S3-Leitlinie „Prophylaxe, Diagnostik und Therapie der Hepatitis-C-Virus (HCV) -Infektion“

Sarrazin, Christoph; Zimmermann, Tim; Berg, Thomas; Neumann, Ulf; Schirmacher, Peter; Schmidt, H; Spengler, Ulrich; Timm, Jörg; Wedemeyer, Heiner; Wirth, Stéfan; Zeuzem, Stefan; Gastroenterologie, Verdauungs und Stoffwechselkrankheiten Deutsche Gesellschaft für; e.V., Deutsche Gesellschaft für Pathologie; Leberstiftung, Deutsche; e.V., Gesellschaft für Virologie; Ernährung, Gesellschaft für Pädiatrische Gastroenterologie und; Hepatologie, Österreichische Gesellschaft für Gastroenterologie und; Gastroenterologie, Schweizerische Gesellschaft für; Transplantationsgesellschaft, Deutsche; e.V., Deutsche Leberhilfe; e.V., Deutsche Gesellschaft für Infektiologie; Suchtmedizin, Deutsche Gesellschaft für; e.V., Deutsche AIDS-Gesellschaft; HIV-Infizierter, Deutsche Arbeitsgemeinschaft niedergelassener Ärzte für die Versorgung; Koch-Institut, Robert

doi:10.1055/a-0599-1320

Cited by 63 publications

(30 citation statements)

References 327 publications

(430 reference statements)

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“…Therefore, it is difficult to analyze the effects of the underlying disease in the same patients with and without liver disease. Due to the approval of many direct acting antiviral drugs (DAA) for the treatment of chronic HCV infection , chronic hepatitis C can be considered an easy-to-cure liver disease in the majority of patients [12,15]. Therefore, chronic hepatitis C can serve as a model to investigate the role of the intestinal microbiota in chronic liver diseases.…”

Section: Introductionmentioning

confidence: 99%

Eradication of Chronic HCV Infection: Improvement of Dysbiosis Only in Patients Without Liver Cirrhosis

et al. 2021

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It is well accepted that liver diseases and their outcomes are associated with intestinal microbiota but causality is difficult to establish. The intestinal microbiota is altered in patients with hepatitis C. As chronic HCV infection can now be cured in almost all patients, it is an ideal model to study the influence of liver disease on the microbiota. We aimed to analyze prospectively the changes in the gut microbiome in patients who received direct acting antivirals (DAA) and achieved sustained virological response (SVR). Amplicon sequencing of the V1-V2 region in the 16S rRNA gene was performed in stool samples of patients with chronic hepatitis C. Patients in the treatment group received direct acting antivirals (n=65) whereas in the control group no DAA were given (n=33). Only patients achieving SVR were included. The alpha diversity increased numerical but not significantly from baseline to SVR24/48 (2.784±0.248 vs. 2.846±0.224; p= 0.057). When stratifying for the presence of liver cirrhosis, a significant increase in diversity was only seen in patients without cirrhosis. Differences in the microbial community structure induced by the achievement of SVR were only observed in patients without liver cirrhosis. In patients with liver cirrhosis and in the control group, no significant differences were observed. In conclusion, the achievement of SVR24/48 in patients with chronic HCV was associated with changes in the intestinal microbiota. However, these changes were only seen in patients without liver cirrhosis. A major role of liver remodeling on the intestinal microbiota is indicated by the dynamics of the intestinal microbial community structure depending on the stage of fibrosis in patients resolving chronic hepatitis C.

