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Z Gastroenterol 2004; 42(8): 682-686
DOI: 10.1055/s-2004-813437
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© Karl Demeter Verlag im Georg Thieme Verlag KG Stuttgart · New York

Indikationsstellung zur Therapie der chronischen Hepatitis B und D

Criteria for the Treatment of Chronic Hepatitis B and DC. Niederau1
  • 1St. Josef Hospital Oberhausen, Klinik für Innere Medizin, Akademisches Lehrkrankenhaus der Universität Essen, Oberhausen
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Publication Date:
16 August 2004 (online)

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Akute Hepatitis B

Konsens

Aufgrund der hohen Spontanheilungsrate ist die akute Hepatitis B beim Erwachsenen keine Indikation für die jetzt verfügbaren antiviralen Medikamente (B). Sonderfälle sind Patienten mit fulminanter Hepatitis B (0,1 - 0,5 % der Fälle bei Erwachsenen); diese sollten im Rahmen von Studien und in (Transplantations-) Zentren betreut und ggf. behandelt werden (C).

Erläuterung

Die akute Hepatitis B heilt beim Erwachsenen in 95 - 99 % der Fälle spontan aus [1] [2].

Literatur

  • 1 McMahon B J, Alward W LM, Hall D B. et al . Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state.  J Infect Dis. 1985;  151 599-603 (III)
    PubMedGoogle Scholar
  • 2 Tassopoulos N C, Papaevangelou G J, Sjogren M H. et al . Natural history of acute hepatitis B surface antigen-positive hepatitis in Greek adults.  Gastroenterology. 1987;  92 1844-1850 (III)
    PubMedGoogle Scholar
  • 3 Hsu Y S, Chien R N, Yeh C T. et al . Long-term outcome after spontaneous HBeAg seroconversion in patients with chronic hepatitis B.  Hepatology. 2002;  35 1522-1527 (III)
    CrossrefPubMedGoogle Scholar
  • 4 Niederau C, Heintges T, Lange S. et al . Long-term follow-up of HBeAg-positive patients treated with interferon alfa for chronic hepatitis B.  N Engl J Med. 1996;  334 1422-1427 (Ib)
    CrossrefPubMedGoogle Scholar
  • 5 Realdi G, Alberti A, Rugge M. et al . Seroconversion from hepatitis B e antigen to anti-HBe in chronic hepatitis B virus infection.  Gastroenterology. 1980;  79 195-199 (III)
    PubMedGoogle Scholar
  • 6 Hoofnagle J H, Dusheiko G M, Seef L B. et al . Seroconversion from hepatitis B e antigen to antibody in chronic type B hepatitis.  Ann Intern Med. 1981;  94 744-748 (III)
    PubMedGoogle Scholar
  • 7 Sánchez-Tapias J M, Vilar J H, Costa J. et al . Natural history of chronic persistent hepatitis B. Relationship between hepatits B virus replication and the course of the disease.  J Hepatol. 1984;  1 15-27 (III)
    PubMedGoogle Scholar
  • 8 Fattovich G, Rugge M, Brollo L. et al . Clinical, virologic and histologic outcome following seroconversion from HBeAg to anti-HBe in chronic hepatitis type B.  Hepatology. 1986;  6 167-172 (III)
    PubMedGoogle Scholar
  • 9 Bortolotti F, Jara P, Crivellaro C. et al . Outcome of chronic hepatitis B in Caucasian children during a 20-year observation period.  J Hepatol. 1998;  29 184-190 (III)
    CrossrefPubMedGoogle Scholar
  • 10 Evans A A, Fine M, London W T. Spontaneous seroconversion in hepatitis B e antigen-positive chronic hepatitis B: implications for interferon therapy.  J Infect Dis. 1997;  176 845-850 (III)
    PubMedGoogle Scholar
  • 11 Chang M H, Sung J L, Lee C Y. et al . Factors affecting clearance of hepatits B e antigen in hepatitis B surface antigen carrier children.  J Pediatr. 1989;  115 385-390 (III)
    PubMedGoogle Scholar
  • 12 Bortolotti F, Cadrobbi P, Crivellaro C. et al . Long-term outcome of chronic type B hepatitis in patients who acquire hepatitis B virus infection in childhood.  Gastroenterology. 1990;  99 805-810 (III)
    PubMedGoogle Scholar
  • 13 Wong D KH, Cheung A M, O’Rourke K. et al . Effect of alpha-interferon treatment in patients with hepatitis B e antigen-positive chronic hepatitis B. A meta-analysis.  Ann Intern Med. 1993;  119 312-323 (Ia)
