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Importance of Treatment Chronic liver disease is among the 10 leading causes of death in the United States. Perhaps even more tragic, it claims the lives of individuals in their most productive years. About half of the deaths attributable to chronic liver disease occur before the age of 60. Persistence of the virus appears to be an important factor in disease progression. Progression of HCV Infection Can Lead to Serious Liver Damage Rates of disease progression vary between chronic hepatitis B and C patients, and by age. Only 5 to 10 percent of adults with acute hepatitis B will progress to chronic disease. However, chronic disease may develop in as many as 55 percent of children with acute hepatitis B infections. In neonates, acute hepatitis B infection leads to chronic disease in virtually all cases. Acute hepatitis C will progress to chronic disease in up to 85 percent of adult patients. Of this number, >20 percent will develop severe chronic hepatitis resulting in cirrhosis, liver failure, and/or hepatocellular carcinoma. Chronic hepatitis C leads to about 30 percent of liver transplants in the United States. Seventy percent of all patients with liver cancers are hepatitis C positive. Early Treatment Increases the Chances of Therapeutic Success Evidence is compelling to indicate that patients who are identified early in the course of their disease and treated when virus levels are low, have the best results from treatment. In studies with interferon, patients with less-severe histologic disease had higher response rates to the therapy than patients with bridging fibrosis or cirrhosis. The goals of treatment for chronic viral hepatitis are to eradicate the virus or decrease viral replication, decrease hepatic necrosis, reduce symptoms of hepatic disease, and halt the progression to cirrhosis and/or hepatocellular carcinoma. In chronic hepatitis B, interferon alfa-2b therapy acts to stimulate the immune system to fight the viral infections and can inhibit the viruses' ability to divide in liver cells. For previously untreated chronic hepatitis C patients with compensated liver disease, and those who have relapsed after alpha interferon treatment, another option is now available: combination therapy composed of ribavirin and interferon. To review data on interferon alfa-2b, see INTRON® A. To review data on combination ribavirin plus interferon alfa-2b, see REBETRON Combination Therapy. |
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