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Contempo 1999
August 11, 1999

Advances in the Treatment of Chronic Viral Hepatitis

Author Affiliations

Author Affiliations: Department of Medicine, MetroWest Medical Center, Framingham, Mass, University of Massachusetts Medical School, Worcester, Mass.

JAMA. 1999;282(6):511-512. doi:10.1001/jama.282.6.511

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 strategies.