    PubMedGoogle Scholar
  • 14 Vajro P, Migliaro F, Fontanella A. et al . Interferon: a meta-analysis of published studies in pediatric chronic hepatitis B.  Acta Gastroenterol Belg. 1998;  61 219-223 (Ia)
    PubMedGoogle Scholar
  • 15 Yuen M F, Hui C K, Cheng C C. et al . Long-term follow-up of interferon alfa treatment in Chinese patients with chronic hepatitis B infection: the effect on hepatitis B e antigen seroconversion and the development of cirrhosis-related complications.  Hepatology. 2001;  34 139-145 (III)
    CrossrefPubMedGoogle Scholar
  • 16 Perrillo R P, Schiff E R, Davis G L. et al . A randomized, controlled trial of interferon alfa-2 b alone and after prednisone withdrawal for the treatment of chronic hepatitis B. The Hepatitis Interventional Therapy Group.  N Engl J Med. 1990;  323 295-301 (Ib)
    PubMedGoogle Scholar
  • 17 Lok A S, Lai C L, Wu P C. et al . Long-term follow-up in a randomised controlled trial of recombinant alpha 2-interferon in Chinese patients with chronic hepatitis B infection.  Lancet. 1988;  2 298-302 (Ib)
    PubMedGoogle Scholar
  • 18 Williams S J, Craig P I, Cooksley W G. et al . Randomised controlled trial of recombinant human interferon-alpha A for chronic active hepatitis B.  Aust N Z J Med. 1990;  20 9-19 (Ib)
    PubMedGoogle Scholar
  • 19 Lok A S, Wu P C, Lai C L. et al . A controlled trial of interferon with or without prednisone priming for chronic hepatitis B.  Gastroenterology. 1992;  102 (6) 2091-2097 (Ib)
    PubMedGoogle Scholar
  • 20 Di Bisceglie A M, Fong T L, Fried M W. et al . A randomized, controlled trial of recombinant alpha-interferon therapy for chronic hepatitis B.  Am J Gastroenterol. 1993;  88 1887-1892 (Ib)
    PubMedGoogle Scholar
  • 21 Wong D K, Yim C, Naylor C D. et al . Interferon alfa treatment of chronic hepatitis B: randomized trial in a predominantly homosexual male population.  Gastroenterology. 1995;  108 165-171 (Ib)
    CrossrefPubMedGoogle Scholar
  • 22 Korenman J, Baker B, Waggoner J. et al . Long-term remission of chronic hepatitis B after alpha-interferon therapy.  Ann Intern Med. 1991;  114 629-634 (III)
    PubMedGoogle Scholar
  • 23 Moreno-Otero R, Garcia-MonzoŽn C, Garcia-Sánchez A. et al . Development of cirrhosis after chronic type B hepatitis: a clinicopathologic and follow-up study of 46 HBeAg-positive asymptomatic patients.  Am J Gastroenterol. 1991;  86 560-564 (III)
    PubMedGoogle Scholar
  • 24 Zarski J P, Marcellin P, Cohard M. et al . Comparison of anti-HBe-positive and HBe-antigen-positive chronic hepatitis B in France.  J Hepatol. 1994;  20 636-640 (III)
    CrossrefPubMedGoogle Scholar
  • 25 Di Marco V, Lo I acono O, Cammá C. et al . The long-term course of chronic hepatitis B.  Hepatology. 1999;  30 257-264 (III)
    CrossrefPubMedGoogle Scholar
  • 26 Liaw Y F, Tai D I, Chu C M. et al . The development of cirrhosis in patients with chronic type B hepatitis: a prospective study.  Hepatology. 1988;  8 493-496 (III)
    PubMedGoogle Scholar
  • 27 Lin S M, Sheen I S, Chien R N. et al . Long-term beneficial effect of interferon therapy in patients with chronic hepatitis B virus infection.  Hepatology. 1999;  29 971-975 (III)
    CrossrefPubMedGoogle Scholar
  • 28 Fattovich G, Brollo L, Giustina G. et al . Natural history and prognostic factors of chronic hepatitis type B.  Gut. 1991;  32 294-298 (III)
    PubMedGoogle Scholar
  • 29 Ikeda K, Saitoh S, Suzuki Y. et al . Disease progression and hepatocellular carcinogenensis in patients with chronic viral hepatitis: a prospective observation in 2215 patients.  J Hepatol. 1998;  28 930-938 (III)
    CrossrefPubMedGoogle Scholar
  • 30 Mazzella G, Saracco G, Festi D. et al . Long-term results with interferon therapy in chronic type B hepatitis: a prospective randomized trial.  Am J Gastroenterol. 1999;  94 2246-2250 (Ib)
