Chronic hepatitis--changing trends.

The clinical expressions, courses and consequences of hepatitis caused by different viruses (A,B,C,D,E,G) are different. Diagnosis of hepatitis is incomplete unless its etiology is specified and for chronic hepatitis, the etiology is apparent in almost all cases when autoimmune and metabolic diseases are also included. Hence, the classification based only on histology is not adequate and emphasis should also be on the etiology. The prognostic indices governing a response to interferon therapy in patients with chronic viral hepatitis have advanced with the knowledge of role played by viral genotypes, serum ferritin, hepatic iron concentration, viral quantification, and severity of histology. There have been recent changes in the definition and classification of autoimmune hepatitis as well as there is availability of newer immunosuppressive agents with encouraging results.