The World Health Organization estimates that between 350 million and 400 million people worldwide are infected with the hepatitis B virus. Every year about 2 million people “seroconvert” to an active infection with hepatitis B which can lead to liver cirrhosis, liver cancer, and death. About 50% of all cases of liver cancer occur in people who have been infected with hepatitis B.

Many of the factors that influence the progression of hepatitis B infection to active symptoms of liver disease are beyond an individual's control, but some of the most important are not. If you are infected with the virus, three things you definitely can do include:

• Avoiding alcohol.
• Avoiding aflatoxin.
• Making sure you get enough protein.

The message about alcohol is straightforward but not necessarily simple. If you drink, stop. A virus-infected liver simply can't handle the load of detoxifying alcohol and/or recreational drugs in addition to fighting the long-term effects of the virus. The other two dietary interventions for supporting remission from hepatitis B are accomplished by following a paleo diet.

Aflatoxin is a poison that accumulates on grains grown in hot, dry weather. In the USA, a farmer's crop may be rejected at the grain elevator if a single sample tests positive for the fungus that creates the toxin. In much of the rest of the world, however, testing for aflatoxin is not standard. You'll never be contaminated by alfatoxin-tainted cereal grains, however, if you just don't eat grains, whether in the form of whole grains or the in form of white flour.

Most people actually don't suffer protein shortages, but hepatitis B puts a special strain on the liver as it needs to repair itself without creating fibers that cause cirrhosis. The more advanced the infection, the greater the demand for complete protein, the kind of protein found in foods of animal origin. You may only need 3 or 4 ounces of meat, fish, or eggs daily, but you can't as easily get complete protein by combining plant foods—and the amount of protein in plant foods is actually quite small, because most of a vegetable or fruit is water.

In countries where hepatitis B infections are common, the condition is associated with a collection of symptoms often labeled “metabolic syndrome.” People who have hepatitis B but who do not suffer food deprivation tend to become overweight with their extra weight accumulating mostly as belly fat, and they tend to develop high blood pressure, high cholesterol, and high triglycerides. All of these symptoms are associated with an underlying problem known as insulin resistance. The liver protects itself against the free radicals of oxygen released by the burning of glucose as fuel by reducing its sensitivity to insulin, forcing sugar to remain in the bloodstream, causing the pancreas to release more insulin, with the insulin used to store fat instead of sugar.

Controlling insulin resistance facilitates weight loss and indirectly lowers blood pressure, triglycerides, and cholesterol. You can lower your insulin resistance just by following the paleo diet, and also by taking a daily dose of at least 100 mg each of R-lipoic acid (or 200 mg of alpha-lipoic acid), biotin, and L-carnitine. These supplements are supportive rather than curative, but you should see some results in the mirror and when you step on the scales within a month, and you may—although it's impossible to know for sure—enjoy longer remission from underlying liver disease.