The ultimate goal is to cure hepatitis B. Unfortunately, our medicines can control but cannot cure hepatitis B. Until a cure is available, we have to decide which patients most benefit from treatment. Remember, most people with chronic hepatitis B lead normal lives without even knowing that they have hepatitis B. If risk of hepatitis B is greater than the risk/cost of taking medicines, then you should be treated. However, if the risk of hepatitis B is lower than the risk/cost of taking medicines, then you should not be treated. This is why it is important to know how hepatitis B behaves - its natural history. High viral load is needed before you consider treating hepatitis B. The viral load should be at least 3 log IU/mL. If the viral load was low, it means the hepatitis B is already being controlled by the immune system and there is nothing to treat.

Not everyone with a high viral load needs to be treated. It is a common myth that everyone with a high viral load needs to be treated. This is not true. Most children have the highest viral load and yet they are at the lowest risk. Treating these young children could be dangerous because of the risk of drug resistance. This will change when we find a cure for hepatitis B.