Update on viral hepatitis in 2004

Abstract

This article highlights recent advances in viral hepatitis published from December 2003 to November 2004. Studies reporting novel and clinically relevant findings were selected after a PubMed search. The aim is to provide an up-to-date summary of important developments in viral hepatitis. Lamivudine was shown to reduce the rate of long-term complications of hepatitis B virus-induced cirrhosis. Adefovir was effective in suppressing lamivudine-resistant hepatitis B virus. Pegylated interferon alone was as effective as pegylated interferon plus lamivudine in the management of HBeAg-negative chronic hepatitis B. A 24-week course of pegylated interferon plus low-dose ribavirin was optimal in patients with hepatitis C virus infected with genotype 2 or 3, but a 48-week course and standard dose of ribavirin were needed in patients with genotype 1. Pegylated interferon plus ribavirin was fairly well tolerated in HIV-hepatitis C virus coinfected patients with stable HIV infection and resulted in response rates that were only slightly lower than that in patients with hepatitis C virus infection only. A dramatic reduction in hepatitis C virus RNA level was observed after 2 days of treatment with an hepatitis C virus protease inhibitor. The optimal management of chronic viral hepatitis is evolving rapidly. Newer treatment options for hepatitis B, including pegylated interferon, tenofovir, and combination regimens were shown to be effective in treatment-naive and treatment-experienced patients. In addition, impressive gains were made in the treatment of hepatitis C virus infection in difficult-to-treat patients, including African Americans and those with HIV-hepatitis C virus coinfection.