Viral hepatitis: Progress and problems

The recognition of viral hepatitis has been facilitated by the use of serologic studies for types A, B and non A, non B. Viral hepatitis is transmitted through blood as indicated by studies in drug addicts, maternal-infant transmission and by close contact, with possible spread by saliva and tears. The course of viral hepatitis is best determined by using serum enzymes, followed by clearance studies of bile acids or dyes, once the enzymes return to normal. In patients with persisting clinical or biochemical abnormalities and subjects in which the nature of the disease is not known, a liver biopsy should be performed. Treatment of acute viral hepatitis and its complications is largely supportive. Special measures for evidence of liver failure have significantly reduced the mortality from fulminant hepatitis, and the use of immunosuppressive agents has decreased morbidity in chronic active hepatitis. Pooled gammaglobulin has varying amounts of antibodies to A, B and non A, non B viruses and may therefore be useful in prophylaxis. Viral B hepatitis is preventable by specific use of immune globulin preparations or specific vaccines now being used in clinical investigative studies.