Abstract
In order to ascertain the proportion of patients with biopsy-proven chronic active hepatitis who meet currently accepted criteria for immunosuppressive treatment, an analysis of 86 patients seen between 1973 and 1978 carrying this diagnosis was undertaken. Only 66 could be confirmed to have this lesion on blind histologic review. Nine of these 66 were on concomitant immunosuppressive therapy, four had inadequate documentation of chronicity, five consumed more than two ounces of alcohol daily, five had concurrent malignancy, two were prepubertal, and one had oxyphenisatin-induced disease. None of the remaining 40 patients met the biochemical criteria for disease activity. The disease was predominantly seen in asymptomatic middle-aged males and was of viral etiology. A small subgroup of elderly female patients was also identified whose disease was apparently nonviral. In conclusion, the vast majority of chronic active hepatitis seen at a large university center occurs in individuals for whom treatment guidelines have not been established.
Similar content being viewed by others
References
De Groote J, Desmet VJ, Gedigk P, Korb G, Popper H, Poulsen H, Scheuer PJ, Schmid M, Thaler H, Uehlinger E, Wepler W: A classification of chronic hepatitis. Lancet 2:626–628, 1968
Mistilis SP: Chronic active hepatitis.In Diseases of the Liver, 4th ed, L Schiff (ed). Philadelphia, JB Lippincott Company, 1975 pp 787–814
Cook GC, Mulligan R, Sherlock S: Controlled prospective trial of corticosteroid therapy in active chronic hepatitis. Q J Med 40:159–185, 1971
Juhl E, Winkel P, Tygstrup N: Sex, ascites and alcoholism in survival of patients with cirrhosis. Effect of prednisone. N Engl J Med 291:271–273, 1974
Murray-Lyon IM, Stern RB, Williams R: Controlled trial of prednisone and azathioprine in active chronic hepatitis. Lancet 1:735–737, 1973
Soloway RD, Summerskill WHJ, Baggenstoss AH, Geall MG, Gitnick GL, Elveback LR, Schoenfield LJ: Clinical, biochemical, and histological remission of severe chronic active liver disease: A controlled study of treatment and early prognosis. Gastroenterology 63:820–833, 1972
Baggenstoss AH, Soloway RD, Summerskill WHJ, Elveback LR, Schoenfield LJ: Chronic active liver disease. The range of histologic lesions, their responses to treatment, and evaluation. Hum Pathol 3:183–198, 1972
Schalm SW, Summerskill WHJ, Gitnick GL, Elveback LR: Contrasting features and responses to treatment of severe chronic active liver disease with and without hepatitis Bs antigen. Gut 17:781–786, 1976
Plotz PH: Asymptomatic chronic hepatitis. Gastroenterology 68:1629–1630, 1975
Wright EC, Sieff LB, Berk PD, Jones EA, Plotz PH: Treatment of chronic active hepatitis. Analysis of three controlled trials. Gastroenterology 73:1422–1430, 1977
Editorial: Immunosuppressive therapy for chronic active hepatitis. Lancet 2:507–508, 1978
Hill AB: Principles of Medical Statistics. New York, Oxford University Press, 1971
Goldberg SJ, Mendenhall CL, Connell AM, Chedid A: “Nonalcoholic” chronic hepatitis in the alcoholic. Gastroenterology 75:598–604, 1977.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Koretz, R.L., Lewin, K.J., Higgins, J. et al. Chronic active hepatitis. Digest Dis Sci 25, 695–699 (1980). https://doi.org/10.1007/BF01308329
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01308329