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DOI: 10.1055/s-0038-1629381
Konnatale Virus-Hepatitis-Infektionen
Congenital infections due to hepatitis virusesPublication History
Eingereicht am:14 November 2013
angenommen am:04 December 2013
Publication Date:
31 January 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034917/201402/lookinside/thumbnails/10-1055-s-0038-1629381_de-1.jpg)
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.
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Literatur
- 1 Alter MJ, Margolis HS, Krawczynski K. et al. The natural history of community-acquired hepatitis C in the United States. The Sentinel Counties Chronic non-A, non-B Hepatitis Study Team. N Engl J Med 1992; 327: 1899-1905.
- 2 American Academy of Pediatrics CoID Hepatitis C. In: Pickering LK. (ed). Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed.. Elk Grove Village, IL: American Academy of Pediatrics; 2012: 489-99.
- 3 AWMF AK-P Infektionsprävention unter der Entbindung. HygMed 2012; 37: 134ff
- 4 Belloni C, Chirico G, Pistorio A. et al. Immunogenicity of hepatitis B vaccine in term and preterm infants. Acta Paediatr 1998; 87: 336-338.
- 5 Bonino F, Marcellin P, Lau GK. et al. Predicting response to peginterferon alpha-2a, lamivudine and the two combined for HBeAg-negative chronic hepatitis B. Gut 2007; 56: 699-705.
- 6 Burdelski M, Wirth S, Laufs R. Viral hepatitis in children and adolescence. Z Gastroenterol 2004; 42: 731-733.
- 7 Chang MH, Sung JL, Lee CY. et al. Factors affecting clearance of hepatitis B e antigen in hepatitis B surface antigen carrier children. J Pediatr 1989; 115: 385-390.
- 8 Cornberg M, Protzer U, Dollinger MM. et al. Prophylaxis, diagnosis and therapy of hepatitis B virus (HBV) infection: the German guidelines for the management of HBV infection. Z Gastroenterol 2007; 45: 1281-1328.
- 9 Daudi N, Shouval D, Stein-Zamir C, Ackerman Z. Breastmilk hepatitis A virus RNA in nursing mothers with acute hepatitis A virus infection. Breastfeed Med 2012; 7: 313-315.
- 10 Deutsche Gesellschaft für Pädiatritsche Infektiologie (Hrsg) DGPI Handbuch: Infektionen bei Kindern und Jugendlichen. Stuttgart, New York: Thieme Verlag; 2013
- 11 European Paediatric Hepatitis C Virus Network Three broad modalities in the natural history of vertically acquired hepatitis C virus infection. Clin Infect Dis 2005; 41: 45-51.
- 12 Farmand S, Wirth S, Loffler H. et al. Spontaneous clearance of hepatitis C virus in vertically infected children. Eur J Pediatr 2012; 171: 253-258.
- 13 Hamid SS, Jafri SM, Khan H. et al. Fulminant hepatic failure in pregnant women: acute fatty liver or acute viral hepatitis?. J Hepatol 1996; 25: 20-27.
- 14 Hussaini SH, Skidmore SJ, Richardson P. et al. Severe hepatitis E infection during pregnancy. J Viral Hepat 1997; 4: 51-54.
- 15 Jonas MM, Hepatitis C. virus infection in children. Edwards MS, Rand EB, Hoppin AG. (eds). Waltham, MA: UpToDate; 2013
- 16 Khuroo MS, Kamili S, Jameel S. Vertical transmission of hepatitis E virus. Lancet 1995; 345: 1025-1026.
- 17 Khuroo MS, Kamili S. Clinical course and duration of viremia in vertically transmitted hepatitis E virus (HEV) infection in babies born to HEV-infected mothers. J Viral Hepat 2009; 16: 519-523.
- 18 Komatsu H, Inui A, Sogo T. et al. Tears from children with chronic hepatitis B virus (HBV) infection are infectious vehicles of HBV transmission: experimental transmission of HBV by tears, using mice with chimeric human livers. J Infect Dis 2012; 206: 478-485.
