Skip to main content
Erschienen in: MMW - Fortschritte der Medizin 2/2016

03.06.2016 | Hepatitiden | FORTBILDUNG . ÜBERSICHT

Update 2016

Aktuelle Therapieoptionen bei chronischer Hepatitis C

verfasst von: Prof. Dr. med. Reinhart Zachoval, Prof. Dr. med. Maria-Christina Jung

Erschienen in: MMW - Fortschritte der Medizin | Sonderheft 2/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Zulassung neuer, direkt antiviral wirkender Substanzen hat die Therapie der Hepatitis C in den letzten zwei Jahren revolutioniert. Eine dauerhafte Viruselimination und damit eine Ausheilung der Hepatitis ist je nach Genotyp, Vorbehandlung und Fibrosestadium bei mehr als 90% der Patienten möglich. Die Therapiedauer hat sich wesentlich verkürzt. Die Nebenwirkungen sind gering (gelegentlich Kopfschmerzen, Übelkeit, Müdigkeit, Durchfälle) und führen nur sehr selten zum Therapieabbruch. Insgesamt hat sich damit die Lage Betroffener deutlich gebessert.
Literatur
1.
Zurück zum Zitat Wedemeyer H, Duberg AS, Buti M et al. Strategies to manage hepatitis C virus (HCV) disease burden. J Viral Hepat. 2014;21(Suppl 1):60–89CrossRefPubMed Wedemeyer H, Duberg AS, Buti M et al. Strategies to manage hepatitis C virus (HCV) disease burden. J Viral Hepat. 2014;21(Suppl 1):60–89CrossRefPubMed
2.
Zurück zum Zitat Meer AJ van der, Wedemeyer H, Feld JJ et al. Life expectancy in patients with chronic HCV infection and cirrhosis compared with a general population. JAMA. 2014;312:1927–8CrossRefPubMed Meer AJ van der, Wedemeyer H, Feld JJ et al. Life expectancy in patients with chronic HCV infection and cirrhosis compared with a general population. JAMA. 2014;312:1927–8CrossRefPubMed
3.
Zurück zum Zitat Robert- Koch-Institut Epidemiologisches Bulletin 2015; Nr. 30 Robert- Koch-Institut Epidemiologisches Bulletin 2015; Nr. 30
4.
Zurück zum Zitat Backus LI, Boothroyd DB, Phillips BR et al. A sustained virologic response reduces risk of all-cause mortality in patients with hepatitis C. Clin Gastroenterol Hepatol. 2011;9:509–16CrossRefPubMed Backus LI, Boothroyd DB, Phillips BR et al. A sustained virologic response reduces risk of all-cause mortality in patients with hepatitis C. Clin Gastroenterol Hepatol. 2011;9:509–16CrossRefPubMed
5.
Zurück zum Zitat Sarrazin C, Berg T, Wedemeyer H et al. Aktuelle Empfehlung der DGVS zur Therapie der chronischen Hepatitis C. Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS). Z Gastroenterol. 2015;53:320–34CrossRefPubMed Sarrazin C, Berg T, Wedemeyer H et al. Aktuelle Empfehlung der DGVS zur Therapie der chronischen Hepatitis C. Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS). Z Gastroenterol. 2015;53:320–34CrossRefPubMed
6.
Zurück zum Zitat Hüppe D, Zehnter E, Mauss S et al. Epidemiologie der chronischen Hepatitis C in Deutschland. Z Gastroenterol. 2008;46:34–44CrossRefPubMed Hüppe D, Zehnter E, Mauss S et al. Epidemiologie der chronischen Hepatitis C in Deutschland. Z Gastroenterol. 2008;46:34–44CrossRefPubMed
7.
Zurück zum Zitat Charlton M, Everson GT, Flamm SL et al. Ledipasvir and sofosbuvir plus ribavirin for treatment of HCV infection in patients with advanced liver disease. Gastroenterology 2015;149:649–59CrossRefPubMed Charlton M, Everson GT, Flamm SL et al. Ledipasvir and sofosbuvir plus ribavirin for treatment of HCV infection in patients with advanced liver disease. Gastroenterology 2015;149:649–59CrossRefPubMed
8.
