[Therapy of chronic hepatitis (author's transl)]

Abstract

Chronic hepatitis can be subdivided in to two subgroups by new serological methods. Controlled prospective studies have shown that HBsAg-negative, autoimmune chronic active hepatitis (CAH), which is characterized by autoantibodies in the blood, responds favourably to prednisone therapy alone or in combination with azathioprine. Preliminary results seem to indicate, that the dosage used may be reduced slowly and therapy finally stopped after 3-4 years of treatment in most patients. If relapses occur, a lifelong therapy seems to be necessary. Prednisone alone or in combination with azathioprine does not influence the course of HBsAg-positive CAH and the development of cirrhosis. For that reason corticoids cannot generally be recommended in these patients. If there is however a severe course of the disease with frequent periods of necrotising inflammatory involvement prednisone therapy for a period of about 12 months may be helpful. Treatment with different compounds supposed to stimulate immunological processes like laevamisol and transfer factor has not yet produced any decisive improvement. Treatment with antiviral substances as interferon, abarinoside A-or chloroquine still needs to be investigated further.