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Chronic Hepatitis B is associated with serious complications including liver failure, cirrhosis and hepatocellular carcinoma. Patients with HBeAg-negative chronic hepatitis B had significantly higher rates of response, sustained for 24 weeks after the cessation of therapy, with peginterferon alfa-2a than with lamivudine.

The hepatitis C virus (HCV) may be capable of causing liver failure. This was discovered when a 68-year-old man was admitted to a hospital for coronary artery bypass surgery. He had no history of liver disease. He received blood transfusions during surgery. He was admitted again one month later with signs of liver disease and died 11 days later of liver failure. Blood samples taken before and after surgery were negative for HCV but turned positive 5 weeks later. Liver samples taken at autopsy tested positive for HCV.

A high dosage of interferon alfa-2a may be an effective treatment for chronic hepatitis D in some patients. Many patients may have a relapse after treatment is discontinued. Among 41 patients with chronic hepatitis D, 14 were treated with 9 million units of interferon alfa-2a, 14 were treated with 3 million units of interferon alfa-2a and 13 received no treatment (control group). Patients in the two treatment groups were treated three times per week for 48 weeks. A complete response to treatment occurred in 50% of the patients treated with the higher dosage, compared with 21% of those treated with the lower dosage and none of the control group. A complete response to treatment was determined by two factors. One was a return to normal blood levels of the enzyme alanine transferase. The other was no detection of hepatitis delta virus in the patient's blood.

Cases of viral hepatitis which could not be demonstrated to be either hepatitis A or hepatitis B have traditionally been lumped together as non-A, non-B hepatitis. While not all such cases have the same cause, the majority of non-A, non-B hepatitis cases which occur after a patient has received a blood transfusion are now known to be caused by another virus, appropriately named hepatitis C virus (HCV). Until recently, little has been known about this virus or the natural history of the infection it causes. However, recently the genes of this virus have been cloned, which provides a valuable tool for researchers probing the course of hepatitis C infection. These tools have now been employed in the study of the course of hepatitis C infection. The highly sensitive polymerase chain reaction (PCR) was used to detect the presence of hepatitis C virus genes in samples of blood serum from five patients with post-transfusion hepatitis. The same method was used to follow the experimental infection of chimpanzees with serum from four of the patients. These samples covered not only the acute infection, but also from 10 to 14 years of patient follow-up. The results demonstrated that the levels of antibodies to hepatitis C virus were not good indicators of the infectious process. During the first several months of the infection, no antibodies could be detected and viral genes in the blood serum were the only markers of infection. One patient had only acute hepatitis which resolved spontaneously; the resolution of symptoms in this patient correlated with the disappearance of viral genes from the blood. Antibodies to HCV, however, persisted for nine years. The remaining four patients developed chronic hepatitis, which was active in three cases. In these patients, persistence of virus in the body could be demonstrated using the PCR technique. These results demonstrate that the measurement of antibodies to hepatitis C virus is not a reliable indicator of the state of infection. (Consumer Summary produced by Reliance Medical Information, Inc.)