Zurück zum Zitat Manns M, Samuel D, Gane EJ et al. Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease: a multicentre, open-label, randomised, phase 2 trial Lancet Infect Dis. 2016 Feb 18. pii: S1473-3099(16)00052-9. doi: 10.1016/S1473-3099(16)00052-9. [Epub ahead of print] Manns M, Samuel D, Gane EJ et al. Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease: a multicentre, open-label, randomised, phase 2 trial Lancet Infect Dis. 2016 Feb 18. pii: S1473-3099(16)00052-9. doi: 10.1016/S1473-3099(16)00052-9. [Epub ahead of print]
9.
Zurück zum Zitat Mantry P, Kwo PY, Coakley E et al. High sustained virologic response rates in liver transplant recipients with recurrent HCV genotype 1 infection receiving ABT-450/r/Ombitasvir + Dasabuvir plus Ribavirin. Hepatology 2014; 60:298A–9A Mantry P, Kwo PY, Coakley E et al. High sustained virologic response rates in liver transplant recipients with recurrent HCV genotype 1 infection receiving ABT-450/r/Ombitasvir + Dasabuvir plus Ribavirin. Hepatology 2014; 60:298A–9A
10.
Zurück zum Zitat Reddy K, Everson GT, Flamm S et al. Ledipasvir/sofosbuvir with ribavirin for the treatment of HCV in patients with post transplant recurrence: preliminary results of a prospective, multicenter study. Hepatology 2014;60:200A–1ACrossRef Reddy K, Everson GT, Flamm S et al. Ledipasvir/sofosbuvir with ribavirin for the treatment of HCV in patients with post transplant recurrence: preliminary results of a prospective, multicenter study. Hepatology 2014;60:200A–1ACrossRef
11.
Zurück zum Zitat Bourlière M, Bronowicki J, Ledinghen V de et al. Ledipasvir/sofosbuvir fixed-dose combination is safe and efficacious in cirrhotic patients who have previously failed protease-inhibitor based triple therapy. Hepatology. 2014;60:LB–6 Bourlière M, Bronowicki J, Ledinghen V de et al. Ledipasvir/sofosbuvir fixed-dose combination is safe and efficacious in cirrhotic patients who have previously failed protease-inhibitor based triple therapy. Hepatology. 2014;60:LB–6
12.
Zurück zum Zitat Afdhal N, Reddy KR, Nelson DR et al. Ledipasvir and sofosbuvir for previously treated HCV genotype 1 infection. N Engl J Med. 2014;370:1483–93CrossRefPubMed Afdhal N, Reddy KR, Nelson DR et al. Ledipasvir and sofosbuvir for previously treated HCV genotype 1 infection. N Engl J Med. 2014;370:1483–93CrossRefPubMed
13.
Zurück zum Zitat Reddy KR, Bourlière M, Sulkowski M et al. Ledipasvir and sofosbuvir in patients with genotype 1 hepatitis C virus infection and compensated cirrhosis: An integrated safety and efficacy analysis. Hepatology. 2015; 62:79–86CrossRefPubMed Reddy KR, Bourlière M, Sulkowski M et al. Ledipasvir and sofosbuvir in patients with genotype 1 hepatitis C virus infection and compensated cirrhosis: An integrated safety and efficacy analysis. Hepatology. 2015; 62:79–86CrossRefPubMed
14.
Zurück zum Zitat Jacobson I, Kwo P, Kowdley K et al. Virologic response rates to all oral fixed-dose combination ledipasvir/sofosbuvir regimens are similar in patients with and without traditional negative predictive factors in phase 3 clinical trials. Hepatology 2014; 60(4 Suppl 1):1141A Jacobson I, Kwo P, Kowdley K et al. Virologic response rates to all oral fixed-dose combination ledipasvir/sofosbuvir regimens are similar in patients with and without traditional negative predictive factors in phase 3 clinical trials. Hepatology 2014; 60(4 Suppl 1):1141A
15.
Zurück zum Zitat Kowdley KV, Gordon SC, Reddy KR et al. Ledipasvir and sofosbuvir for 8 or 12 weeks for chronic HCV without cirrhosis. N Engl J Med 2014; 370:1879–1888CrossRefPubMed Kowdley KV, Gordon SC, Reddy KR et al. Ledipasvir and sofosbuvir for 8 or 12 weeks for chronic HCV without cirrhosis. N Engl J Med 2014; 370:1879–1888CrossRefPubMed
16.
