Advances in chronic viral hepatitis

Chronic liver disease due to hepatitis B virus or hepatitis C virus infection results in cirrhosis and hepatocellular carcinoma. Successful eradication or suppression of viral replication may lead to clinical improvement and better prognosis. Important discoveries have been made in recent years on the management of these diseases. This article aims at reviewing important publications of the past year that contribute to better understanding and treatment of chronic viral hepatitis.

The effect of virus genotype on the natural history continued to be an important topic of research. Landmark studies on the use of pegylated interferon in chronic hepatitis B and benefit of antiviral treatment in patients with advanced fibrosis or cirrhosis have been published. New antiviral agents were evaluated with encouraging results. In chronic hepatitis C, several treatment trials using pegylated interferon on HIV-coinfected patients have been published. Treatment in specific groups of patients, including those with normal alanine transaminase or posttransplantation recurrence, has also been investigated.

Major progress has been made in the treatment of chronic hepatitis B and pegylated interferon is likely to become one of the first-line therapeutic options in the near future. Combined pegylated interferon and ribavirin will be the standard treatment regimen for hepatitis C and HIV coinfection. Future challenges include treatment of hepatitis B and HIV coinfection and discovery of more potent antiviral agents.