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Chronic Hepatitis

An active inflammatory process affecting the liver for more than six months. Causes include viral infections, autoimmune disorders, drugs, and metabolic disorders.

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(Source: NIH - National Cancer Institute)

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Evidence reviews

Hepatitis B (Chronic): Diagnosis and Management of Chronic Hepatitis B in Children, Young People and Adults

Chronic hepatitis B describes a spectrum of disease usually characterised by the presence of detectable hepatitis B surface antigen (HBsAg) in the blood or serum for longer than 6 months. In some people, chronic hepatitis B is inactive and does not present significant health problems, but others may progress to liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The progression of liver disease is associated with hepatitis B virus (HBV) DNA levels in the blood. Without antiviral treatment, the 5-year cumulative incidence of cirrhosis ranges from 8 to 20%. People with cirrhosis face a significant risk of decompensated liver disease if they remain untreated. Five-year survival rates among people with untreated decompensated cirrhosis can be as low as 15%. Chronic hepatitis B can be divided into e antigen- (HBeAg) positive or HBeAg-negative disease based on the presence or absence of e antigen. The presence of HBeAg is typically associated with higher rates of viral replication and therefore increased infectivity.

Treatments for Patients with Genotype 1 Chronic Hepatitis C: A Review of Evidence-based Guidelines [Internet]

Approximately 242,000 Canadians are infected with the hepatitis C virus (HCV), although there are believed to be a number of infected individuals who are unaware that they have HCV. Of those infected, approximately 25% clear infection spontaneously (range 15% to 45%) and the remainder develop chronic hepatitis C (CHC). There are six genotypes and treatment strategy tends to differ depending on genotype.

Interferon-free Regimens for Genotype 1 Chronic Hepatitis C: A Review of the Clinical Evidence and Cost-Effectiveness [Internet]

In Canada it is estimated that 242,000 Canadians have chronic hepatitis C virus (HCV) infection; however, the exact number affected is unknown as 30% to 70% of patients are unaware that they are infected. Fifteen to 25% of patients with chronic infection will develop hepatocellular carcinoma, progressive liver disease, end-stage liver disease, or will require a liver transplant over 20 to 30 years of infection. There are six major HCV genotypes, and genotype 1 accounts for approximately 60% of HCV infections in Canadians.

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Summaries for consumers

Chronic hepatitis C: What are the advantages or disadvantages of boceprevir (Victrelis)?: People with chronic hepatitis C who have not responded to previous treatment or who have had a recurrence

This text summarizes the effects of boceprvir for people with chronic hepatitis C who have not responded to previous treatment or who have had a recurrence. IQWiG assessed trials that compared triple therapy consisting of boceprevir and the previous standard drugs peginterferon alfa and ribavirin, with dual standard therapy consisting only of peginterferon alfa and ribavirin.

Chronic hepatitis C: What are the advantages or disadvantages of boceprevir (Victrelis)?: Boceprevir for people with chronic hepatitis C who have not been treated before

This text summarizes the effects of Boceprevir for people with chronic hepatitis C who have not been treated before. IQWiG assessed trials that compared triple therapy consisting of boceprevir and the previous standard drugs peginterferon alfa and ribavirin, with dual standard therapy consisting only of peginterferon alfa and ribavirin.

Simeprevir (Olysio) for chronic hepatitis C: Simeprevir (Olysio) for hepatitis C (genotype 1) that has been treated unsuccessfully

In 2014, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) assessed the advantages and disadvantages of simeprevir in combination with peginterferon and ribavirin in treating chronic hepatitis C compared with standard therapies.The following results apply to people with chronic HCV infection who have previously been treated unsuccessfully and are not infected with HIV. One of the studies compared the drug simeprevir with telaprevir. Both drugs were used in combination with peginterferon alfa and ribavirin.

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More about Chronic Hepatitis

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Other terms to know:
Autoimmune Disease, Metabolic Disorders

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