Zurück zum Zitat Ferenci P, Bernstein D, Lalezari J et al. ABT-450/r-ombitasvir and dasabuvir with or without ribavirin for HCV. N Engl J Med 2014; 370:1983–1992CrossRefPubMed Ferenci P, Bernstein D, Lalezari J et al. ABT-450/r-ombitasvir and dasabuvir with or without ribavirin for HCV. N Engl J Med 2014; 370:1983–1992CrossRefPubMed
17.
Zurück zum Zitat Fried M, Forns X, Reau N et al. TURQUOISE-II: regimens of ABT-450/r/ombitasvir and dasabuvir with ribavirin achieve high SVR 12 rates in HCV genotype 1-infected patients with cirrhosis, regardless of baseline characteristics. Hepatology 2014; 60:238A Fried M, Forns X, Reau N et al. TURQUOISE-II: regimens of ABT-450/r/ombitasvir and dasabuvir with ribavirin achieve high SVR 12 rates in HCV genotype 1-infected patients with cirrhosis, regardless of baseline characteristics. Hepatology 2014; 60:238A
18.
Zurück zum Zitat Andreone P, Colombo MG, Enejosa JV et al. ABT-450, ritonavir, ombitasvir, and dasabuvir achieves 97 and 100% sustained virologic response with or without ribavirin in treatment-experienced patients with HCV genotype 1b infection. Gastroenterology 2014; 147:359–365CrossRefPubMed Andreone P, Colombo MG, Enejosa JV et al. ABT-450, ritonavir, ombitasvir, and dasabuvir achieves 97 and 100% sustained virologic response with or without ribavirin in treatment-experienced patients with HCV genotype 1b infection. Gastroenterology 2014; 147:359–365CrossRefPubMed
19.
Zurück zum Zitat Feld JJ, Kowdley KV, Coakley E et al. Treatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin. N Engl J Med 2014; 370:1594–1603CrossRefPubMed Feld JJ, Kowdley KV, Coakley E et al. Treatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin. N Engl J Med 2014; 370:1594–1603CrossRefPubMed
20.
Zurück zum Zitat Zeuzem S, Jacobson IM, Baykal T et al. Retreatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin. N Engl J Med 2014; 370:1604–1614CrossRefPubMed Zeuzem S, Jacobson IM, Baykal T et al. Retreatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin. N Engl J Med 2014; 370:1604–1614CrossRefPubMed
21.
Zurück zum Zitat Feld JJ, Moreno C, Trinh R et al. Sustained virologic response of 100% in HCV genotype 1b patients with cirrhosis receiving ombitasvir/paritaprevir/r and dasabuvir for 12weeks. J Hepatol. 2016;64:301–7CrossRefPubMed Feld JJ, Moreno C, Trinh R et al. Sustained virologic response of 100% in HCV genotype 1b patients with cirrhosis receiving ombitasvir/paritaprevir/r and dasabuvir for 12weeks. J Hepatol. 2016;64:301–7CrossRefPubMed
22.
Zurück zum Zitat Poordad F, Hezode C, Trinh R et al. ABT-450/r-ombitasvir and dasabuvir with ribavirin for hepatitis C with cirrhosis. N Engl J Med 2014; 370:1973–1982CrossRefPubMed Poordad F, Hezode C, Trinh R et al. ABT-450/r-ombitasvir and dasabuvir with ribavirin for hepatitis C with cirrhosis. N Engl J Med 2014; 370:1973–1982CrossRefPubMed
23.
Zurück zum Zitat Lawitz E, Sulkowski MS, Ghalib R et al. Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders to pegylated interferon and ribavirin and treatment-naive patients: the COSMOS randomised study. Lancet 2014; 384:1756–1765CrossRefPubMed Lawitz E, Sulkowski MS, Ghalib R et al. Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders to pegylated interferon and ribavirin and treatment-naive patients: the COSMOS randomised study. Lancet 2014; 384:1756–1765CrossRefPubMed
24.
