Zusammenfassung
Die Behandlungsoptionen der Hepatitis B Virusinfektionen haben sich in den letzten Jahren stark erweitert. Weiterhin haben neue Erkenntnisse zum natürlichen Verlauf der Hepatitis B eine Anpassung der Leitlinien erforderlich gemacht. Das Kompetenznetz Hepatitis hat daher in Kooperation mit der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten e. V. (DGVS), der Deutschen Gesellschaft für Pathologie e. V. (DGP), der Gesellschaft für Virologie (GfV) und der Deutschen Gesellschaft für Pädiatrische Gastroenterologie und Ernährung (DPGE) die S3 Leitlinien zur Hepatitis B von 2003 überarbeitet. Wichtige Neuerungen betreffen die Bedeutung der Indikationsstellung zu einer antiviralen Therapie, wobei eine HBV-Viruslast von 104 Kopien/ml (2000 IU/ml) als kritische Grenze angesehen wird. Weiterhin werden klare Empfehlungen zur Vermeidung und Behandlung von Resistenzen gegen Nukleos(ti)analoga gegeben. Eigene Kapitel beschäftigen sich mit der Bedeutung von HBV im Kontext von Organtransplantation und Koinfektionen, der Therapie von Kindern und der Prophylaxe einer HBV Infektion.
Summary
Therapeutic option for hepatitis B virus infection have significantly improved in recent years. Moreover, new insights in the natural history of hepatitis B required an update of current national guidelines. Therefore, the German network of competence on viral hepatitis (Hep-Net) has revised guidelines on diagnosis and treatment og HBV incetion in cooperation with the national societies for Gastroenterology, Pathology, Virology, and Pediatric Gastroenterology. Important alterations concern the indication for antiviral therapy considering an HBV viremia of 104 copies/ml (2000 IU/ml) as a critical level. Moreover, specific recommendations how to prevent and to treat antiviral drug resistance are given. Finally, the importance of HBV in the context of organ and bone marrow transplantation, treatment of coinfections and children and prophylaxis of HBV is covered.
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Priv.-Doz. Dr. Heiner Wedemeyer
Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
Carl-Neuberg Straße 1
30625 Hannover
Phone: +49/511/5326814
Fax: +49/511/5328662
Email: Wedemeyer.Heiner@mh-hannover.de
