Author Affiliations: Department of Medicine, MetroWest Medical Center, Framingham, Mass, University of Massachusetts Medical School, Worcester, Mass.
Chronic viral hepatitis is now the predominant chronic liver disease
in the United States. It impairs health-related quality of life and when it
progresses to cirrhosis, end-stage liver disease, or hepatocellular carcinoma,
life expectancy is reduced.1- 3
Chronic viral hepatitis is responsible for at least half of all deaths attributed
to chronic liver disease, but this may be an underestimate since accelerated
progression is seen in patients with concomitant alcohol-induced liver disease.
End-stage liver disease due to chronic viral hepatitis is now the single most
common indication for liver transplantation in the United States and Western
Europe. Despite declines in new infections, health care expenditures and resource
use for chronic viral hepatitis will increase during the next decade as the
disease progresses with time in those currently with clinically silent disease.
Alfa interferons, with a wide range of biological activities, have been the
mainstays of therapy. Advances in treatment, expanded treatment options, evidence
of long-term benefits, and cost-effectiveness analyses are changing management
Koff RS. Advances in the Treatment of Chronic Viral Hepatitis. JAMA. 1999;282(6):511-512. doi:10.1001/jama.282.6.511