Update on viral hepatitis: 2006

Purpose of review This is a concise review of recent developments in the field of viral hepatitis, based on publications between December 2005 and November 2006. Recent findings Elevated hepatitis B virus DNA levels in patients in their 40s with perinatally acquired hepatitis B virus infection increases the risk for cirrhosis and hepatocellular carcinoma. Six approved therapies are available for chronic hepatitis B. Entecavir is a potent antiviral for nucleoside-naive patients. For lamivudine resistant hepatitis B virus infection, adefovir should be added to lamivudine to reduce the risk of adefovir-resistant mutations; however, tenofovir may be a more promising alternative to adefovir. A shorter duration of treatment wth pegylated interferon and ribavirin is sufficient for genotype 2 hepatitis C infection but the benefits of extending treatment to 72 weeks for genotype 1 needs to be confirmed. Pegylated interferon monotherapy was shown to be effective in patients with hepatitis D and ribavirin provides no additional benefit. Summary New developments in the past year will help us fine tune the treatment of viral hepatitis. Even as new treatments are approved, the potential benefits of treatment should be weighed against the risk of drug-resistant mutations with long-term therapy.