[Summary of the practice guideline 'Viral hepatitis and other liver diseases' (second revision) from the Dutch College of General Practitioners].
The revised Dutch College of General Practitioners' practice guideline 'Viral hepatitis and other liver diseases' offers advice in the diagnosis and management of viral hepatitis A, B and C and other liver diseases. The guideline is important for general practitioners as well as specialists in internal medicine and gastroenterology. The emphasis is on the management of chronic hepatitis B en C, because the prevalence of these diseases has increased in the Netherlands and, in addition, the treatment options for chronic hepatitis have improved. Consequently, timely recognition and adequate referral of patients with chronic hepatitis B or hepatitis C have become more important. However, many patients with a chronic liver disease have no symptoms. Therefore, the general practitioner should be aware that a patient visiting the practice with fatigue and malaise could have a liver disease if he or she belongs to a high-risk group or has had high-risk contacts. If the general practitioner repeatedly finds increased liver transaminase values during routine examination of asymptomatic patients, additional diagnostic tests should be performed. Further tests should focus on viral hepatitis as well as on non-alcoholic fatty liver disease and non-alcoholic steatohepatitis or, depending on the history-taking, liver damage due to excessive alcohol, medication or drug use.
Bouma
M
M
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Postbus 3231, 3502 GE Utrecht. m.bouma@nhg.org
van Geldrop
W J
WJ
Numans
M E
ME
Wiersma
Tj
T
Goudswaard
A N
AN
D000998:Antiviral Agents / Q000627:therapeutic use*; D005194:Family Practice / Q000592:standards*; D006525:Hepatitis, Viral, Human / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D012955:Societies, Medical
D000998:Antiviral Agents