- 19 Losonsky GA, Wasserman SS, Stephens I. et al. Hepatitis B vaccination of premature infants: a reassessment of current recommendations for delayed immunization. Pediatrics 1999; 103: E14
- 20 Motte A, Blanc J, Minodier P, Colson P. Acute hepatitis A in a pregnant woman at delivery. Int J Infect Dis 2009; 13: e49-51.
- 21 Nanda SK, Yalcinkaya K, Panigrahi AK. et al. Etiological role of hepatitis E virus in sporadic fulminant hepatitis. J Med Virol 1994; 42: 133-137.
- 22 O’Donovan DJ. Hepatitis viruses and the newborn: Clinical manifestations and treatment. Weisman LE, Kaplan SL, Rand EB. (eds). Waltham, MA: UpToDate; 2013
- 23 Ohto H, Terazawa S, Sasaki N. et al. Transmission of hepatitis C virus from mothers to infants. The Vertical Transmission of Hepatitis C Virus Collaborative Study Group. N Engl J Med 1994; 330: 744-750.
- 24 Palomba E, Manzini P, Fiammengo P. et al. Natural history of perinatal hepatitis C virus infection. Clin Infect Dis 1996; 23: 47-50.
- 25 Pasetti G, Calzetti C, Degli Antoni A. et al. Clinical features of hepatitis delta virus infection in a northern Italian area. Infection 1988; 16: 345-348.
- 26 Patra S, Kumar A, Trivedi SS. et al. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med 2007; 147: 28-33.
- 27 Renge RL, Dani VS, Chitambar SD, Arankalle VA. Vertical transmission of hepatitis A. Indian J Pediatr 2002; 69: 535-536.
- 28 Rosenblum LS, Villarino ME, Nainan OV. et al. Hepatitis A outbreak in a neonatal intensive care unit: risk factors for transmission and evidence of prolonged viral excretion among preterm infants. J Infect Dis 1991; 164: 476-482.
- 29 Ruiz-Extremera A, Salmeron J, Torres C. et al. Follow-up of transmission of hepatitis C to babies of human immunodeficiency virus-negative women: the role of breast-feeding in transmission. Pediatr Infect Dis J 2000; 19: 511-516.
- 30 Tai AW, Chung RT. Studies of telaprevir and boceprevir in the treatment of chronic hepatitis C Virus genotype 1. Bisceglie AMD, Bloom A. (eds) Waltham, MA: UpToDate; 2013
- 31 Thaler MM, Park CK, Landers DV. et al. Vertical transmission of hepatitis C virus. Lancet 1991; 338: 17-18.
- 32 Thomas SL, Newell ML, Peckham CS. et al. A review of hepatitis C virus (HCV) vertical transmission: risks of transmission to infants born to mothers with and without HCV viraemia or human immunodeficiency virus infection. Int J Epidemiol 1998; 27: 108-117.
- 33 Tong MJ, Thursby MW, Lin JH. et al. Studies on the maternal-infant transmission of the hepatitis B virus and HBV infection within families. Prog Med Virol 1981; 27: 137-147.
- 34 Tovo PA, Pembrey LJ, Newell ML. Persistence rate and progression of vertically acquired hepatitis C infection. European Paediatric Hepatitis C Virus Infection. J Infect Dis 2000; 181: 419-424.
- 35 Watson JC, Fleming DW, Borella A. et al. Vertical transmission of hepatitis A resulting in an outbreak in a neonatal intensive care unit. J Infect Dis 1993; 167: 567-571.
- 36 Wen WH, Chang MH, Hsu HY. et al. The development of hepatocellular carcinoma among prospectively followed children with chronic hepatitis B virus infection. J Pediatr 2004; 144: 397-399.
- 37 Wirth S, Pieper-Boustani H, Lang T. et al. Peginterferon alfa-2b plus ribavirin treatment in children and adolescents with chronic hepatitis C. Hepatology 2005; 41: 1013-1018.
- 38 Zanetti AR, Tanzi E, Paccagnini S. et al. Mother-to-infant transmission of hepatitis C virus. Lombardy Study Group on Vertical HCV Transmission. Lancet 1995; 345: 289-291.
- 39 Zhang RL, Zeng JS, Zhang HZ. Survey of 34 pregnant women with hepatitis A and their neonates. Chin Med J (Engl) 1990; 103: 552-555.