History of Chronic Hepatitis

Abstract

Chronic hepatitis, a disease identified around 1950, became of increasing interest to clinicians and pathologists by reason of the introduction of percutaneous liver biopsy for diagnosis, serum transaminase tests for monitoring, serologically defined autoantibodies for pathogenetic insights, and corticosteroid drugs for treatment.¹ Although the cases described initially during the 1950s displayed some particular clinical features, such as predominance among cases of young females and marked hyperglobulinemia, it was widely presumed that the disease was the sequel to a subclinical acute viral hepatitis, and was referred to by some as subacute hepatitis. The term active chronic hepatitis was used to distinguish cases marked by ongoing inflammatory activity from the less frequent inactive chronic cases in which the disease had become quiescent.² Active chronic became replaced by chronic active hepatitis (CAH) as the preferred description. Activity in CAH was defined biochemically by elevated serum levels of transaminase enzymes and histologically by inflammatory cellular infiltration within and around portal tracts in the liver with associated hepatocellular damage. The wide range of clinical and pathologic expressions of the disease depend essentially on the degree of inflammatory activity and on the rate of progression to cirrhosis. Initially, the disease was regarded as a single entity of unknown cause.³