Virushepatitis – wann daran denken?

Abstract

Chronic viral hepatitis can remain unrecognized but may nevertheless lead to liver cirrhosis and hepatocellular carcinoma. Thus, patients with elevated liver enzymes as well as risk groups need to be screened and treated for viral hepatitis. These groups include, in particular, migrants from countries with high HBV or HCV prevalence, persons with previous or current intravenous drug use, and homosexual men. For HBV- or HCV-associated diseases, such as panarteriitis nodosa, cryoglobulinemic vasculitis or B-cell lymphoma, antiviral therapy may lead to remission. Prior to high-dose immunosuppressive therapy, especially with regimes containing rituximab, chronic or resolved HBV infection must be ruled out or antiviral prophylaxis may be required to avoid a potentially fatal HBV reactivation.

Die chronische Virushepatitis kann unbemerkt zu Leberzirrhose und -karzinom fortschreiten. Daher sind Patienten mit erhöhten Leberwerten sowie Risikogruppen konsequent zu testen und ggf. zu therapieren. Extrahepatische Manifestationen einer Virushepatitis sind z. B. eine kryoglobulinämische Vaskulitis oder ein Guillain-Barré-Syndrom. Bei Immunsupprimierten gilt es, die teils fulminante Reaktivierung einer „ausgeheilten“ Hepatitis B zu verhindern.

Schlüsselwörter

Hepatitis C - Hepatitis B - Hepatitis E - HBV-Reaktivierung - extrahepatische Manifestation

Key words

hepatitis C - hepatitis B - hepatitis E - HBV reactivation - extrahepatic manifestation

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