    CrossrefPubMedGoogle Scholar
  • 31 Perillo R P. Acute flares in chronic hepatitis B: the natural and unnatural history of an immunologically mediated liver disease.  Gastroenterology. 2001;  120 1009-1022 (III)
    CrossrefPubMedGoogle Scholar
  • 32 Liaw Y F, Tai D I, Chu C M. et al . Early detection of hepatocellular carcinoma in patients with chronic type B hepatitis. A prospective study.  Gastroenterology. 1985;  90 263-267 (III)
    PubMedGoogle Scholar
  • 33 Realdi G, Fattovich G, Hadziyannis S. et al . Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study.  J Hepatol. 1994;  21 656-666 (III)
    CrossrefPubMedGoogle Scholar
  • 34 Fattovich G, Giustina G, Christensen E. et al . Influence of hepatitis delta virus infection on morbidity and mortality in compensated cirrhosis type B.  Gut. 2000;  46 420-426
    CrossrefPubMedGoogle Scholar
  • 35 De Jongh F E, Janssen H LA, De Man R A. et al . Survival and prognostic indicators in hepatitis B surface antigen-positive cirrhosis of the liver.  Gastroenterology. 1992;  103 1630-1635 (III)
    PubMedGoogle Scholar
  • 36 Fattovich G, Giustina G, Realdi G. et al . Long-term outcome of hepatitis B e antigen-positive patients with compensated cirrhosis treated with interferon alfa.  Hepatology. 1997;  26 1338-1342 (III)
    CrossrefPubMedGoogle Scholar
  • 37 Fattovich G, Giustina G, Schalm S W. et al . Occurrence of hepatocellular carcinoma and decompensation in Western European patients with cirrhosis type B.  Hepatology. 1995;  21 77-82 (III)
    CrossrefPubMedGoogle Scholar
  • 38 Chan H LY, Leung N WY, Hussain M. et al . Hepatitis B e antigen-negative chronic hepatitis B in Hong Kong.  Hepatology. 2000;  31 763-768 (III)
    CrossrefPubMedGoogle Scholar
  • 39 Hadziyannis S J, Vassilopoulos D. Hepatitis B e antigen-negative chronic hepatitis B.  Hepatology. 2001;  34 617-624
    CrossrefPubMedGoogle Scholar
  • 40 Funk M L, Rosenberg D M, Lok A SF. World-wide epidemiology of HBeAg-negative chronic hepatitis B and associated precore and core promoter variants.  J Viral Hepat. 2002;  9 52-61 (III)
    CrossrefPubMedGoogle Scholar
  • 41 Rizzetto M, Volpes R, Smedile A. Response of pre-core mutant chronic hepatitis B infection to Lamivudin.  J Med Virol. 2000;  61 398-402 (III)
    CrossrefPubMedGoogle Scholar
  • 42 Brunetto M R, Oliveri F, Coco B. et al . Outcome of anti-HBe positive chronic hepatitis B in alpha-interferon treated and untreated patients: a long term cohort study.  J Hepatol. 2002;  36 263-270 (III)
    PubMedGoogle Scholar
  • 43 Papatheodoridis G V, Manesis E, Hadziyannis S J. The long-term outcome of interferon-a treated and untreated patients with HBeAg-negative chronic hepatitis B.  J Hepatol. 2001;  34 306-313 (III)
    CrossrefPubMedGoogle Scholar
  • 44 Alward W LM, McMahon B J, Hall D B. et al . The long-term serological course of asymptomatic hepatitis B virus carriers and the development of primary hepatocellular carcinoma.  J Infect Dis. 1985;  151 604-609 (III)
    PubMedGoogle Scholar
  • 45 Fattovich G, Giustina G, Sanchez-Tapias J. et al . Delayed clearance of serum HBsAg in compensated cirrhosis B: relation to interferon alpha therapy and disease prognosis.  Am J Gastroenterol. 1998;  93 896-900 (III)
    CrossrefPubMedGoogle Scholar
  • 46 Liaw Y F, Sheen I S, Chen T J. et al . Incidence,determinants and significance of delayed clearance of serum HBsAg in chronic hepatitis B virus infection: a prospective study.  Hepatology. 1991;  13 627-631 (III)
    CrossrefPubMedGoogle Scholar
  • 47 Orito E, Mizokami M, Sakugawa H. et al . A case-control study for clinical and molecular biological diffferences between hepatitis B viruses of genotype B and C. Japan HBV Genotype Research Group.  Hepatology. 2001;  33 218-223 (III)
