title: [Laboratory requirements to diagnose viral hepatitis under the development of guidelines].
abstract: Infections with hepatitis B-, C- and D- viruses have a significant health burden. In Germany, the seroprevalence of HBs-Ag is calculated with 0.6 % and of HCV-antibodies with 0.3 %. However, most patients are not diagnosed. Sequelae are liver-cirrhosis and hepatocellular carcinoma. Several S3-guidelines for the diagnosis and treatment of viral hepatitis have been established. However, implementation of guidelines is not easy to evaluate. To estimate the changes of medical knowledge and diagnostic procedures about viral hepatitis, 7 parameters of liver-diagnostics were elected to analyze the requirements profile in the years 2005 - 2011 in 4 German federal states. GPT/ALT showed no important change except the influence of the laboratory-reformation. HBs-Ag and HCV-Ab show only a minor increase in adults. The molecular differentiation of HBV-DNA and HCV-RNA showed changes up to 200 % in some regions; however, this might not be explained by more screening but rather increased treatment monitoring or new region-specific regulations. The most significant increase was observed for HDV-antibodies, but the amount of testing is still at a low level. The development and update of guidelines, the World-Hepatitis-Awareness-Day, and other specific nationwide activities did not result in a major increase in the screening of viral hepatitis with the exception of HDV. The results and the new treatment options against hepatitis C should motivate to continue the education in the field of viral hepatitis in an intensified manor.
authors.forename: Hans
authors.initials: H
authors.lastname: Becker
authors.forename: Jona Theodor
authors.initials: JT
authors.lastname: Stahmeyer
authors.affiliation: Medizinische Hochschule Hannover, Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Germany.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
authors.affiliation: Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Krauth
authors.affiliation: Medizinische Hochschule Hannover, Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Cornberg
mesh_terms: D000328:Adult; D019411:Clinical Laboratory Techniques / Q000592:standards*; D005762:Gastroenterology / Q000592:standards*; D005858:Germany; D006525:Hepatitis, Viral, Human / Q000175:diagnosis* / Q000821:virology*; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult