Treatment

With all forms of hepatitis, it is important to avoid alcohol and other substances that are harmful to the liver (including medications, unless they are indispensable).

There is no specific therapy for hepatitis A.

In acute hepatitis B, usually only the symptoms are treated.

Chronic hepatitis B can be treated with interferon. Interferons are specific signalling proteins that are produced by cells, for example in response to viral infections, have an antiviral effect and activate natural “killer cells” that can destroy virus-infected cells.

Interferon therapy (involving many side effects) is aimed at stopping viral replication. To this end, interferon is usually injected subcutaneously once a week over a period of one year.

There is also long-term therapy with so-called nucleoside or nucleotide analogues that interfere with the viral replication as “false building blocks” of the genetic material. The therapy is aimed at stopping fibrosis and is well tolerated.

Medications directly acting against HCV (direct-acting antivirals, DAAs) can cure the infection in more than 95% of the cases with relatively few side effects and usually within eight to twelve weeks. The best combination of active ingredients and the therapy period are determined based on the genotype, the extent of fibrosis, and any previous hepatitis C therapies. Patients who have no or only mild liver fibrosis are usually treated without the addition of ribavirin over a period of eight to twelve weeks. In the case of advanced fibrosis, cirrhosis, or pre-treated patients, the therapy may take 16 weeks, in rare cases even 24 weeks; in addition, a combination with ribavirin is more frequently required. The chance of recovery is slightly smaller and the complication rate is higher.

Successful treatment does not impart immunity, i.e. reinfection is possible.