Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virus-(HBV-)Infektion: „Upgrade” der Leitlinie, AWMF-Register-Nr.: 021/011

Cornberg, Markus; Protzer, Ulrike; Dollinger, Matthias; Petersen, J.; Wedemeyer, Heiner; Berg, T.; Jilg, Wolfgang; Erhardt, Andreas; Wirth, Stéfan; Schirmacher, Peter; Fleig, Wolfgang E.; Manns, Michael P.

doi:10.1055/s-2007-963232

Cited by 54 publications

(55 citation statements)

References 234 publications

(303 reference statements)

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“…Die Leitlinien der Deutschen Gesellschaft für Verdauungs-und Stoffwechselkrankheiten (DGVS) und des Kompetenznetzes Hepatitis aus dem Jahr 2004 [17] wurden kürzlich überarbeitet [4]. Die aktuellen Leitlinien erfüllen den hohen S3-Standard der AWMF (Arbeitsgemeinschaft Medizinisch Wissenschaftlicher Fachgesellschaften) und sind sehr detailliert.…”

Section: Indikation Zur Antiviralen Therapieunclassified

“…Im Jahr 2007 wurde auch eine neue Leitlinie der AASLD (American Association for the Study of Liver Diseases) publiziert. Die amerikanische Leitlinie [12] unterscheidet sich in einigen Punkten von den deutschen Leitlinien [4]. Diese Unterschiede wurden kürzlich im Detail diskutiert [19].…”

Section: Indikation Zur Antiviralen Therapieunclassified

“…Die Therapieindikation bei chronischer Hepatitis-B-Virus-(HBV-) Infektion orientiert sich nun mehr an der Höhe der HBV-DNA und weniger an der Höhe der GPT ( [4,17]; . Tab.…”

Section: Indikation Zur Antiviralen Therapieunclassified

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Aktuelle Therapie der chronischen Hepatitis B und C

Niederau

2008

Internist

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According to the new German guidelines therapy of chronic hepatitis B is recommended when HBV-DNA is >10.000 copies/ml and when GPT is >twice the ULN or biopsy shows inflammation/fibrosis. When patients are not suitable for interferon therapy, mono-therapy with adefovir, entecavir, telbivudine of lamivudine may be initiated provided that HBV-DNA is <1 Mio. copies/ml and cirrhosis is absent. When viral load is high, entecavir should be preferred. HBV-DNA need to be checked for early detection of non-response or resistance. When resistance is present, combination therapy is recommended.New studies warrant individualization of previous recommendation for therapy of hepatitis C because one can now early evaluate how successful and long the therapy shall be. When viral load is low and HCV-RNA becomes negative after 4 weeks, therapy may be shortened to 24 weeks. Without such rapid response HCV-RNA needs to be checked after 12 and 24 weeks: when HCV-RNA becomes negative only after 24 weeks, a prolongation of therapy might be advisable.

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Section: Indikation Zur Antiviralen Therapieunclassified

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Aktuelle Therapie der chronischen Hepatitis B und C

Niederau

2008

Internist

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“…Die Therapie der HBV-Infektion erfolgt heute entweder mit Interferon (IFNά2a, -ά2b oder pegyliertes IFNά2a) oder antiviral wirksamen Nukleosid-oder Nukleotidanaloga [7]. Während die IFNTherapie in bis 40% der therapierten Patienten in einer dauerhaften partiellen oder kompletten Immunität gegen HBV resultiert, ist die Situation bei der Therapie mit Nukleos(t)id-Analoga komplexer.…”

Section: Introductionunclassified

“…Alle weisen ein gutes Nebenwirkungsprofil auf und führen unabhän-gig vom HBV-Genotyp zu einer Reduktion der Viruskonzentration um mehrere Zehnerpotenzen. Nachteilig ist, dass bei der initial verwendeten Substanz Lamivudin bereits nach 3 Jahren Therapie bis zu 70% der behandelten Patienten resistente Viren selektiert hatten [7]. Bei neueren Substanzen tritt die Selektion resistenter Viruspopulationen deutlich seltener auf.…”

Section: Introductionunclassified

Sexuell übertragbare Hepatitisviren

Schaefer

2009

Hautarzt

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The transmission of hepatitis viruses as a result of sexual activity is a common problem in medical practice. A system of stages is proposed to diagnose viral hepatitis. Testing for anti-HBc, HBsAg, anti-HAV and anti-HCV is sufficient for initial screening. Depending on the circumstances, this may be followed by further tests for HBV, HCV and HAV. If initial screening provides no evidence, further tests for HEV, Epstein-Barr virus, cytomegalovirus or other agents are conducted.

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Prevalence of HBV genotypes in Central and Eastern Europe

Deterding

Constantinescu

Nedelcu

et al. 2008

Journal of Medical Virology

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The importance of hepatitis B virus (HBV) genotypes for disease progression and response to interferon-alpha-based treatment is well established. While almost all patients in the Mediterranean area are infected with HBV genotype D, HBV genotype A is dominant in Northern Europe. However, the distribution of HBV genotypes is unknown for several Central and Eastern European countries. Data are described of 1313 HBsAg-positive patients recruited at 14 referral centers in eight countries. There were only very few cases of HBV genotype B, C, E, F, and H infection while HBV genotypes A and D were found in 42% and 48% of patients, respectively. Eight percent of patients had positive bands for more than one genotype using the hybridization assay. The frequency of genotype A was higher in Poland (77%) and the Czech Republic (67%) as compared to Hungary (47%), Lithuania (41%), Croatia (8%), and Germany (32%). In contrast, HBV genotype D was most frequent in Croatian, Romanian, and Russian patients with 80%, 67%, and 93% of cases, respectively. In conclusion, HBV genotype A versus D showed significantly different distribution patterns in Central and Eastern Europe which deserves consideration for national guidelines and treatment decisions.

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Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virus-(HBV-)Infektion: „Upgrade” der Leitlinie, AWMF-Register-Nr.: 021/011

Abstract: AffiliationsDie Institutsangaben sind am Ende des Beitrags gelistet.

Cited by 54 publications

References 234 publications

Aktuelle Therapie der chronischen Hepatitis B und C

Aktuelle Therapie der chronischen Hepatitis B und C

Sexuell übertragbare Hepatitisviren

Prevalence of HBV genotypes in Central and Eastern Europe

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