Viral Hepatitis: Diagnosis, Therapy, and Prevention [Hardcover]

Steven Specter (Editor)

Book Description

ISBN-10: 0896034240 | ISBN-13: 978-0896034242 | Publication Date: April 5, 1999 | Edition: 1

Leading international virologists review the state-of-the-art in the biology, pathogenesis, and epidemiology of the hepatitis viruses. The authorities writing here examine the five well-recognized hepatitis viruses, A through E, and some of the newer agents, the so-called non- A-E hepatitis viruses. They also provide in-depth discussions of the biological nature of the viruses, the pathogenesis of the acute and chronic diseases they cause, the methods and ease with which they are transmitted, and their clinical signs and symptoms. Additional topics include diagnostic tests and routine blood screening, new vaccines, and the use of interferon and antiviral drugs. Viral Hepatitis: Diagnosis, Therapy, and Prevention provides the most comprehensive and up-to-date survey of the hepatitis viruses currently available

Editorial Reviews

From The New England Journal of Medicine

Jaundice was recognized as a disease as long ago as the fifth century b.c., and its infectious nature was suspected as early as the eighth century a.d. Large epidemics of hepatitis, first reported in the Middle Ages, have continued to occur into the 20th century during times of war, famine, or other catastrophic events. In the 1930s and 1940s, the cause of hepatitis was established and two forms of the disease -- infectious hepatitis (hepatitis A) and serum hepatitis (hepatitis B) -- were distinguished. It was, however, the discovery in the mid-1960s of an antigen specific to hepatitis B virus, the Australia antigen, that ignited interest in viral hepatitis and resulted in an explosion of new information about the disease and the viruses that cause it. Five hepatotropic viruses -- hepatitis A, B, C, D, and E -- are now recognized, and all are important public health issues, although more so in some countries than in others. Two additional viruses, hepatitis G (GBV-C) and TT, have been discovered recently but have yet to be proved to be hepatotropic and pathogenic to the liver.

Even with the sophisticated diagnostic methods now available, not all clinical cases of viral hepatitis can be attributed to a known virus, and it is evident that other hepatotropic viruses remain to be identified. Viral Hepatitis is therefore timely.

The first six chapters of this mostly excellent book are devoted to the five known hepatotropic viruses. They provide comprehensive information on the biology, pathogenesis, and epidemiology of each of these viruses and on the clinical presentation and diagnosis of the diseases they cause, using a uniform format and style that are easy to follow.

It is evident that these viruses, although similar in some respects, have a number of intriguing differences. Most are RNA viruses, but one (hepatitis B) is a DNA virus. Each belongs to a different viral family and, with the exception of hepatitis D virus, has unique features that have resulted in its being classified in a new genus within the family. Two viruses (hepatitis B and C) are enveloped, and two (hepatitis A and E) are not, whereas the hepatitis D virus requires an envelope provided by the surface-coat material of hepatitis B virus for it to propagate. Only hepatitis B virus DNA integrates into host DNA. Two viruses (hepatitis A and E) are spread enterically and cause acute illness, whereas three (hepatitis B, C, and D) are spread parenterally and cause both acute and chronic disease. Although viral factors may contribute to the nature of the diseases they cause, the host's immunologic reaction to the presence of the virus in hepatocytes emerges as the dominant mechanism of liver-cell damage and inflammation.

The remaining chapters are largely devoted to treatment and prevention. Although all forms of acute viral hepatitis are usually easily managed (less is better than more), treatment of chronic hepatitis is less rewarding. Theories explaining how interferon alfa (or the other interferons) should eliminate these viruses are presented, but in practice the desired result is achieved in only a minority of patients. Increasing the duration of treatment or the dose of interferon may increase the response rates, but only moderately.

A number of novel approaches to treatment are discussed, of which the most promising appear to be the nucleoside analogues. Unfortunately, few of the large trials of the efficacy of these agents had been completed at the time the book was written. This is an inevitable result of the lag between the writing and the publication of books and is illustrated by the fact that all the references concerning the treatment of hepatitis B and C were published before 1997.

