Present and future management of viral hepatitis

Abstract

Viral hepatitis can result in important morbidity and mortality, with its impact on health conditioned by the specific type of hepatitis, the geographical region of presentation and the development and access to new drugs, among other factors. Most acute presentation forms are self-limiting and may even go unnoticed, with just a small percentage of cases leading to acute liver failure that may necessitate transplantation or even cause the death of the patient. However, when they become chronic, as in the case of hepatitis B virus and C virus, unless they are diagnosed and treated adequately they may have severe consequences, like cirrhosis or hepatocarcinoma. Understanding of the mechanisms of transmission, the pathogenesis, the presence of vaccinations and the development over recent years of new highly-efficient, potent drugs have meant that we are now faced with a new scenario in the management of viral hepatitis, particularly hepatitis B virus and hepatitis C virus. The spectacular advances in hepatitis C virus treatment have led the World Health Organization to propose the objective of its eradication by 2030. The key aspect to achieving this goal is to ensure that these treatments reach all the more vulnerable population groups, in whom the different types of viral hepatitis have a high prevalence and constitute a niche that may perpetuate infection and hinder its eradication. Accordingly, micro-elimination programs assume special relevance at the present time.

Keywords: Hepatitis viral; Diagnosis; Treatment; Trend direct-acting antivirals; Inhibiting recycling

Core Tip: The various types of viral hepatitis have resulted in important morbidity and mortality for many years. Greater understanding of the pathogenesis as well as the development of new, highly efficient potent drugs mean that we are now faced with a new scenario in the approach to this disease. The spectacular advances in the treatment of hepatitis C virus suggest that we can now envisage its eradication, as put forward by the World Health Organization in its objectives for 2030. In this review we comment on the current situation, recent advances and future perspectives in the approach to viral hepatitis.