Bühler H
Medizinische Klinik, Stadtspital Waid, Zürich.
Schweiz Med Wochenschr. 1991 May 18;121(20):721-6.
The characterization of the hepatitis C virus (HCV) and the development of an anti-HCV antibody test have closed a further gap in the etiological diagnosis of viral hepatitis, but at the same time new questions have been raised. It has been shown that HCV is by far the most frequent source of the parenterally transmitted form of non-A, non-B hepatitis (NANBH). The anti-HCV test is reactive in the majority of cases with chronic NANBH. However, seroconversion is delayed by weeks or even months and therefore the test is inappropriate for confirmation of acute NANBH. Most patients with autoimmune hepatitis and some with alcoholic liver injury were shown to be anti-HCV reactive, giving rise to a debate on the specificity of the anti-HCV test. The significance of these findings has not yet been explained, since a confirmation test is currently lacking. Alpha-interferon has been shown to be the first promising drug for treatment of chronic viral hepatitis. In a high percentage of patients with chronic NANBH, treatment with interferon induces biochemical and histological remission. Nevertheless, about half of the patients had relapses under the treatment regimens currently used. The aim of ongoing studies is to improve results by optimizing the dosage and duration of interferon treatment.
丙型肝炎病毒（HCV）的鉴定以及抗HCV抗体检测方法的开发，进一步缩小了病毒性肝炎病因诊断方面的差距，但同时也引发了新的问题。研究表明，HCV是经肠道外传播的非甲非乙型肝炎（NANBH）最常见的病因。在大多数慢性NANBH病例中，抗HCV检测呈阳性。然而，血清转化会延迟数周甚至数月，因此该检测不适用于急性NANBH的确诊。大多数自身免疫性肝炎患者以及一些酒精性肝损伤患者抗HCV检测也呈阳性，这引发了关于抗HCV检测特异性的争论。由于目前缺乏确诊试验，这些发现的意义尚未得到解释。α干扰素已被证明是治疗慢性病毒性肝炎的首个有前景的药物。在高比例的慢性NANBH患者中，干扰素治疗可诱导生化和组织学缓解。然而，在目前使用的治疗方案下，约有一半的患者会复发。正在进行的研究旨在通过优化干扰素治疗的剂量和疗程来改善治疗效果。