Zurück zum Zitat Dieterich D, Bacon B, Flamm S et al. Evaluation of sofosbuvir and simeprevir-based regimens in the TRIO network: academic and community treatment of a real-world, heterogeneous population. Hepatology 2014; 60:220A Dieterich D, Bacon B, Flamm S et al. Evaluation of sofosbuvir and simeprevir-based regimens in the TRIO network: academic and community treatment of a real-world, heterogeneous population. Hepatology 2014; 60:220A
25.
Zurück zum Zitat Jensen D, O’Leary J, Pockros P et al. Safety and efficacy of sofosbuvir-containing regimens for hepatitis C: real-world experience in a diverse, longitudinal observational Hepatology 2014; 58:219A–20A Jensen D, O’Leary J, Pockros P et al. Safety and efficacy of sofosbuvir-containing regimens for hepatitis C: real-world experience in a diverse, longitudinal observational Hepatology 2014; 58:219A–20A
26.
Zurück zum Zitat Gane EJ, Stedman CA, Hyland RH et al. Nucleotide polymerase inhibitor sofosbuvir plus ribavirin for hepatitis C. N Engl J Med. 2013;368:34–44CrossRefPubMed Gane EJ, Stedman CA, Hyland RH et al. Nucleotide polymerase inhibitor sofosbuvir plus ribavirin for hepatitis C. N Engl J Med. 2013;368:34–44CrossRefPubMed
27.
Zurück zum Zitat Osinusi A, Meissner EG, Lee YJ et al. Sofosbuvir and ribavirin for hepatitis C genotype 1 in patients with unfavorable treatment characteristics: a randomized clinical trial. JAMA. 2013;310:804–11CrossRefPubMedPubMedCentral Osinusi A, Meissner EG, Lee YJ et al. Sofosbuvir and ribavirin for hepatitis C genotype 1 in patients with unfavorable treatment characteristics: a randomized clinical trial. JAMA. 2013;310:804–11CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Jacobson IM, Gordon SC, Kowdley KV et al. Sofosbuvir for hepatitis C genotype 2 or 3 in patients without treatment options. N Engl J Med. 2013;368:1867–77CrossRefPubMed Jacobson IM, Gordon SC, Kowdley KV et al. Sofosbuvir for hepatitis C genotype 2 or 3 in patients without treatment options. N Engl J Med. 2013;368:1867–77CrossRefPubMed
29.
Zurück zum Zitat Lawitz E, Mangia A, Wyles D et al. Sofosbuvir for previously untreated chronic hepatitis C infection. N Engl J Med. 2013;368:1878–87CrossRefPubMed Lawitz E, Mangia A, Wyles D et al. Sofosbuvir for previously untreated chronic hepatitis C infection. N Engl J Med. 2013;368:1878–87CrossRefPubMed
30.
Zurück zum Zitat Zeuzem S, Dusheiko GM, Salupere R et al. Sofosbuvir and ribavirin in HCV genotypes 2 and 3. N Engl J Med. 2014;370:1993–2001CrossRefPubMed Zeuzem S, Dusheiko GM, Salupere R et al. Sofosbuvir and ribavirin in HCV genotypes 2 and 3. N Engl J Med. 2014;370:1993–2001CrossRefPubMed
31.
Zurück zum Zitat Nelson D, Cooper J, Lalezari J et al. All-oral 12-week combination treatment with daclatasvir (DCV) and sofosbuvir (SOF) in patients infected with HCV genotype (GT) 3: ALLY-3 phase 3 study. Hepatology. 2015;61:1127–35CrossRefPubMedPubMedCentral Nelson D, Cooper J, Lalezari J et al. All-oral 12-week combination treatment with daclatasvir (DCV) and sofosbuvir (SOF) in patients infected with HCV genotype (GT) 3: ALLY-3 phase 3 study. Hepatology. 2015;61:1127–35CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Gane E, Hyland R, An D et al. Ledipasvir/sofosbuvir fixed-dose combination is safe and effective in difficult-to-treat populations including GT 3 patients, decompensated GT 1 patients, and GT 1 patients with prior sofosbuvir experience. J Hepatol. 2014;60:S3–S4CrossRef Gane E, Hyland R, An D et al. Ledipasvir/sofosbuvir fixed-dose combination is safe and effective in difficult-to-treat populations including GT 3 patients, decompensated GT 1 patients, and GT 1 patients with prior sofosbuvir experience. J Hepatol. 2014;60:S3–S4CrossRef
33.
