Managing Chronic Active Hepatitis B: A Comprehensive Approach

Chronic active hepatitis B requires a well-rounded treatment strategy to prevent long-term complications such as liver fibrosis and cirrhosis. The primary goal of treatment is to suppress viral replication, reduce liver inflammation, and slow or prevent the progression of liver damage. Here are the key approaches to managing this condition effectively:

1. Liver Protection and Anti-Inflammatory Therapy

One of the main characteristics of chronic active hepatitis is persistent abnormal liver enzyme levels, particularly ALT and AST. In such cases, liver-protecting and anti-inflammatory medications are essential. Drugs such as glycyrrhizin, glutathione, and silymarin (milk thistle extract) are commonly prescribed to reduce liver enzyme levels and alleviate inflammation. These medications help stabilize liver cells and promote overall liver health.

2. Antifibrotic Treatment to Prevent Liver Scarring

Long-standing liver inflammation often leads to the development of fibrosis. If imaging tests like liver ultrasound show uneven echotexture or a liver biopsy reveals fibrosis stage 2 or higher, antifibrotic therapy becomes crucial. Medications such as Fufang Biejia Ruangan Tablets and Fuzheng Huayu Capsules may be prescribed to inhibit the progression of fibrosis by modulating immune responses and reducing extracellular matrix deposition in the liver.

3. Antiviral Therapy for Long-Term Viral Suppression

Since chronic active hepatitis B can progress to cirrhosis or liver failure, long-term antiviral treatment is often necessary. When liver inflammation persists despite liver-protecting therapies, it is usually due to ongoing viral replication. In such cases, nucleoside analogs like entecavir or tenofovir are typically the first-line treatment options. Interferon therapy may also be considered, especially for patients with a strong immune response and a higher chance of achieving sustained virologic response.

In conclusion, a combination of liver protection, antifibrotic measures, and potent antiviral therapy offers the best chance of managing chronic active hepatitis B effectively. Regular monitoring and personalized treatment plans are essential to ensure long-term liver health and prevent disease progression.