[New data and recommendations of antiviral therapy of chronic hepatitis B and C].
According to the new German guidelines therapy of chronic hepatitis B is recommended when HBV-DNA is >10.000 copies/ml and when GPT is >twice the ULN or biopsy shows inflammation/fibrosis. When patients are not suitable for interferon therapy, mono-therapy with adefovir, entecavir, telbivudine of lamivudine may be initiated provided that HBV-DNA is <1 Mio. copies/ml and cirrhosis is absent. When viral load is high, entecavir should be preferred. HBV-DNA need to be checked for early detection of non-response or resistance. When resistance is present, combination therapy is recommended.New studies warrant individualization of previous recommendation for therapy of hepatitis C because one can now early evaluate how successful and long the therapy shall be. When viral load is low and HCV-RNA becomes negative after 4 weeks, therapy may be shortened to 24 weeks. Without such rapid response HCV-RNA needs to be checked after 12 and 24 weeks: when HCV-RNA becomes negative only after 24 weeks, a prolongation of therapy might be advisable.
Niederau
C
C
Klinik für Innere Medizin, St. Josef Hospital, Katholische Kliniken Oberhausen gGmbH, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen, Mülheimer Strasse 83, 46045, Oberhausen, Deutschland. claus.niederau@st-josef.de
D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D024882:Drug Resistance, Viral; D015507:Drugs, Investigational / Q000627:therapeutic use; D016174:Hepacivirus / Q000235:genetics; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D011379:Prognosis; D019562:Viral Load
D000998:Antiviral Agents; D004279:DNA, Viral; D015507:Drugs, Investigational