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Treatment of chronic viral hepatitis 

Treatment of chronic viral hepatitis
Chapter:
Treatment of chronic viral hepatitis
Author(s):

Peter Davey

, Mark Wilcox

, William Irving

, and Guy Thwaites

DOI:
10.1093/med/9780199689774.003.0034
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date: 12 April 2021

With over 500 million individuals chronically infected with either hepatitis B or C viruses, all of whom are at risk of development of end-stage liver disease and hepatocellular carcinoma, chronic viral hepatitis creates a huge health and economic burden worldwide. This chapter describes the management of patients with chronic viral hepatitis. The natural history of chronic hepatitis B infection is described, including phases of immune tolerance, immune clearance, immune control, and reactivation. Indications for therapy (which patients should be treated?) are outlined, and the two approaches to therapy—interferon-based, and nucleos(t)ide analogue therapy—are described, including monitoring regimens. For chronic hepatitis C infection, again, the key questions discussed are, which patients should be treated? How is treatment monitored? Which drugs should be used? What factors influence the likelihood of response to therapy?

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