Chronic Hepatitis B: What You Need to Know and Do
Chronic hepatitis B (HBV) can quietly damage the liver for years. If you or a loved one has chronic HBV, the good news is modern care can usually control the virus and cut the risk of cirrhosis and liver cancer. This page gives clear, practical steps you can use when talking to your doctor.
How chronic HBV is managed
Most treatment aims to lower the amount of virus in the blood (HBV DNA), protect liver function, and prevent long-term problems. Antiviral pills like tenofovir and entecavir are the common first choices because they work well and rarely cause resistance. Treatment is often long-term — sometimes lifelong — depending on your liver tests and viral activity.
Key tests you should have regularly: liver enzymes (ALT), HBV DNA level, HBeAg/anti-HBe status, and an assessment of liver fibrosis (FibroScan, ultrasound, or blood scores like APRI/FIB-4). If you have cirrhosis or are at high risk, add liver cancer surveillance with ultrasound (often every 6 months) and AFP blood checks.
Not everyone with chronic HBV needs immediate antivirals. Some people have low viral levels and normal liver tests and can be monitored instead. Still, monitoring must be consistent — don’t skip follow-ups.
Simple steps you can take today
1) Get the right tests and keep a record. Ask for HBV DNA, ALT, and fibrosis check results each visit. Bring copies when you see new providers.
2) Avoid alcohol and be cautious with other drugs that stress the liver. Even moderate drinking raises risk when HBV is present. Ask your doctor about safe doses of common medicines like acetaminophen.
3) Protect people around you. Family members and sexual partners should be tested and vaccinated if they’re not immune. Use condoms if you’re unsure of a partner’s status.
4) If you’re pregnant or planning pregnancy, tell your provider. Pregnant people with high HBV DNA may be offered tenofovir in the third trimester to lower transmission risk to the baby. Newborns should get hepatitis B vaccine and immunoglobulin at birth when appropriate.
5) Check for other infections. Testing for HIV and hepatitis C is standard. Co-infections change treatment choices and urgency.
6) Stick with your meds and appointments. Missing doses or follow-ups raises the chance of the virus rebounding and the liver getting worse.
If you’re unsure about anything — whether you need treatment, what tests mean, or how to handle a tricky medicine interaction — ask for a referral to a hepatologist or infectious disease doctor. They see HBV cases every day and can make a clear plan that fits your life. Managing chronic hepatitis B is about steady steps: testing, protection, and treatment when needed.
