Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (647 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Inflammation of the liver with ongoing hepatocellular injury for 6 months or more, characterized by necrosis of hepatocytes and inflammatory cell (leukocytes) infiltration. Chronic hepatitis can be caused by viruses, medications, autoimmune diseases, and other unknown factors.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Chronic Hepatitis; Hepatitis, Chronic Active; Chronic Active Hepatitis; Cryptogenic Chronic Hepatitis; Chronic Hepatitis, Cryptogenic; Hepatitis, Cryptogenic Chronic; Hepatitis, Chronic, Cryptogenic; Hepatitis, Chronic Persistent.
Where it fits in the MeSH classification
- Broader topics
- Hepatitis; Chronic Disease
- Narrower topics
- Hepatitis B, Chronic; Hepatitis C, Chronic; Hepatitis D, Chronic; Hepatitis, Autoimmune
Related concepts
- Inflammation
- Liver
- Necrosis
- Hepatocytes
- Leukocytes
Research landscape
PubMed indexes 58,540 records tagged with the MeSH heading “Hepatitis, Chronic” (counts retrieved 2026-11-04). 11,629 of them (19.9%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 24,336 records.
Reviews account for 9,428 records (16.1%) and meta-analyses for 905. Randomized controlled trials number 2,550 (4.4%) as a share of all records on the topic.
Show the data
| Period | Records |
|---|---|
| through 1999 | 5,973 |
| 2000-2009 | 16,602 |
| 2010-2019 | 24,336 |
| 2020 onward | 11,629 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 9,428 | 16.1% |
| Meta-analyses | 905 | 1.5% |
| Randomized controlled trials | 2,550 | 4.4% |
Method: PubMed query "Hepatitis, Chronic"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in digestive system and liver
Gut and liver research ranges from laboratory studies of the microbiome to large trials of drugs and surgery. Symptoms such as pain, reflux or bowel change are reported by patients and overlap between conditions, and diet and microbiome studies are mostly observational. Check whether the study measured symptoms, tissue findings or long-term outcomes, how the diagnosis was made and how long people were followed. Nothing here replaces advice from a qualified clinician.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Diagnostic Impact of Liver Biopsy Among Antinuclear Antibody Positive Individuals With Mild Liver Enzyme Elevation | 2026 | Research article Design not recorded in structured metadata | 5 | cc by PMID 41954042 · DOI · PMC13251592 |
| Impact of Disease-Specific Treatment and Non-Selective Beta Blockers on Risk of PVT in Cirrhotic Patients With HCV or PBC | 2026 | Research article Design not recorded in structured metadata | 3 | cc by PMID 41933920 · DOI · PMC13049362 |
| Immune profiling links autoimmune hepatitis to human herpesvirus 6 and relaxin receptor antigens | 2026 | Research article Design not recorded in structured metadata | 2 | cc by PMID 41774077 · DOI · PMC12955711 |
Diagnostic Impact of Liver Biopsy Among Antinuclear Antibody Positive Individuals With Mild Liver Enzyme Elevation [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Background and aimsAbnormal liver enzyme elevations with positive antinuclear antibodies (ANA) frequently prompt investigation for autoimmune hepatitis after common causes such as viral hepatitis or drug-induced liver injury have been excluded.
