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Kinder- und Jugendmedizin 2014; 14(02): 93-100
DOI: 10.1055/s-0038-1629381
Infektiologie
Schattauer GmbH

Konnatale Virus-Hepatitis-Infektionen

Congenital infections due to hepatitis viruses
D. Lenz
1   Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg
,
P. Henneke
1   Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg
2   Centrum für Chronische Immundefizienz, Universitätsklinikum Freiburg
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Publikationsverlauf

Eingereicht am:14. November 2013

angenommen am:04. Dezember 2013

Publikationsdatum:
31. Januar 2018 (online)

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Zusammenfassung

Konnatale Infektionen durch Hepatitis-Viren sind weltweit weiterhin wichtige Ursachen für terminales Leberversagen und Lebertransplantationen. Während konnatale Infektionen durch Hepatitis-B-Virus (HBV) bei in Deutschland geborenen Kindern durch Schwangerschaftsscreening und flächendeckende Impfung sehr selten geworden sind, bleiben Hepatitis-C-Virus (HCV)-Infektionen in vielen Fällen unbemerkt.

Die Identifikation von Frauen mit besonderem Risiko für eine Hepatitis-B-Primärinfektion während der Schwangerschaft bleibt eine besondere Herausforderung. Ohne Behandlung sind Transmissions- und Chronifzierungsraten sehr hoch. Gleichzeitig ist aber die perinatale Prophylaxe durch Simultanimpfung sehr effektiv. Hat sich eine chronische HBV-Infektion beim Kind etabliert, so sind die zur Verfügung stehenden Behandlungsmöglichkeiten weiterhin unbefriedigend. Im Gegensatz zur HBV-Infektion bestehen bei Kenntnis einer HCV-Infektion bei Schwangeren zunächst keine Möglichkeiten zur Verringerung der Transmission auf das Kind (Transmissionsrate 5–10 %). Die Kenntnis einer HCV-Infektion des Kindes ist aber wichtig, da je nach Genotyp wirksame bis sehr wirksame Therapieoptionen zur Verfügung stehen.

Summary

Congenital infections by hepatitis viruses are important causes of terminal liver failure and liver transplantation worldwide. While congenital infection by hepatitis B virus (HBV) in children born in Germany have become very rare due to pregnancy screening and vaccination programs, hepatitis C Virus (HCV) infections often stay unnoticed.

The identification of women with a particular risk for a primary hepatitis B infection during pregnancy remains a particular challenge. Rates of transmission and chronification are very high, but at the same time perinatal prophylaxis by simultaneous vaccination is very effective. Once a chronic HBV infection is established in a child, the available treatment options are still unsatisfactory. Contrary to HBV infections, in HCV infection in a pregnant woman effective measures to reduce transmission to the child are not available (transmission rate 5–10 %). Nevertheless, the knowledge of a HCV infection in the child is important because effective or very effective treatment options are available depending on the genotype.

Schlüsselwörter

Vertikale Transmission - konnatale Infektion - Hepatitis B - Hepatitis C

Keywords

Vertical transmission - congenital infection - hepatitis B - hepatitis C
 

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