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Hepatitis B infection is a leading cause of chronic liver damage that can potentially result in life-threatening cirrhosis, cancer, or total liver failure. The virus responsible for infection is notoriously difficult to treat and currently considered incurable, but recent innovations in medicine and clinical hepatitis B therapy have significantly improved the outlook for patients with the disease. Hepatitis B therapy may include antiviral drugs that stop viral cells from replicating and interferon medications that boost immune system defenses. Patients who have experienced major complications from long-term infection may require liver transplants to avoid fatal complications.
Antivirals are the most effective components of hepatitis B therapy in most cases. Common drugs include adefovir, tenofovir, lamivudine, and entecavir, which may be taken alone or in combination. Such antivirals are called nucleoside reverse transcriptase inhibitors (NRTIs) based on the way they combat the hepatitis B virus. NRTIs incorporate themselves into viral RNA and block the activity of reverse transcriptase enzymes, chemicals that are necessary for viruses to replicate and invade new tissues. NRTIs are usually very effective at slowing the progression of liver damage and, in some cases, actually reversing it.
Most patients are given interferon drugs in addition to antivirals during the course of hepatitis B therapy. Interferons enhance the effectiveness of white blood cells as they try to fight off and kill viral pathogens. While antivirals can be taken orally on a daily basis, interferons are usually administered through injections one to three times a week. Patients who respond well to the drugs may only need to be treated for a few months, while others might continue their courses of therapy for two years or longer. Some unpleasant side effects, such as nausea, weight loss, fatigue, and fever can occur when taking interferons and NRTIs, so a doctor may need to adjust dosage amounts or try different medications during treatment to limit negative reactions.
Liver transplantation is only needed as part of hepatitis B therapy whenever major, permanent liver damage has already occurred. Patients who must undergo transplant procedures are typically hospitalized for at least a week before their procedures and given immune system-suppressing drugs to reduce the chances of organ rejection. Following a transplant, a person may need to stay in the hospital for several more days for monitoring and then attend regular health checkups throughout his or her life. Specialized diet, exercise, and medication guidelines are put into place to give patients the best possible chances of recovering from their procedures and avoiding hepatitis B complications in the future.
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