Scheig R
State University of New York at Buffalo, USA.
Lippincotts Prim Care Pract. 1998 Jul-Aug;2(4):390-7.
Hepatitis A, B, C, D, E, and G are important causes of viral hepatitis. It is estimated that there are at least 32,000 new cases of hepatitis A, 300,000 new cases of hepatitis B, and 150,000 new cases of hepatitis C each year in the United States alone. Risk factors for hepatitis infection include sexual activity with multiple partners, intravenous drug use or sharing cocaine straws, tattooing or body piercing, exposure to blood and body fluids through health-care work, and having a blood transfusion or transplant. Diagnostic markers are important to determine the type of hepatitis and to differentiate acute from chronic infection. Up to 5% of adult patients infected with hepatitis B virus and up to 80% of those infected with hepatitis C virus become chronic carriers. Whereas acute hepatitis C virus infection is usually mild, chronic hepatitis C infection develops insidiously after an average of 10 years and may lead to cirrhosis and possibly hepatocellular carcinoma. Currently, interferon-alpha is the only FDA-approved agent to treat chronic hepatitis B and C and relapses are common with hepatitis C infection. There are many clinical trials using other antivirals and combination therapies to treat these chronic infections. Prevention through patient education of high-risk behaviors and immunization remain the best defense against acute and chronic viral hepatitis.
甲型、乙型、丙型、丁型、戊型和庚型肝炎是病毒性肝炎的重要病因。据估计，仅在美国，每年就至少有3.2万例甲型肝炎新病例、30万例乙型肝炎新病例和15万例丙型肝炎新病例。肝炎感染的危险因素包括与多个性伴侣发生性行为、静脉注射吸毒或共用可卡因吸管、纹身或穿耳洞、通过医疗工作接触血液和体液，以及接受输血或移植。诊断标志物对于确定肝炎类型以及区分急性感染和慢性感染很重要。感染乙型肝炎病毒的成年患者中高达5%，感染丙型肝炎病毒的患者中高达80%会成为慢性携带者。虽然急性丙型肝炎病毒感染通常较轻，但慢性丙型肝炎感染平均10年后会隐匿发展，可能导致肝硬化并有可能发展为肝细胞癌。目前，α干扰素是唯一获得美国食品药品监督管理局批准用于治疗慢性乙型和丙型肝炎的药物，丙型肝炎感染复发很常见。有许多使用其他抗病毒药物和联合疗法治疗这些慢性感染的临床试验。通过对高危行为进行患者教育和免疫接种来预防，仍然是抵御急性和慢性病毒性肝炎的最佳防御措施。
