What you need to know about antiviral treatment for chronic hepatitis B

Oral anti-hepatitis B medications should be taken regularly (at a fixed time) every day. Frequent missed doses can affect efficacy and increase the risk of drug resistance mutations. Entecavir should be taken on an empty stomach two hours after a meal. The medication only inhibits viral replication, and those who stop taking it without permission will experience recurrence or worsening of the disease. Each person is different and if the initial antiviral drug of choice is not effective at 3-6 months, consult your doctor if you need to adjust your regimen. Long-term use of any anti-hepatitis B virus drug may result in virus mutation, drug resistance, subsequent HBVDNA positivity and abnormal liver function. Regular review is recommended. If viral mutation and drug resistance occur, the treatment regimen needs to be adjusted promptly. Antiviral therapy only reduces the occurrence of cirrhosis and liver cancer, but not completely eliminates them. Young women need to use contraception while taking medication. Even if they are taking tenofovir or telbivudine, they must talk to their doctor before planning pregnancy. If there are any other possible complications that cannot be anticipated or prevented, please seek medical attention. The frequency and items to be tested during hepatitis B interferon treatment (refer to China’s 2015 guidelines for hepatitis B prevention and treatment, with modifications) Recommended frequency of testing for patients on IFN treatment Blood tests Every 1-2 weeks for the first month, then once a month until the end of treatment Biochemical indicators Once a month until the end of treatment HBV DNA once every 3 months until the end of treatment Hepatitis B quantification Once every 3 months Methemoglobin every 6 months Liver hardness every 6 months Thyroid function and blood glucose every 3 months, if thyroid function is abnormal before treatment or diabetes, it is recommended that thyroid function and blood glucose should be checked every month Mental status Close observation, regular assessment of mental status, immediate discontinuation of treatment and close monitoring if depression and suicidal tendencies are evident Abdominal ultrasound every 6 months If abnormalities are found in ultrasound, CT or MRI is recommended. Other tests will be determined according to the patient’s condition Hepatitis B oral drug screening items and frequency (refer to China’s 2015 Hepatitis B Prevention and Control Guidelines, with modifications) Screening items Oral anti-hepatitis B virus drug therapy patients recommended testing frequency Blood routine Every 6 months until the end of treatment Biochemical indicators Every 3-6 months HBV DNA once every 3-6 months until the end of treatment Hepatitis B quantification once every 6 months until the end of treatment Fetoprotein once every 6 months until the end of treatment Liver stiffness once every 6 months until the end of treatment Abdominal ultrasound once every 6 months, if abnormalities are found by ultrasound, CT or MRI examination is recommended Other examinations Taking tibivudine –Creatine kinase tested every 3-6 months Taking tenofovir or adefovir: kidney function and blood phosphorus tested every 3-6 months Thyroid function, blood sugar, mental status: determined by previous medical conditions Cirrhosis, or over 40 years of age, or family history of cirrhosis/hepatocellular carcinoma: testing every 3 months is recommended This article is published with permission from Dr. B. Ye Please do not reproduce without authorization.