- Closing excerpt
- In such cases, the procedure can be safely deferred, reserving biopsy for higher enzyme elevations or unclear differential diagnoses.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (224 words)
Background and aimsAbnormal liver enzyme elevations with positive antinuclear antibodies (ANA) frequently prompt investigation for autoimmune hepatitis after common causes such as viral hepatitis or drug-induced liver injury have been excluded. Current guidelines recommend liver biopsy for suspected autoimmune hepatitis, but its utility in patients with only mild transaminase elevation remains uncertain. This study evaluated the diagnostic yield of liver biopsy in such patients, particularly when alanine aminotransferase is below 101 U/L.MethodsWe retrospectively analysed 313 adults who underwent percutaneous liver biopsy at the University Hospital Heidelberg between 2019 and 2024 for unexplained liver enzyme elevation including suspected autoimmune hepatitis. Clinical data were extracted, and histology was classified according to the 2022 International Autoimmune Hepatitis Pathology Group consensus recommendations. Patients with malignancy, post-transplant biopsy, or incomplete data were excluded.ResultsThe median age was 49 years; 55.3% were female. Median alanine aminotransferase and aspartate aminotransferase were 161 U/L and 106 U/L, respectively. Antinuclear antibodies were positive in 61.3% of cases. 22.4% of antinuclear antibody positive and 15.7% of antinuclear antibody negative patients had autoimmune hepatitis compatible histology. Among patients with positive antinuclear antibodies and alanine aminotransferase ConclusionsLiver biopsy provides limited additional diagnostic value in ANA-positive, non-cirrhotic patients with alanine aminotransferase < 101 U/L and no alternative suspected aetiology. In such cases, the procedure can be safely deferred, reserving biopsy for higher enzyme elevations or unclear differential diagnoses.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41954042 · DOI · PMC13251592
Impact of Disease-Specific Treatment and Non-Selective Beta Blockers on Risk of PVT in Cirrhotic Patients With HCV or PBC [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundPortal vein thrombosis (PVT) is a common sequela of cirrhosis.
- Closing excerpt
- NSBB treatment was independently associated with > 2 times the risk of PVT in both samples, regardless of compensated or decompensated status.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (267 words)
BackgroundPortal vein thrombosis (PVT) is a common sequela of cirrhosis. Despite regression of fibrosis/cirrhosis observed among some patients after disease-specific treatment, few studies have considered the role of treatment and response on risk of PVT among patients with cirrhosis across different liver disease states. We considered aetiological treatment and response as well as whether non-selective beta-blockers (NSBBs), statins, and anticoagulants were associated with risk of PVT.MethodsWe used data for patients with cirrhosis (compensated or decompensated) from two large, US-based multisite cohort studies. Patients with hepatitis C (HCV) were drawn from the Chronic Hepatitis Cohort Study. Patients with primary biliary cholangitis (PBC) were drawn from the Fibrotic Liver Disease Consortium. Risk for PVT was assessed using a discrete survival model that includes both fixed covariates and time-dependent variables.ResultsAmong 6659 HCV patients, 274 developed PVT across ~13 years of follow-up. Significant risk factors included time-varying decompensated cirrhosis (adjusted hazard ratio [aHR] 27.41, 95% confidence interval [CI] 15.89-47.30), male sex (aHR 1.48, 95% CI 1.12-1.94), and use of NSBBs (aHR 2.07, 95% CI 1.61-2.67). Among 786 PBC patients, 67 developed PVT across ~8 years of follow-up. Use of NSBBs was the only significant PVT risk factor in these patients (aHR 2.56, 95% CI 1.52-4.31). Neither sustained virological response [SVR] after antiviral treatment (HCV patients) nor response to ursodeoxycholic acid [UDCA] treatment (PBC patients) was associated with risk of PVT.ConclusionsIn two large well-characterized samples of cirrhotic patients with HCV or PBC, disease-specific treatments were not associated with PVT risk. NSBB treatment was independently associated with > 2 times the risk of PVT in both samples, regardless of compensated or decompensated status.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41933920 · DOI · PMC13049362
Immune profiling links autoimmune hepatitis to human herpesvirus 6 and relaxin receptor antigens [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Autoimmune hepatitis (AIH) is a severe, chronic disease where IgG elevation and autoantibody profile are defining features.
