Treatment of chronic viral hepatitis

A substantial number of anti-viral compounds have been evaluated for the treatment of patients with chronic viral hepatitis. A few of these compounds have now achieved clinical applicability. alpha-Interferon is the most widely studied and remains the main treatment for chronic hepatitis B and C. Unfortunately in both these conditions only a minority of patients respond to interferon therapy, although the response can be complete in some patients. Some parameters have been identified which assist in the selection of patients for treatment. Several other cytokines, including thymosin, have been evaluated for the treatment of chronic hepatitis B. There are a number of promising new nucleosides which may inhibit hepatitis B virus and their action is being studied. Relapse rates are unknown however with these compounds. Ribavirin, a guanosine analogue, is also efficacious in treating a proportion of patients with chronic hepatitis C and the drug may be useful in treating patients with cirrhosis or patients who have an auto-immune diathesis.