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Diagnostik und Therapie der chronischen Hepatitis B und C

Diagnostics and therapy of chronic hepatitis B and C

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Zusammenfassung

Die Therapie der chronischen Hepatitis B und C hat sich in den letzten Jahren durch eine zunehmende Individualisierung bei der Hepatitis C, durch die Entwicklung neuer Medikamente für die Hepatitis B sowie durch immer sensitivere Nachweisverfahren für virale Nukleinsäuren kontinuierlich weiterentwickelt. Die Prognose der Erkrankungen und ihre Heilungschancen haben sich durch diese Weiterentwicklungen gebessert, allerdings haben sich auch die vor und während einer Behandlung zu beachtenden Faktoren erweitert, sodass eine antivirale Therapie zunehmend komplexer wird. Im Jahr 2007 wurden daher die im Jahr 2004 erstmals erarbeiteten Leitlinien zur Behandlung der chronischen Hepatitis-B-Virus(HBV)-Infektion aktualisiert und angepasst. Ein ähnlicher Schritt ist für die chronische Hepatitis C im Jahr 2008 geplant. Im vorliegenden Artikel werden Therapieempfehlungen der aktuellen deutschen Leitlinie zur Behandlung der chronischen Hepatitis B zusammengefasst. Für die chronische Hepatitis C werden wichtige Entwicklungen dargestellt, die in die Erarbeitung der neuen Richtlinien einfließen werden. In Anbetracht der zunehmenden Komplexität der Behandlungsoptionen beider Infektionen sollte die Therapie durch Internisten mit spezieller Erfahrung in der Hepatologie durchgeführt werden, die individuell angepasste Therapiekonzepte innerhalb der Leitlinien entwickeln und umsetzen können.

Abstract

Therapy of chronic hepatitis B (HBV) und C (HCV) virus infection has continuously improved over the last years by the invention of new therapeutic agents for HBV, greater individualization for HCV and more sensitive tests for viral nucleic acids. Prognosis and therapeutic success rates have improved, however, more and more response predicting factors have to be considered prior to and during antiviral treatment to adjust therapy on an individual basis. Thus, in 2007 the German National Treatment Guidelines for HBV infection have been revised. A similar update is planned for chronic HCV infection in the year 2008. This review summarizes recommendations of the German National Hepatitis B Treatment Guidelines and shows current trends in the management of chronic hepatitis C which will be included in the future revised guidelines for hepatitis C. Since treatment of both infections will be characterized by a growing complexity, therapy should only be performed by internists with special experience in hepatology who are able to create individual concepts within evidenced-based treatment guidelines.

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  1. Medizinische Klinik und Poliklinik II, Universitätsklinikum Leipzig, AöR, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Deutschland

    J. Wiegand, J. Mössner &  H.L. Tillmann

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  1. J. Wiegand
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Wiegand, J., Mössner, J. & Tillmann, H. Diagnostik und Therapie der chronischen Hepatitis B und C. Internist 49, 817–832 (2008). https://doi.org/10.1007/s00108-008-2146-4

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