急性B 型肝炎在國內推動新生兒全面B 型肝炎預防注射後，已逐漸減少，但臨床診療病患中，仍然有機會遇到急性B 型肝炎的患者，可能的原因包含未施打疫苗者，對現行疫苗反應低下的人未有保護效果，另外經免疫或抗病毒藥物篩選下產生的突變株，可跳脫經疫苗產生抗體的結合。急性B 型肝炎的治療研究，相對稀少，雖然大多數患者會痊癒，但仍然有個案產生肝衰竭，面對明顯的肝指數上升，甚至黃疸產生，與病患的不安，投予抗病毒藥物是否恰當? 臨床可見有個案依慢性B 型肝炎代償不良原則，接受抗病毒藥物治療。藉由文獻回顧，在此篇文章中探討抗病毒藥物的使用角色，非嚴重型患者使用抗病毒藥物治療，預後並無差異，但可能會減少B 型肝炎表面抗體的產生。但是在嚴重的急性B 型肝炎，病患面臨肝衰竭、高死亡率，此時給予抗病毒藥物治療，有機會減少死亡和移植率。

Acute hepatitis B was decreasing after the policy of global hepatitis B virus (HBV) vaccination in Taiwan.However, sporadic cases of acute hepatitis B were still encountered in our daily practice. Non-vaccination,
non-response or poor response to current hepatitis B vaccine may be the cause. In addition, immune-selected or antiviral selected mutant strain may also cause new HBV infection in post-vaccination era. Studies for acute hepatitis B are not as much as for chronic hepatitis B. What is the role of antiviral agent in treating acute hepatitis B? Articles involved antiviral treatments for acute hepatitis B were reviewed. These studies showed antiviral agent may be beneficial in severe acute hepatitis B. But antiviral agent may play no role for non-severe form because it
may interfere normal immune reaction and also impair anti-HBs formation.