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Treatment of chronic hepatitis type virus B.

The current status of therapy for chronic HBsAg positive hepatitis is reviewed. Corticosteroid therapy usually has little, if any, benefit; in fact, in addition to its customary side-effects, it may enhance viral replication. Corticosteroids are indicated only in the rare case of life-threatening HBsAg-positive severe chronic active hepatitis with immune features. Clinical studies on antiviral treatment are continuing. Today interferon, ARA-A, and acyclovir appear the most promising agents under investigation. Patients with HBeAg-positive chronic hepatitis should be referred to centers evaluating antiviral treatment, particularly in the case of progressive liver dysfunction, relapsing activity or psychological imbalance because of contagious blood. There are at present few prospects of eradicating hepatitis B virus in patients with HBsAg, antiHBe positive cirrhosis, who remain at risk of developing hepatocellular carcinoma. With the exception of the above-mentioned categories, patients with chronic HBsAg-positive hepatitis should be encouraged to pursue as normal a life as possible. To define the natural history of the disease more precisely, they should be followed carefully after being adequately informed about their disease and the proper preventive measures.