Empfehlungen zur antiviralen Therapie der chronischen Hepatitis C bei Patienten auf der Warteliste und nach Transplantation

T. Zimmermann; S. Beckebaum; C. Berg; T. Berg; F. Braun; D. Eurich; K. Herzer; U. Neumann; C. Rupp; M. Sterneck; C. Strassburg; M.-W. Welker; R. Zachoval; D. N. Gotthardt; K. Weigand; H. Schmidt; H. Wedemeyer; P. R. Galle; S. Zeuzem; C. Sarrazin

doi:10.1055/s-0042-107360

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2016; 54(07): 665-684
DOI: 10.1055/s-0042-107360

Mitteilungen

Empfehlungen zur antiviralen Therapie der chronischen Hepatitis C bei Patienten auf der Warteliste und nach Transplantation

Expert recommendations: Hepatitis C and transplantation

Authors

T. Zimmermann

¹I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
S. Beckebaum

²Klinik für Transplantationsmedizin, Universitätsklinikum Münster
C. Berg

³Abteilung Innere Medizin I, Universitätsklinikum Tübingen
T. Berg

⁴Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig
F. Braun

⁵Transplantationszentrum, Universitätsklinikum Schleswig-Holstein, Kiel
D. Eurich

⁶Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité-Universitätsmedizin Berlin
K. Herzer

⁷Klinik für Gastroenterologie und Hepatologie/Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen
U. Neumann

⁸Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Fakultät, RWTH Aachen
C. Rupp

⁹Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
M. Sterneck

¹⁰Klinik und Poliklinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Universitätsklinikum Hamburg-Eppendorf
C. Strassburg

¹¹Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn
M.-W. Welker

¹²Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
R. Zachoval

¹³Transplantationszentrum München der LMU, München
D. N. Gotthardt

⁹Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
K. Weigand

¹⁴Innere Medizin I, Universitätsklinikum Regensburg
H. Schmidt

²Klinik für Transplantationsmedizin, Universitätsklinikum Münster
H. Wedemeyer

¹⁵Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
P. R. Galle

¹I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
S. Zeuzem

¹²Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
C. Sarrazin

¹²Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main

Abstract

Zusammenfassung

Mit der Zulassung der neuen direkt antiviral wirksamen Substanzen (DAA) wurden die Therapiemöglichkeiten der chronischen Hepatitis C-Virus(HCV)-Infektion bei Patienten vor und nach Lebertransplantation (LTx) durch effektive, interferonfreie und nebenwirkungsarme Kombinationstherapien deutlich erweitert. Da bislang nur wenige Daten zu Patienten mit höhergradig eingeschränkter Leberfunktion sowie nach LTx vorliegen, ist die klinische Erfahrung mit einer DAA-basierten HCV-Behandlung in diesen speziellen Patientenpopulationen limitiert. Die nachstehenden Empfehlungen zur Therapie der Hepatitis C im Rahmen der LTx wurden in einer Expertenrunde als Stellungnahme erarbeitet und geben den Kenntnisstand der recherchierten Literatur, verfügbaren Fachinformationen sowie klinischen Erfahrungen der beteiligten Autoren wieder. Sie sollen hinsichtlich der Entscheidungsfindung bei antiviraler Therapie vor und nach LTx als Orientierungshilfe dienen.

Abstract

With the approval of new direct acting antiviral agents (DAA), therapeutic options for patients with chronic hepatitis C virus (HCV) infection are now generally available before and after liver transplantation (LT). Interferon-free DAA regimens are highly effective therapies and provide a good safety profile. However, the body of clinical evidence in this patient population is limited and the best treatment strategies for patients on the waiting list with (de)compensated cirrhosis and after LT are not well defined. The following recommendations for antiviral therapy in the context of LT are based on the currently available literature and clinical experience of experts in the field, and have been discussed in an expert meeting. The aim of this article is to guide clinicians in the decision making when treating patients before and after LT with DAAs.

Schlüsselwörter

Hepatitis C - Transplantation - DAA - Warteliste - Immunsuppression

Key words

hepatitis C - transplantation - DAA - waiting list - immunosuppression

Full Text

References

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