Viral hepatitis will eventually be prevented by immunization. Effective and safe vaccines against hepatitis B and A viruses are already available. Of the two, hepatitis B immunization is globally the more important because of the morbidity and mortality associated with chronic infection with this virus. In the light of this fact, the book's coverage of this vaccine is disappointingly brief and fails to emphasize the pressing need for universal immunization, at least in the countries in Africa and the Far East in which the virus is endemic. No mention is made of the distressing statistic that only 1 percent of black babies in Africa currently receive the vaccine. In contrast, hepatitis A vaccine is discussed in exhaustive detail.

This book will serve as a useful guide to the hepatitis alphabet, which grows ever longer and more complex.

Reviewed by Michael C. Kew, M.D., Ph.D.
Copyright © 1999 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

"...a cadre of international investigators thoroughly review all aspects of these human pathogens, including available therapeutic and prevention strategies...These well-organized chapters provide an in-depth account of the current knowledge of each of these viral agents including their basic virology, diagnosis, pathogenesis, epidemiology, and natural history, as well as the clinical features of the diseases they cause...the book is well-written and organized...[it] crystallizes in one volume a remarkable amount of information. It should be enjoyed by primary care practitioners, as well as gastroenterologists, hepatologists, [and] virologists." -Antiviral Research "This clearly written and readable review of viral hepatitis provides useful information for family physicians interested in this protean disorder...Coverage of viral hepatitis is thorough and complete...Good-sized print and pointed chapter subheadings make the book easy to peruse or read cover to cover. Each chapter is divided into sections, allowing the reader to quickly access desired information...The clear writing style and useful content provide an effective review of biochemistry and genetics that is suitable for family physicians. The illustrations consist mainly of table and graphics offering helpful clinical information and providing clear diagnostic and prognostic clues... Dr. Specter has put together an up-to-date summary of all that is known about viral hepatitis in a highly readable book...This book is written by clinicians and researchers but clearly aimed at clinicians. It successfully provides us with distinct guidelines for thinking about viral hepatitis and its management." -American Family Physician "...quite an improvement over similar texts published to date in this area...The text has a number of attractive features....the writing is clear and concise. Overlap, despite the multi-authored format and chapter development, has been kept to a minimum. Another positive feature is the depth with which the majority of topics are dealt. This is particularly evident in the sections dealing with the viruses themselves and their replicative cycles. For example, interested readers will be pleased to find descriptions of the hairpin structures that might participate in regulation of hepatitis C virus genome expression and the precise positions of large stem loops, which are thought to represent internal ribosomal entry sites...In summary, this textbook deals with an important and timely subject. For the virologist, the answer to many if not all questions dealing with hepatotrophic viruses can be found within its pages...a recommended purchase for virologists, hepatologists and infectious disease specialists." -Can J Infect Dis "The chapter on hepatitis A is comprehensive...Laboratory diagnosis was clearly set out with no omissions...I found the chapter on anti viral therapy particularly helpful in its concise coverage of all appropriate therapies...this is a very useful book for clinical virologists, hepatologists, scientists researching any of the hepatitis viruses and epidemiologists with an interest in this field." -Clinical Chemistry and Laboratory Medicine "Clinical chemists and other laboratory professionals, physicians, educators, and scientists needing an update on viral hepatitis should find this book a useful, detailed, and readily accessible source of information all of the major hepatitis viruses." - Clinical Chemistry "The general style of the book is comfortable and easy to read. It would be a useful addition to the book collections of gastroenterologists and for medical students with an interest in hepatology." -Microbiology Today

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Product Details

• Hardcover: 416 pages
• Publisher: Humana Press; 1 edition (April 5, 1999)
• Language: English
• ISBN-10: 0896034240
• ISBN-13: 978-0896034242
• Product Dimensions: 9 x 6.1 x 1.2 inches
• Shipping Weight: 4.4 pounds (View shipping rates and policies)
• Amazon Best Sellers Rank: #5,760,536 in Books (See Top 100 in Books)