[Prevention and therapy of viral hepatitis].

The hepatitis viruses A to E are biologically and clinically heterogeneous: hepatitis A and E are transmitted faecal-orally and never lead to chronic infection. In contrast, the other viruses-B, C, D-are transmitted parenterally and are the leading causes of chronic viral infections in humans worldwide. Highly efficient vaccines are available against hepatitis A and B. The therapeutic armamentarium for chronic hepatitis B and C has significantly expanded during the last several years. Two nucleoside analogues, lamivudine and adefovir, have been licensed for the treatment of chronic hepatitis B and can be used for patients in whom interferon would be contra-indicated such as decompensated cirrhotics. Standard therapy for chronic hepatitis C is a combination of a pegylated interferon-alpha and ribavirin, which can lead to sustained viral clearance in more than 50% of treatable patients. Patients with decompensated cirrhosis can be treated by liver transplantation which offers a 5-year-survival of greater than 80%.