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Am Fam Physician. 2000;61(2):577-581

Viral Hepatitis: Diagnosis, Therapy and Prevention

Edited by Steven Spector. Pp. 416. Price, $99.50. Humana Press, 999 Riverview Dr., Ste. 208. Totowa, NJ 07512. Phone: 973-256-1699. ISBN; 0-896-03424-0

This clearly written and readable review of viral hepatitis provides useful information for family physicians interested in this protean disorder. Although 400 pages may seem excessive, the book is well outlined, with chapters addressing each of the specific viral hepatitides, as well as additional chapters on making correct diagnoses, antiviral therapies and vaccine prevention of hepatitis A and B. Coverage of viral hepatitis is thorough and complete and, although the field is continually evolving, the reader is alerted to significant trends and areas of research. 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, but the chapters also flow well together and prove authoritative and informative in their entirety. Chapters on specific viral hepatitis entities include sections on biology and pathogenesis of disease, as well as useful sections on transmission, signs and symptoms, treatment, prevention and future directions in the field of viral hepatitis. The depth of information seems “just right,” and each chapter is extensively referenced for further review.

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 tables and graphics offering helpful clinical information and providing clear diagnostic and prognostic clues. The graphic legends are generally clear, although one legend in the chapter on hepatitis A refers readers to the text to gain adequate understanding. Fortunately, this occurs only once, and the other graphics have appropriate and informative legends that allow them to stand alone.

The authors of the chapters have varying backgrounds, some being clinicians and some being researchers. This variation does not affect the basic formats of the chapters but does slightly affect the content and concentration on specific areas within the chapters. Specifically, the chapter on hepatitis B contains an abundance of information on biochemistry, and the chapter on the hepatitis A vaccine contains excessive details on its development, making this chapter among the longest in the book. However, much useful information is made readily available by the use of chapter subheadings and sections.

The chapter on the laboratory diagnosis of viral hepatitis provides beneficial information ranging from specimen preparation to clarification and usefulness of various serologic and viral quantitation tests. The informative chapter on antiviral therapies includes sections on variations among different clinical and demographic populations, as well as lists of response predictors to antiviral treatment.

Dr. Spector has put together an up-to-date summary of all that is known about viral hepatitis in a highly readable book. Tables augment the text by clarifying basic points. Detailed pathologic discussions are kept to a minimum, and the reader is not asked to view microscopic pictures of damaged hepatocytes. 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. The depth of this book makes it appropriate for family physicians who are more focused on viral hepatitis, and it is also useful as a reference for those with a more casual interest in the topic.

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