Therapie der Virushepatitis – Was muss der Klinikarzt wissen?

Virale Hepatitiden sind hinsichtlich Häufigkeit, Verlauf, Prognose und Therapie sehr vielfältig. Das Spektrum der klinischen Manifestationen reicht von einer passageren, milden Transaminasenerhöhung bis zum fulminanten Leberversagen. Unter den akuten viralen Hepatitiden hat insbesondere die akute Hepatitis E in den letzten Jahren eine besondere Aufmerksamkeit erlangt, da sie häufiger in Mitteleuropa diagnostiziert wurde. Neue Therapien für Patienten mit Hepatitis C sowie effektive Therapien und die Impfung bei Hepatitis B sind die häufigsten Gründe, dass eine viral bedingte Zirrhose Erfolg versprechend behandelbar ist. Es ist anzunehmen, dass Transplantationen für viral bedingte Zirrhosen stark abnehmen werden. Wichtig ist auch, an andere hepatotrope Viren zu denken, denn insbesondere die Herpes-simplex-assoziierten Leberversagen haben eine schlechte Prognose.

Viral hepatitis diseases are very diverse with regard to incidence, course, prognosis and therapy. The spectrum of clinical manifestations ranges from a temporary, mild elevation of transaminases through to fulminant liver failure. Among the acute forms of viral hepatitis acute hepatitis E in particular has generated special interest in the past few years because it has been diagnosed more and more frequently in Central Europe. New therapies for patients with hepatitis C as well as effective therapies and vaccinations for hepatitis B are the main reasons why patients with cirrhosis of viral origin can be treated with good chances of success. It may be assumed that the number of transplantations for cirrhosis of viral origins will decrease in the future. It is also important to take other hepatotrophic viruses into consideration since especially cases of herpes simplex-associated liver failure have a poor prognosis.

Key words

Viral hepatitis - hepatitis A - hepatitis B/D - hepatitis C - hepatitis E - herpes simplex - liver failure - cirrhosis

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