Key Developments in Gastroenterology [antikvár]

Key Developments in Gastroenterology Edited by P. R. Salmon © 1988 John Wiley & Sons Ltd Modern Management of Chronic Viral Hepatitis Howard C. Thomas St Mary's Hospital and Medical School, University of London, London Chronic HBV Infection Factors influencing response Patients with this condition are heterogeneous in terms of: 1) Time of infection (neonatal in Japanese and Chinese; early childhood in Africa; early adult life in Western Europe and North America) 2) Duration of infection 3) Severity of hepatitis 4) Immune status (homosexual patients have a second-degree immunodeficiency unrelated to HIV (Regenstein et al, 1983) infection and also, in some cases, to HIV infection). Neonatal infection, long duration of infection, immunodeficiency and low inflammatory activity may reduce probability of response (Scullard et al, 1981c). Indications for therapy (not definitely identifíed) 1) Infectivity—HBe antigen and HBV-DNA positive patients 2) Evidence of progressive liver disease—histological evidence of chronic active hepatitis. Contra-indication for therapy Evidence of decompensated cirrhosis 1