Chronic hepatitis

Abstract

Evaluation, management and treatment of patients with chronic inflammation of the liver is an important task for the clinician. Almost every ongoing liver injury has an element of inflammation. In those disorders grouped as chronic hepatitis, the brunt of the liver injury is borne by the hepatocyte and continues until either the stimulus is removed or the inflammatory response is blunted. Chronic viral infection is by far the most important cause of chronic hepatitis. Hepatitis B and hepatitis C infections are both frequent causes and may result in cirrhosis. Interferon therapy has proven useful in the treatment of some patients with both disorders. Idiopathic autoimmune chronic hepatitis is an important contributor to the diagnosis of chronic hepatitis and usually responds to corticosteroid therapy. Because of the availability of effective therapy, Wilson's disease, which is a quite rare but important cause of chronic hepatitis, should be considered. Even more rarely, an ongoing reaction to the continued administration of a therapeutic drug leads to chronic hepatitis. Advances in diagnosis, increased understanding of the courses followed by each of the major disorders, and the availability of effective treatment for many patients has heightened interest in the syndrome of chronic hepatitis.