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Hamostaseologie 2017; 37(03): 186-195
DOI: 10.5482/HAMO-16-07-0019
State of the art
Schattauer GmbH

Management of chronic hepatitis C in 2017

Management der chronischen Hepatitis C im Jahr 2017
Leona von Köckritz
1   Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital Bern, Switzerland
,
Jean-François Dufour
1   Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital Bern, Switzerland
› Author Affiliations
Further Information

Publication History

received: 01 July 2016

accepted in revised form: 04 November 2016

Publication Date:
28 December 2017 (online)

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Summary

Hepatitis C virus (HCV) represents one of the most common aetiologies of chronic liver disease and causes a major global health burden. Globally an estimated 80 million people are chronically infected, but the majority of whom is still undiagnosed. Prior to the discovery of the virus in 1989 a significant number of patients were exposed and consecutively infected with HCV via contaminated transfusions, as it is a blood-borne disease. Chronic HCV infection pursues a progressive course that ultimately results in the development of cirrhosis, liver failure and hepatocellular carcinoma (HCC), if left untreated. The efficiency and tolerability of therapeutical approaches improved considerably with the development of direct-acting antivirals (DAA). The majority of patients treated with the recommended DAA combinations can be cured, which is reflected in achievement of sustained virological response (SVR).

This review is intended to provide guidance in the management of patients with chronic hepatitis C, including recommendations for adequate screening, diagnostic procedures, clinical care, treatment and follow-up strategies.

Zusammenfassung

Das Hepatitis-C-Virus zählt zu den Hauptursachen chronischer Lebererkrankungen. Weltweit sind schätzungsweise 80 Millionen Menschen chronisch infiziert, die Infektion ist bei der Mehrheit der Betroffenen jedoch nicht diagnostiziert. Das Virus wird vor allem über das Blut übertragen, weshalb viele Patienten vor der Entdeckung des Virus 1989 durch kontaminierte Transfusionen infiziert wurden. Die Infektion verläuft progressiv und resultiert unbehandelt letztendlich in Zirrhose, Leberversagen und hepatozellulärem Karzinom. Mit der Entwicklung der direkt-antiviral wirksamen Substanzen haben sich die Therapiemöglichkeiten hinsichtlich Effektivität und Verträglichkeit deutlich verbessert. Die Mehrheit der behandelten Patienten wird heute geheilt. Dieses Review soll eine Orientierungshilfe für das Management von Patienten mit chronischer Hepatitis C darstellen und gibt Empfehlungen hinsichtlich angemessener Strategien für Screening, Diagnostik, klinischer Versorgung, Therapie und Follow-up Untersuchungen.

Keywords

hepatitis C Virus - risk factors - direct-acting antivirals - sustained virological response

Schlüsselwörter

Hepatitis-C-Virus - Risikofaktor - direkt antiviral wirkende Substanzen - anhaltendes virologisches Ansprechen
 

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