Ongoing Monitoring

Living With Hep B

Having chronic hep B means that you will have it for a long time and maybe the rest of your life. Ignoring it may lead to long-term consequences, such as serious liver damage. But there are many ways to manage chronic hep B.

Getting tested regularly is an extremely important part of managing your chronic hep B.

Some tests that your doctor may do are:

This test measures how much hep B virus is in your body (your viral load).

If your viral load is above 2,000 IU/mL (HBeAg negative) or above 20,000 IU/mL (HBeAg positive), your doctor may prescribe you medicine that may help reduce your viral load.

Your viral load should be as close to undetectable as possible. Undetectable means that your viral load is so low that it cannot be measured by a lab test.

Being undetectable does not mean you are cured from chronic hep B. Always talk to your doctor about your test results and what they mean.

Even if your viral load and ALT levels are low, they can change over time.

That’s why it’s so important to get tested regularly. Seeing your doctor for routine testing will help him or her monitor the hep B virus and start you on treatment if it’s appropriate.

ALT is an enzyme found in liver cells. It can leak into the bloodstream if there is damage to the liver.

In general, normal ALT levels are 35 IU/mL for men and 25 IU/mL for women.

If ALT levels are high, it may indicate that you have active liver damage. Your doctor may consider treatment to help normalize your ALT levels.

Even if your viral load and ALT levels are low, they can change over time.

That’s why it’s so important to get tested regularly. Seeing your doctor for routine testing will help him or her monitor the hep B virus and start you on treatment if it’s appropriate.

The AFP (alpha-fetoprotein) test may be used to screen for liver cancer. The test will measure the levels of this protein in the blood. If AFP levels are high, your doctor may do more blood tests or an imaging study, such as a liver ultrasound.

A liver ultrasound is when the doctor scans an image of your liver. The doctor can use the imaging to screen for liver cancer.

5 Keys to managing Hep B

Taking care of yourself can have many health benefits, but if you have chronic hep B, self-care may not be enough.

It's important to talk with your doctor to see if treatment is right for you.

Here are 5 things you can do to help manage your chronic hep B.

Keep a healthy, balanced diet

Avoid drinking alcohol (alcohol can speed up progression of liver disease)

Tell your doctor about any medications, vitamins, or herbal remedies you’re taking (some may be harmful to your liver)

Avoid smoking

Because the amount of the hep B virus varies over time and may never go away, it’s important to see your doctor regularly. Your doctor will determine how often you should be tested to monitor your hep B.

Routine monitoring may include measuring your viral load and ALT levels, and possibly screening for disease progression, including liver cancer.

Skipping appointments and lab tests may affect the management of your condition.

Remember to remind your doctor, dentist, and other healthcare providers that you have chronic hep B.

Ways to protect yourself and others:

Never share anything that could be contaminated with blood, like toothbrushes, razors, or nail clippers

Never share needles used for tattooing, acupuncture, or injections of any kind

Avoid donating blood, sperm, or body organs

Use condoms during sexual contact

Cover any cuts or scratches

Clean up any blood using bleach

Encourage family to get tested and, if possible, to get vaccinated for hep B

Always take your medicine as instructed.

When tests show you have high amounts of the hep B virus in your liver, your doctor may prescribe a medicine called an antiviral that may lower the amount of virus in your blood.

It may be dangerous to stop taking your medications without talking to your doctor.

The more information your doctor has, the better he/she can help you with managing your health.

Before your visits:

  • Ask a family member or friend to come with you
  • Bring a notebook with questions or concerns

During your visits:

  • Take notes so you will remember what you discuss during your appointment
  • Be honest and open and say, “I don’t really understand…” when you need clarification

Learn the Truth About Hep B

Hepatitis B is a disease that affects each person differently. It is also a disease that often does not have any symptoms, so sometimes people with hep B do not know how sick they may be.

Here are some things that people commonly think or hear about hep B. Make sure you learn about the disease, so you can tell your family and friends the truth about hep B.

7 myths people commonly hear about hep B.


You may feel fine and have no symptoms, but the virus is still in your body and may be doing harm to your liver. People with hep B who don’t feel sick can spread the virus to others just as easily as people with hep B who do feel sick. Be sure to see your health care provider regularly even if you do not feel sick.


There is no such thing as being “only a carrier.” A carrier of the virus is still infected with hep B, can transmit the disease to others, and can still develop serious liver problems over time. Your health care provider can monitor the virus and your liver, and start you on treatment, if necessary.


Hep B is not spread by casual contact, such as touching, hugging, coughing, sneezing, touching doorknobs or toilet seats, or through the air. Hep B can only spread through blood-to-blood contact or bodily fluids from an infected person, and from sharing contaminated items like razors, toothbrushes, needles, and syringes. A common way to get hep B is from your mother if she had it when you were born.


The hep B vaccine will only work for people who do not already have hep B. It is not possible to get hep B from the vaccine since it does not contain the live virus. Talk to your friends and family about getting tested and vaccinated.


Effective medicines for chronic hep B are available. Antiviral medications can help lower the amount of virus in your body and reduce the risk of liver problems. Talk to your health care provider to find out if treatment is an option for you.


Many people have financial concerns. There are programs available to assist you if you are eligible. Ask your healthcare provider for more information.


Lifestyle changes are important, but they can’t cure or treat chronic hep B. If you have chronic hep B, you must seek guidance from your health care provider on how to manage your disease. For some patients, long-term—if not lifelong—treatment may be recommended to help keep the virus from multiplying and to minimize the risk of developing serious liver problems.