Durmashkina Elena, Zeuzem Stefan, Sarrazin Christoph
Medizinische Klinik II, St. Josefs-Hospital Wiesbaden, Beethovenstr. 20, 65189, Wiesbaden, Deutschland.
Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland.
Internist (Berl). 2022 Apr;63(4):388-396. doi: 10.1007/s00108-022-01287-y. Epub 2022 Mar 18.
The parenterally transmittable hepatitides B, D and C and their complications are a problem worldwide and also in Germany that should not be underestimated. Due to the estimated high gray area, a broad distribution, particularly by drug abuse, increasing prevalence due to immigration and a pandemic-related delay in the diagnostics, the identification of affected persons and therefore potentially infectious patients represents a great challenge for the healthcare system. Highly effective treatment concepts with practically no side effects and a tablet ingestion once daily are available for hepatitis B and also hepatitis C. For hepatitis B this involves long-term treatment for suppression of replication, whereas for hepatitis C virus elimination occurs within a few weeks. A new treatment concept with inhibition of virus uptake for treatment of hepatitis D first became available in September 2020. For all patients a long-term further monitoring is necessary when advanced liver damage or even liver cirrhosis occurs, especially for the exclusion of liver cell carcinoma.
经肠道外传播的乙型、丁型和丙型肝炎及其并发症在全球范围内以及德国都是一个不可低估的问题。由于估计存在较大的灰色区域、广泛传播（尤其是通过药物滥用）、因移民导致患病率上升以及与大流行相关的诊断延迟，识别受影响者以及因此潜在的感染患者对医疗系统构成了巨大挑战。对于乙型肝炎和丙型肝炎，有几乎无副作用且每日只需服用一片的高效治疗方案。对于乙型肝炎，这涉及长期治疗以抑制复制，而对于丙型肝炎，病毒在几周内即可清除。一种用于治疗丁型肝炎的抑制病毒摄取的新治疗方案于2020年9月首次问世。对于所有患者，当出现晚期肝损伤甚至肝硬化时，尤其是为了排除肝细胞癌，长期的进一步监测是必要的。
