Hepatitis

Description

Treatment for Chronic Hepatitis

Chronic Hepatitis B and C. Drug treatments for chronic hepatitis B and C are aimed at reducing or preventing liver damage and boosting or modifying the immune system to promote its attack on the viruses. The important agents for treating chronic hepatitis are interferons (particularly interferon alpha) and nucleoside analogues (ribavirin, lamivudine, famciclovir, and adefovir), which act directly against the virus. They are being used as sole therapy and in combinations. These drugs are used differently depending on the specific hepatitis. Other drugs with different mechanisms are also being tested. Smokers with hepatitis C should make every attempt to quit, as research now indicates that smoking is associated with increased severity of the infection.

Autoimmune Hepatitis. Patients with autoimmune hepatitis who have mild symptoms and slight inflammation of the liver do not require any treatment except to alleviate symptoms. They should be monitored, however, for any signs of disease progression. Severe autoimmune hepatitis is a life-threatening condition and requires intensive therapy.

Liver Transplantation

Liver transplantation may be indicated in the following patients:

• Those who have developed life-threatening cirrhosis and who have a life expectancy of more than 12 years.
• Patients with liver cancer that has not spread beyond the liver may also be candidates.

Current five-year survival rates after liver transplantation are between 55% and 80%, depending on different factors. Patients also report improved quality of life and mental functioning after liver transplantation. Unfortunately, in about half of all chronic hepatitis patients, the disease recurs after transplantation.

Patients should consider medical centers that have performed more than 50 transplants per year and produced better-than-average results. Unfortunately, in 2003 with 18,000 Americans waiting for a liver donor, only 4,244 liver transplantations were performed. And, given the large number of people with hepatitis C, this situation will almost certainly worsen over the following years.