Strassburg C P, Cornberg M
Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Deutschland.
Internist (Berl). 2009 Dec;50(12):1358-68. doi: 10.1007/s00108-009-2464-1.
In Germany, around 800.000 to 1 million individuals are chronically infected with either the hepatitis B or the hepatitis C virus. Viral hepatitis is therefore highly relevant for the everyday management in clinical practice. For the treatment of hepatitis B, potent antiviral drugs have become available that, in the majority of patients, induce viral suppression. This requires a strategic therapeutic planning in view of a likelihood of long term administration and the prevention of viral resistance. Recent advances in the treatment of hepatitis C are based on a therapeutic individualization based upon viral kinetics and genotypes that also requires strategic planning. In contrast to hepatitis B, viral elimination can be reached in 50-90% of hepatitis C patients. Hepatitis D is associated with a migration background, is most likely under diagnosed and does not yet have a satisfactory curative treatment option. An effective vaccine exists for hepatitis A that offers protection lasting decades. Hepatitis A does not lead to chronic infection. This was also assumed for hepatitis E. However, reports indicate chronic courses in selected patient groups. A vaccine for hepatitis E is currently not yet available.
在德国,约有80万至100万人长期感染乙型肝炎病毒或丙型肝炎病毒。因此,病毒性肝炎在临床实践的日常管理中具有高度相关性。对于乙型肝炎的治疗,已有强效抗病毒药物可供使用,在大多数患者中可诱导病毒抑制。鉴于长期用药的可能性和预防病毒耐药性,这需要进行战略性治疗规划。丙型肝炎治疗的最新进展基于根据病毒动力学和基因型进行的个体化治疗,这也需要战略规划。与乙型肝炎不同,50%-90%的丙型肝炎患者可以实现病毒清除。丁型肝炎与移民背景有关,很可能诊断不足,且尚无令人满意的治愈性治疗方案。甲型肝炎有有效的疫苗,可提供持续数十年的保护。甲型肝炎不会导致慢性感染。戊型肝炎也曾被认为如此。然而,报告显示某些患者群体存在慢性病程。目前尚无戊型肝炎疫苗。