- Closing excerpt
- These data provide evidence for a novel serological profile in AIH, linking HHV6 reactivation anti-RXFP1 antibodies to disease pathogenesis.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (156 words)
Autoimmune hepatitis (AIH) is a severe, chronic disease where IgG elevation and autoantibody profile are defining features. However, linking autoantibodies to AIH pathogenesis remains elusive. We employed phage-display immunoprecipitation sequencing and uncovered a novel humoral signature specific to AIH. Embedded within this signature were antibodies against the known AIH autoantigen SLA/LP and novel reactivities to disco-interacting protein 2 homolog A (DIP2A), and the relaxin family peptide receptor 1 (RXFP1). Fine mapping of the DIP2A epitope revealed preferential enrichment for a nearly identical 9-amino acid sequence derived from the U27 protein of human herpesvirus 6 (HHV6). Preincubation with the HHV6 epitope blocked DIP2A binding, consistent with cross-reactivity. AIH patients positive for anti-DIP2A had higher titers of HHV6 IgG, suggestive of reactivation. AIH patients had antibodies against the antifibrotic receptor, RXFP1, which inhibited relaxin-2 signaling in an IgG-dependent manner. These data provide evidence for a novel serological profile in AIH, linking HHV6 reactivation anti-RXFP1 antibodies to disease pathogenesis.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41774077 · DOI · PMC12955711
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Antiviral therapy in chronic hepatitis B viral infection during pregnancy: A systematic review and meta-analysis [4]
- Research article Risk of Late Relapse or Reinfection With Hepatitis C Virus After Achieving a Sustained Virological Response: A Systematic Review and Meta-analysis [5]
- Research article Long-Term Treatment Outcomes of Patients Infected With Hepatitis C Virus: A Systematic Review and Meta-analysis of the Survival Benefit of Achieving a Sustained Virological Response [6]
- Research article Direct-acting antiviral treatment for hepatitis C among people who use or inject drugs: a systematic review and meta-analysis [7]
- Research article Chronic hepatitis D and hepatocellular carcinoma: A systematic review and meta-analysis of observational studies [8]
- Research article Efficacy and safety of antiviral prophylaxis during pregnancy to prevent mother-to-child transmission of hepatitis B virus: a systematic review and meta-analysis [9]
References
- Niazi DMA, Charbel A, Pfeiffenberger J, Merle U, Seessle J, Wenz T, et al.. Diagnostic Impact of Liver Biopsy Among Antinuclear Antibody Positive Individuals With Mild Liver Enzyme Elevation. . 2026. PMID 41954042 · DOI · PMC13251592
- Gonzalez HC, Gordon SC, Trudeau S, Wu T, Rupp L, Melkonian C, et al.. Impact of Disease-Specific Treatment and Non-Selective Beta Blockers on Risk of PVT in Cirrhotic Patients With HCV or PBC. . 2026. PMID 41933920 · DOI · PMC13049362
- Klepper A, Asaki J, Caspar CM, Kung AF, Vazquez SE, Bodansky A, et al.. Immune profiling links autoimmune hepatitis to human herpesvirus 6 and relaxin receptor antigens. . 2026. PMID 41774077 · DOI · PMC12955711
- Brown RS, McMahon BJ, Lok AS, Wong JB, Ahmed AT, Mouchli MA, et al.. Antiviral therapy in chronic hepatitis B viral infection during pregnancy: A systematic review and meta-analysis. Hepatology. 2016. PMID 26565396 · DOI
- Simmons B, Saleem J, Hill A, Riley RD, Cooke GS. Risk of Late Relapse or Reinfection With Hepatitis C Virus After Achieving a Sustained Virological Response: A Systematic Review and Meta-analysis. Clin Infect Dis. 2016. PMID 26787172 · DOI · PMC4772843
- Simmons B, Saleem J, Heath K, Cooke GS, Hill A. Long-Term Treatment Outcomes of Patients Infected With Hepatitis C Virus: A Systematic Review and Meta-analysis of the Survival Benefit of Achieving a Sustained Virological Response. Clin Infect Dis. 2015. PMID 25987643 · DOI · PMC4530725
- Hajarizadeh B, Cunningham EB, Reid H, Law M, Dore GJ, Grebely J. Direct-acting antiviral treatment for hepatitis C among people who use or inject drugs: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2018. PMID 30245064 · DOI
- Alfaiate D, Clément S, Gomes D, Goossens N, Negro F. Chronic hepatitis D and hepatocellular carcinoma: A systematic review and meta-analysis of observational studies. J Hepatol. 2020. PMID 32151618 · DOI
- Funk AL, Lu Y, Yoshida K, Zhao T, Boucheron P, van Holten J, et al.. Efficacy and safety of antiviral prophylaxis during pregnancy to prevent mother-to-child transmission of hepatitis B virus: a systematic review and meta-analysis. Lancet Infect Dis. 2021. PMID 32805200 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.