[Non-A, Non-B hepatitis: advances in diagnosis and therapy].

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.