TREATMENT OF CHRONIC HEPATITIS

Chronic hepatitis is classified etiologically. The autoimmune type pre dominantly affects genetically predisposed females. It is classified a ccording to the pattern of circulating autoantibodies. Long-term corti costeroid therapy is usually successful. Associations between antibodi es to liver-kidney microsomes and the hepatitis C virus can cause diag nostic difficulties. Antiviral treatment of chronic hepatitis B and C is aimed at controlling symptoms and abnormal biochemistry and particu larly the progression to cirrhosis and liver cancer. Interferon-alpha is usually employed but there is no consensus concerning the best regi men. Patients who have developed cirrhosis rarely respond. Hepatitis C is particularly liable to relapse after apparently successful treatme nt. Serum hepatitis C viral RNA should be used to predict response and monitor progress. Alternative therapies such as thymosin for hepatiti s B virus and ribavirin for hepatitis C virus are being evaluated. Som e nucleoside analogues such as FIAU (fluoro-iodo-arabino-furanosyl-ura cil) have had disastrous results in clinical trials.