepatitis C develop the chronic form of the disease. Doctors treat both acute and chronic forms of hepatitis C with antiviral medications.

Hepatitis C virus occurs in different strains called genotypes. Current medications are highly effective across all genotypes. At NYU Langone, interferon-free direct-acting antiviral therapy is now the standard of care. Your doctor determines the specific medications and duration likely to be most appropriate based on other medications you take, the presence or absence of cirrhosis, and whether you have taken antiviral medication previously.

The arrival of effective medications with fewer side effects may allow many more people with chronic hepatitis C to begin treatment and become disease-free. Our doctors have played an active role in the research and development of these medications and have extensive experience with the care of affected patients. Because of these medicines, public health organizations are focused on eliminating hepatitis C as a public health threat.

After people with hepatitis C finish their course of antiviral medication and blood tests reveal no evidence of the C virus for at least six months, they are considered cured. Most people remain clear of the virus permanently if treatment is successful. However, it is possible to become reinfected or infected with a different genotype of the virus, so preventive measures remain important even for someone who has had treatment.

Antiviral Medications for Hepatitis D and Hepatitis E

Doctors can treat chronic hepatitis D with injections of a medication known as pegylated interferon, but the rate of long-term success of this treatment is limited. Because hepatitis D infection only occurs in people with hepatitis B, antivirals are also given to treat the hepatitis B component of their condition. These antiviral medications have no effect on hepatitis D.

While pegylated interferon remains the standard of care for hepatitis D, researchers continue to evaluate potential new therapies for this type of viral hepatitis. Our doctors are conducting clinical trials with a new form of interferon called interferon lambda.

For chronic hepatitis E, which occurs almost exclusively in transplant recipients and other people with compromised immune systems, doctors sometimes recommend ribavirin. Ribavirin is an antiviral medication taken by mouth. Side effects can include rash, gastrointestinal upset, cough, and anemia. It cannot be taken when the patient is pregnant or breastfeeding.