[Therapy of hepatitis B. Practical implications]

There is as yet no specific treatment for viral hepatitis, and in an uncomplicated course no further action apart from moderate bedrest is necessary. The patient should however, be isolated in a special ward. In fulminant hepatic failure the benefit of glucocorticoid therapy is still controverted and appears to depend on an early beginning. Treatment with HBsAg-rich human serum in fulminant hepatitis B is still under evaluation. In chronic active hepatitis the administration of azathioprine in combination with glucocorticoids is highly effective, and it appears to be irrelevant whether HBsAg is present in plasma or not; however, the best results have been achieved in "lupoid" hepatitis. The use of transfer factor, laevamisol or thymosin to suppress T-cell action on antibody production of the B-cells cannot yet be finally evaluated with respect to its effectiveness in chronic active hepatitis. Prevention is of major importance in solving the problems involved in hepatitis B infections. Recent experience with active immunization using HBsAg-rich sera or purified formalin inactivated HBsAg preparations suggest the possibility of successful vaccination against hepatitis B in the near future, but the precondition for obtaining sufficient quantities of vaccine is to find suitable culture media for the virus.