[Pharmacological treatment of acute hepatitis B]

The incidence of acute B hepatitis is decreasing due to socioeconomical changes and the implementation of vaccination programs. Nevertheless it is potentially severe, causing approximately 30% of acute liver failures in Spain. Pharmacological treatment of acute B hepatitis has become a matter of issue over the last decade. This text offers a review of the published data and international guidelines. Most published studies have a low methodological quality and lamivudine was used as treatment in all of them. A survival improvement with prompt treatment has been shown in acute liver injury and probably in severe acute hepatitis (total bilirubin>10mg/dl and INR>1.5). International guidelines support treatment in these cases, but there is no consensus on the drug to use or the length of treatment.