Chronic hepatitis B including cirrhosis

• 2001Tenofovir disoproxil approved (FDA)
• 2005Entecavir anhydrous approved (FDA)
• 1986Interferon alfa-2b approved (FDA)
• 1995Lamivudine approved (FDA)
• 1996Hepatitis b virus hbsag surface protein antigen approved (FDA)
• 2002Peginterferon alfa-2a approved (FDA)
• 2002Adefovir dipivoxil approved (FDA)
• 2015Tenofovir alafenamide approved (FDA)
• 1959Hydrochlorothiazide approved (FDA)
• 1960Spironolactone approved (FDA)

Trials started per year, stacked by phase (darker = later phase). Source: ClinicalTrials.gov via Clin2, which tracks studies recruiting in recent years — early years undercount.

Chronic hepatitis B is one of the most preventable major infections: a safe, effective vaccine can stop nearly all new cases. For people already living with the virus, daily antiviral pills such as tenofovir and entecavir can suppress it and slow progression to cirrhosis and liver cancer, though they rarely eliminate the infection entirely. The trajectory is uneven: in countries with routine infant vaccination, new infections have fallen sharply, while access gaps persist in many regions. The single most important milestone is the hepatitis B vaccine, which has already reshaped the disease's future. Research is now focused on finding a functional cure.

Can chronic hepatitis B be cured?

Most people cannot be completely cured, but antivirals can keep the virus suppressed for years. This reduces liver damage and lowers the risk of cirrhosis and liver cancer. Researchers are testing new drugs aimed at a functional cure, where the virus stays dormant without daily treatment.

If I have hepatitis B, will I definitely get cirrhosis or liver cancer?

No. Without treatment, the risk is significant, but antivirals lower it substantially. Regular monitoring and avoiding alcohol also help. Many people on treatment live long, healthy lives without developing serious liver complications.

How effective is the hepatitis B vaccine?

The vaccine is about 95% effective at preventing chronic infection. It works best when given at birth or in early childhood, which is why routine infant immunization has dramatically cut new cases in many countries. Protection lasts for decades.

Why does hepatitis B remain common if we have a vaccine?

Vaccination coverage is uneven. Many babies in low-income regions still miss the birth dose, and some adults were infected before vaccines existed. Also, once someone is chronically infected, the vaccine cannot cure them, so the existing burden remains for decades.

What are researchers working on right now?

More than 400 trials are underway, including dozens in late-stage testing. The main goals are to achieve a functional cure and to test combination therapies that might eliminate the virus. Progress is steady, but no breakthrough treatment is approved yet.