Rambusch E G, Manns M P
Abteilung Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover.
Ther Umsch. 1998 Feb;55(2):71-6, 78-9.
The therapy of viral hepatitis has great medical and socioeconomic impact. Today chronic viral hepatitis is the most important cause for chronic liver disease, liver cirrhosis, and hepatocellular carcinoma. Hepatitis A and E cause acute courses exclusively whereas infection with the hepatitis B, C, and D virus might result in chronic hepatitis as well. The goal of therapy of chronic viral hepatitis has to be a reduction/normalisation of elevated transaminases, decrease of the serologic parameters of active viral replication, improvement of histology and prevention of complications of chronic hepatitis. The only drug with proven benefit in the treatment of chronic viral hepatitis is interferon alpha. This therapy results in a sustained response in 25 to 40% for hepatitis B and 10 to 25% for hepatitis C infection. New developments under clinical evaluation are Lamivudine and Famciclovir in the treatment of HBV-infection and Ribavirin in combination with INFa for chronic HCV-infection.
病毒性肝炎的治疗具有重大的医学和社会经济影响。如今,慢性病毒性肝炎是导致慢性肝病、肝硬化和肝细胞癌的最重要原因。甲型和戊型肝炎仅引起急性病程,而感染乙型、丙型和丁型肝炎病毒也可能导致慢性肝炎。慢性病毒性肝炎的治疗目标必须是降低/使升高的转氨酶正常化,降低活跃病毒复制的血清学参数,改善组织学状况并预防慢性肝炎的并发症。在治疗慢性病毒性肝炎方面唯一已证实有疗效的药物是α干扰素。这种疗法对乙型肝炎的持续缓解率为25%至40%,对丙型肝炎感染的持续缓解率为10%至25%。正在临床评估的新进展包括拉米夫定和泛昔洛韦用于治疗乙肝感染,利巴韦林与干扰素α联合用于治疗慢性丙肝感染。