Chronic viral hepatitis
The B, C, D and G viruses are the cause of frequent chronic hepatitis. Infections with the HGV and TTV viruses are also common, but they have not been shown to cause chronic hepatitis. Until then, a distinction was made between so-called persistent chronic hepatitis (generally benign) and active chronic hepatitis, the risk of which is high in the course of cirrhosis. Today, more advanced means of investigation allow a more precise diagnosis and give indications of antiviral treatments or surveillance.
Chronic hepatitis is very common : 350 million people worldwide are affected by the B virus and 170 million by the C virus.
In 20% of cases, these hepatitis develops into cirrhosis with a 3 to 5% risk of hepatocellular carcinoma.
Symptoms of the disease
Most often the disease is latent, but there are some symptoms :
- asthenia, frequent but inconsistent ;
- cutaneous, articular, neurological, renal manifestations ;
- slight increase in liver volume.
• Treatment of chronic hepatitis B uses interferon alpha to stop viral multiplication, but also lamivudine, which is more effective in the short to medium term but limited in the long term due to the risk of escape.
• Treatment of hepatitis D, also antiviral, also advocates the use of interferon alpha, but the chances of success are only 25%.
• Treatment of chronic hepatitis C combines alpha interferon and ribavirin, with a chance of success of around 40%.