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Z Gastroenterol 2016; 54(07): 665-684
DOI: 10.1055/s-0042-107360
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© Georg Thieme Verlag KG Stuttgart · New York

Empfehlungen zur antiviralen Therapie der chronischen Hepatitis C bei Patienten auf der Warteliste und nach Transplantation

Expert recommendations: Hepatitis C and transplantation
T. Zimmermann
1   I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
,
S. Beckebaum
2   Klinik für Transplantationsmedizin, Universitätsklinikum Münster
,
C. Berg
3   Abteilung Innere Medizin I, Universitätsklinikum Tübingen
,
T. Berg
4   Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig
,
F. Braun
5   Transplantationszentrum, Universitätsklinikum Schleswig-Holstein, Kiel
,
D. Eurich
6   Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité-Universitätsmedizin Berlin
,
K. Herzer
7   Klinik für Gastroenterologie und Hepatologie/Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen
,
U. Neumann
8   Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Fakultät, RWTH Aachen
,
C. Rupp
9   Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
,
M. Sterneck
10   Klinik und Poliklinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Universitätsklinikum Hamburg-Eppendorf
,
C. Strassburg
11   Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn
,
M.-W. Welker
12   Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
,
R. Zachoval
13   Transplantationszentrum München der LMU, München
,
D. N. Gotthardt
9   Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
,
K. Weigand
14   Innere Medizin I, Universitätsklinikum Regensburg
,
H. Schmidt
2   Klinik für Transplantationsmedizin, Universitätsklinikum Münster
,
H. Wedemeyer
15   Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
,
P. R. Galle
1   I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
,
S. Zeuzem
12   Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
,
C. Sarrazin
12   Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
› Author Affiliations
Further Information

Publication History

03 March 2016

19 April 2016

Publication Date:
18 July 2016 (online)

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Zusammenfassung

Mit der Zulassung der neuen direkt antiviral wirksamen Substanzen (DAA) wurden die Therapiemöglichkeiten der chronischen Hepatitis C-Virus(HCV)-Infektion bei Patienten vor und nach Lebertransplantation (LTx) durch effektive, interferonfreie und nebenwirkungsarme Kombinationstherapien deutlich erweitert. Da bislang nur wenige Daten zu Patienten mit höhergradig eingeschränkter Leberfunktion sowie nach LTx vorliegen, ist die klinische Erfahrung mit einer DAA-basierten HCV-Behandlung in diesen speziellen Patientenpopulationen limitiert. Die nachstehenden Empfehlungen zur Therapie der Hepatitis C im Rahmen der LTx wurden in einer Expertenrunde als Stellungnahme erarbeitet und geben den Kenntnisstand der recherchierten Literatur, verfügbaren Fachinformationen sowie klinischen Erfahrungen der beteiligten Autoren wieder. Sie sollen hinsichtlich der Entscheidungsfindung bei antiviraler Therapie vor und nach LTx als Orientierungshilfe dienen.

Abstract

With the approval of new direct acting antiviral agents (DAA), therapeutic options for patients with chronic hepatitis C virus (HCV) infection are now generally available before and after liver transplantation (LT). Interferon-free DAA regimens are highly effective therapies and provide a good safety profile. However, the body of clinical evidence in this patient population is limited and the best treatment strategies for patients on the waiting list with (de)compensated cirrhosis and after LT are not well defined. The following recommendations for antiviral therapy in the context of LT are based on the currently available literature and clinical experience of experts in the field, and have been discussed in an expert meeting. The aim of this article is to guide clinicians in the decision making when treating patients before and after LT with DAAs.

Schlüsselwörter

Hepatitis C - Transplantation - DAA - Warteliste - Immunsuppression

Key words

hepatitis C - transplantation - DAA - waiting list - immunosuppression
 

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