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Epidemiology, clinical course and treatment of chronic viral hepatitis
W Stremmel1, J Schwarzendrube, C Niederau
1Abteilung für Gastroenterologie, Heinrich-Heine-Universität Düsseldorf, Germany.
Insights
Chronic hepatitis B and C infections are significant health concerns. Advances in understanding viral structure and immune responses aid in predicting disease outcomes and developing effective treatments like alpha-interferon.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis encompasses infections from hepatitis B virus (HBV), delta virus, and hepatitis C virus (HCV).
- These viral infections are primarily transmitted through parenteral and sexual routes.
- Hepatitis C virus (HCV) is now recognized as the main cause of chronic non-A, non-B hepatitis.
Purpose of the Study:
- To define the replicative state of hepatitis B virus (HBV) using new insights into its structure and host immune responses.
- To predict disease outcomes and identify major complications such as cirrhosis and hepatocellular carcinoma.
- To discuss recent advancements in diagnosing and managing chronic hepatitis B and C.
Main Methods:
- Utilizing new insights into hepatitis B virus (HBV) structure and immune response mechanisms.
- Development of assays for detecting hepatitis C virus (HCV)-antibodies.
- Implementation of screening tests for HBV and HCV in blood donors.
Main Results:
- Clear definition of HBV replicative states and improved prediction of disease outcomes.
- Facilitated diagnosis of chronic non-A, non-B hepatitis through HCV-antibody detection.
- Reduced risk of transfusion-transmitted hepatitis via donor screening.
Conclusions:
- Alpha-interferon shows promise for treating chronic hepatitis B and C.
- Further studies are required to optimize treatment protocols, including dosage, duration, and patient selection.
- Enhanced understanding of viral structure and immune responses improves disease management and prognosis.
Abstract:
Chronic hepatitis may take the form of a hepatitis B infection, a delta virus infection, or a non-A, non-B hepatitis including hepatitis C. All the viruses involved are transmitted predominantly by parenteral or sexual routes. New insights into the structure of the hepatitis B virus (HBV) and the immune response mechanisms of the organism permit a clear definition of the replicative state of the virus, and allow predictions to be made about the outcome of the disease. Development of cirrhosis and hepatocellular carcinoma are the major complications associated with impaired life expectancy. Recently, the hepatitis C virus (HCV) was identified as the agent responsible for most cases of chronic non-A, non-B hepatitis. The development of an assay for the detection of HCV-antibodies facilitated the diagnosis of this type of hepatitis. Moreover, the use of screening tests for hepatitis B and hepatitis C in blood donors will decrease the risk of acquiring hepatitis via contaminated blood products. Treatment of chronic hepatitis B and C with alpha-interferon has shown promising results. However, the dosage schedule, the period of treatment, and the selection of patients needs to be evaluated in further studies.