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Section: Introductionmentioning

confidence: 99%

Eradication of Chronic HCV Infection: Improvement of Dysbiosis Only in Patients Without Liver Cirrhosis

et al. 2021

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“…Interferon-Regime werden nicht mehr propagiert. DAA-Regime erreichen SVR-Raten von > 90 %, werden besser toleriert und erfordern eine kürzere Therapiedauer [20].…”

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“…Ebenso war bei HCV-positiven Frauen ein prolongierter Blasensprung signifikant mit einem erhöhten Risiko für eine HCV-Transmission verbunden [22]. Daher sollte ein exspektatives Management bei vorzeitigem Blasensprung vermieden werden [20,23].…”

Section: Agg -Empfehlungunclassified

“…Stillen sollte bei HCV-positiver Patientin gefördert werden.Es gibt keinen Anstieg der maternofetalen Transmission durch das Stillen von Kindern HCV-infizierter Mütter. Ein erhöhtes Risiko liegt vor, wenn eine HCV-/HIV-Koinfektion, blutende und traumatisierte Brustwarzen oder ein aktiver Drogenkonsum vorliegen[12,20].Anti-HCV-Antikörper können in der Schwangerschaft über die Plazenta von der Mutter zum Fetus gelangen. Daher sind Anti-HCV-Antikörper im Blut des Neugeborenen kurz nach der Geburt kein Nachweis einer neonatalen Infektion.…”

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Recommendations of the AGG (Task Force for Obstetrics, Section Maternal Diseases) on the Management of Maternal Hepatitis B, C and D Infection in Pregnancy

Kühnert¹,

Kehl

Pecks

et al. 2021

Geburtshilfe Frauenheilkd

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“…Much shorter duration of treatment compared to prior options, coupled with fewer side effects and easy oral application of direct acting antivirals (DAAs), has facilitated and improved HCV therapy considerably. German guidelines acknowledge the need and feasibility of treating PWID, especially in the context of substitution therapy and under close monitoring [ 4 ]. People on opioid substitution therapy (OST) can be effectively cured from HCV infection, as shown in several transnational studies [ 5 , 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pharmacotherapy Profiles in People with Opioid Use Disorders: Considerations for Relevant Drug–Drug Interactions with Antiviral Treatments for Hepatitis C

et al. 2021

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People who inject drugs (PWID) are often affected by physical and psychological diseases and prone to co-medication. In Germany, about 50% of PWID are on opioid substitution therapy (OST). Comprehensive data on pharmacotherapy in these patients may help to select antiviral therapy against hepatitis C virus (HCV) infections and avoid drug–drug interactions (DDIs). We compared co-medication profiles based on statutory health insurance prescriptions (IQVIA database) of PWID (n = 16,693), OST (n = 95,023) and treated HCV patients (n = 7886). Potential DDIs with the most widely used HCV direct-acting agents (Sofosbuvir/Velpatasvir, Glecaprevir/Pibrentasvir and Elbasvir/Grazoprevir) were evaluated based on the Liverpool DDI database. Co-medication was present in 57% of PWID, 57% of OST, 44% of patients on HCV therapy and 46% in a subgroup receiving OST+HCV therapy (n = 747 of 1613). For all groups, co-medication belonging to ATC-class N (nervous system) was most commonly prescribed (in 75%, 68%, 41% and 62% of patients, respectively). Contraindications (i.e., DDIs precluding HCV therapy) were infrequent (0.4–2.5% of co-medications); potential DDIs with HCV therapies were shown for 13–19% of co-medications, namely for specific substances including some analgesics, antipsychotics, anticoagulants, lipid lowering drugs and steroids. In conclusion, concomitant pharmacotherapy is common and clinically relevant when treating HCV infection in PWID.

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S3-Leitlinie „Prophylaxe, Diagnostik und Therapie der Hepatitis-C-Virus (HCV) -Infektion“

Abstract: Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.

Cited by 63 publications

References 327 publications

Eradication of Chronic HCV Infection: Improvement of Dysbiosis Only in Patients Without Liver Cirrhosis

Eradication of Chronic HCV Infection: Improvement of Dysbiosis Only in Patients Without Liver Cirrhosis

Recommendations of the AGG (Task Force for Obstetrics, Section Maternal Diseases) on the Management of Maternal Hepatitis B, C and D Infection in Pregnancy

Pharmacotherapy Profiles in People with Opioid Use Disorders: Considerations for Relevant Drug–Drug Interactions with Antiviral Treatments for Hepatitis C

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