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Dtsch Med Wochenschr 2003; 128(38): 1963-1968
DOI: 10.1055/s-2003-42367
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© Georg Thieme Verlag Stuttgart · New York

Hepatitis C: Update

Hepatitis C: updateTh Hügle1 , A. Cerny1
  • 1Clinica Medica, Ospedale Civico, Lugano
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Publication History

eingereicht: 17.12.2002

akzeptiert: 7.7.2003

Publication Date:
19 September 2003 (online)

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Hepatitis C: UpdateDtsch Med Wochenschr 2003; 128(50): 2668-2668
DOI: 10.1055/s-2003-45487

Glossar

HCV = Hepatitis-C-Virus

HIV = Humanes Immundefizienz-Virus

HCC = Hepatozelluläres Karzinom

PEG = Polyethylenglycol

IFN = Interferon

SVR = sustained viral response, anhaltende Therapieantwort

EVR = early viral response, frühe Therapieantwort

PCR = Polymerase-Kettenreaktion

ELISA = Enzyme-linked-immunosorbent-assay

RIBA = Rekombinanter-immunoblot-assay

Weltweit ist das Hepatitis-C-Virus (HCV) eine der häufigsten Ursachen für die chronische Hepatitis, die Leberzirrhose und das hepatozelluläre Karzinom (HCC). Das HCV ist ein einzelsträngiges, positiv orientiertes RNA-Virus und gehört damit zur Familie der Flaviviridae. Die Übertragung verläuft parenteral durch Blut oder Blutprodukte. Seit der Einführung des systematischen HCV-Screenings ist der intravenöse Drogenkonsum einem der häufigsten Übertragungswege geworden. In bis zu 40 % bleibt die Ursache der Übertragung jedoch unklar. Neben der chronischen Hepatitis wird das HCV auch mit extrahepatischen Erkrankungen wie z. B. der Kryoglobulinämie, dem Sjögren-Syndrom oder Non-Hodgin-Lymphomen in Verbindung gebracht. Die Therapie dieser Infektion gestaltet sich vor allem für den häufigen Genotyp 1 immer noch als schwierig, jedoch kann mit Hilfe von Polyethylenglycol (PEG)-konjugiertem Interferon (INF)-α in Kombination mit dem Nukleosidanalogon Ribavirin in Genotyp 2 und 3 in bis zu 80 % eine „anhaltende virologische Antwort” (sustained virological response, SVR) erreicht werden. Der Fortschritt der molekularen Virologie der Hepatitis C hat außerdem neue gentechnologische Therapieansätze ermöglicht, die auf der Hemmung der Virus-Replikation, Genexpression oder der Stärkung der Immunantwort gegen das HCV basieren und sich bereits in klinischer Erprobung befinden. Von einer baldigen Entwicklung der effizienten Vakzinierung kann aufgrund der hohen genetischen Variabilität leider noch nicht ausgegangen werden.

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Prof. Dr. A. Cerny

Clinica Medica, Ospedale Civico

CH-6903 Lugano

Phone: ++41/91/8116046

Fax: ++41/91/8116045

Email: andreas.cerny@bluewin.ch