    CrossrefPubMedGoogle Scholar
  • 48 Yu M W, Hsu F C, Sheen I S. et al . Prospective study of hepatocellular carcinoma and liver cirrhosis in asymptomatic chronic hepatitis B virus carriers.  Am J Epidemiol. 1997;  145 1039-1047 (III)
    PubMedGoogle Scholar
  • 49 McMahon B J, Bulkow L, Harpster A. et al . Screening for hepatocellular carcinoma in Alaska natives infected with chronic hepatitis B: a 16-year population based study.  Hepatology. 2000;  32 842-846 (III)
    CrossrefPubMedGoogle Scholar
  • 50 McMahon B J, Holck P, Bulkow L. et al . Serologic and clinical outcomes of 1536 Alaska natives chronically infected with hepatitis B virus.  Ann Intern Med. 2001;  135 759-768 (III)
    CrossrefPubMedGoogle Scholar
  • 51 Lok A SF, Lai C L, Wu P C. et al . Spontaneous hepatits B e antigen to antibody seroconversion and reversion in Chinese patients with chronic hepatitis B virus infection.  Gastroenterology. 1987;  92 1839-1843 (III)
    PubMedGoogle Scholar
  • 52 Davis G L, Hoofnagle J H, Waggoner J G. Spontaneous reactivation of chronic hepatitis B virus infection.  Gastroenterology. 1984;  86 230-235 (III)
    PubMedGoogle Scholar
  • 53 Fattovich G, Brollo L, Alberti A. et al . Spontaneous reactivation of hepatitis B virus infection in patients with chronic type B hepatitis.  Liver. 1990;  10 141-146 (III)
    PubMedGoogle Scholar
  • 54 Yeo W, Chan P K, Zhong S. et al . Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemotherapy: a prospective study of 626 patients with identification of risk factors.  J Med Virol. 2000;  62 299-307 (III)
    CrossrefPubMedGoogle Scholar
  • 55 Shibolet O, Ilan Y, Gillis S. et al . Lamivudin therapy for prevention of immunosuppressive-induced hepatitis B virus reactivation in hepatitis B surface antigen carriers.  Blood. 2002;  100 391-396 (IIa)
    CrossrefPubMedGoogle Scholar
  • 56 Rossi G, Pelizzari A, Motta M. et al . Primary prophylaxis with Lamivudin of hepatitis B virus reactivation in chronic HbsAg carriers with lymphoid malignancies treated with chemotherapy.  Br J Haematol. 2001;  115 58-62 (III)
    CrossrefPubMedGoogle Scholar
  • 57 Markovic S, Drozina G, Vovk M. et al . Reactivation of hepatitis B but not hepatitis C in patients with malignant lymphoma and immunosuppressive therapy. A prospective study in 305 patients.  Hepatogastroenterology. 1999;  46 2925-2930 (III)
    PubMedGoogle Scholar
  • 58 Kao J H, Chen P J, Lai M Y. et al . Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B.  Gastroenterology. 2000;  118 554-559 (III)
    CrossrefPubMedGoogle Scholar
  • 59 Chan H L, Tsang S W, Liew C T. et al . Viral genotype and hepatitis B virus DNA levels are correlated with histological liver damage in HBeAg-negative chronic hepatitis B virus infection.  Am J Gastroenterol. 2002;  97 406-412 (III)
    CrossrefPubMedGoogle Scholar
  • 60 Liaw Y F, Lin D Y, Chen T J. et al . Natural course after the development of cirrhosis in patients with chronic type B hepatitis: a prospective study.  Liver. 1989;  9 235-241 (III)
    PubMedGoogle Scholar
  • 61 Beasley R P. Hepatitis B virus. The major etiology of hepatocellular carcinoma.  Cancer. 1988;  61 1942-1956
    PubMedGoogle Scholar
  • 62 McMahon B J, Alberts S R, Wainwright R B. et al . Hepatitis B-related sequelae. Prospective study in 1400 hepatitis B surface antigen-positive Alaska Native carriers.  Arch Intern Med. 1990;  150 1051-1054 (III)
    CrossrefPubMedGoogle Scholar
  • 63 Benvegnù L, Fattovich G, Noventa F. et al . Concurrent hepatitis B and C virus infection and risk of hepatocellular carcinoma in cirrhosis.  Cancer. 1994;  74 2442-2448 (III)
    CrossrefPubMedGoogle Scholar

Prof. Dr. med. Claus Niederau

St. Josef Hospital Oberhausen, Klinik für Innere Medizin, Akademisches Lehrkrankenhaus der Universität Essen

Mülheimer Str. 83

46045 Oberhausen

Email: claus.niederau@st-josef.de