Zurück zum Zitat Leroy V, Angus P, Bronowicki JP et al. Daclatasvir, Sofosbuvir, and Ribavirin for Hepatitis C Virus Genotype 3 and Advanced Liver Disease: A Randomized Phase III Study (ALLY-3+). Hepatology. 2016, Jan 28. doi: 10.1002/hep.28473. [Epub ahead of print) Leroy V, Angus P, Bronowicki JP et al. Daclatasvir, Sofosbuvir, and Ribavirin for Hepatitis C Virus Genotype 3 and Advanced Liver Disease: A Randomized Phase III Study (ALLY-3+). Hepatology. 2016, Jan 28. doi: 10.1002/hep.28473. [Epub ahead of print)
34.
Zurück zum Zitat Foster GR, Pianko S, Brown A et al. Efficacy of sofosbuvir plus ribavirin with or without peginterferon-alfa in patients with hepatitis C virus genotype 3 infection and treatment-experienced patients with cirrhosis and hepatitis C virus genotype 2 infection. Gastroenterology. 2015;149:1462–70CrossRefPubMed Foster GR, Pianko S, Brown A et al. Efficacy of sofosbuvir plus ribavirin with or without peginterferon-alfa in patients with hepatitis C virus genotype 3 infection and treatment-experienced patients with cirrhosis and hepatitis C virus genotype 2 infection. Gastroenterology. 2015;149:1462–70CrossRefPubMed
35.
Zurück zum Zitat Kapoor R, Kohli A, Sidharthan S et al. Treatment of hepatitis C genotype 4 with ledipasvir and sofosbuvir for 12 weeks: results of the SYNERGY trial (oral presentation). Hepatology. 2014;60:91A Kapoor R, Kohli A, Sidharthan S et al. Treatment of hepatitis C genotype 4 with ledipasvir and sofosbuvir for 12 weeks: results of the SYNERGY trial (oral presentation). Hepatology. 2014;60:91A
36.
Zurück zum Zitat Pol S, Reddy K, Baykal T et al. Interferon-free regimens of ombitasvir and ABT-450/r with or without ribavirin in patients with HCV genotype 4 infection: PEARL-I study results. Hepatology. 2014;60:1129A Pol S, Reddy K, Baykal T et al. Interferon-free regimens of ombitasvir and ABT-450/r with or without ribavirin in patients with HCV genotype 4 infection: PEARL-I study results. Hepatology. 2014;60:1129A
37.
Zurück zum Zitat Gane E, Hyland R, An D et al. High efficacy of LDV/SOF regimens for 12 weeks for patients with HCV genotype 3 or 6 infection. Gastroenterology 2015;149:1454–61CrossRefPubMed Gane E, Hyland R, An D et al. High efficacy of LDV/SOF regimens for 12 weeks for patients with HCV genotype 3 or 6 infection. Gastroenterology 2015;149:1454–61CrossRefPubMed
38.
Zurück zum Zitat Sulkowski MS, Gardiner DF, Rodriguez-Torres M et al. Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection. N Engl J Med. 2014;370:211–21CrossRefPubMed Sulkowski MS, Gardiner DF, Rodriguez-Torres M et al. Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection. N Engl J Med. 2014;370:211–21CrossRefPubMed
39.
Zurück zum Zitat Roth D, Nelson DR, Bruchfeld A et al. Grazoprevir plus elbasvir in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet. 2015;386:1537–45CrossRefPubMed Roth D, Nelson DR, Bruchfeld A et al. Grazoprevir plus elbasvir in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet. 2015;386:1537–45CrossRefPubMed
40.
Zurück zum Zitat Foster GR, Afdhal N, Roberts SK et al. Sofosbuvir and Velpatasvir for HCV Genotype 2 and 3 Infection. N Engl J Med. 2015; 373:2608-17 41. Feld JJ, Jacobson IM, Hézode C et al. Sofosbuvir and Velpatasvir for HCV Genotype 1, 2, 4, 5, and 6 Infection. N Engl J Med. 2015; 373:2599–607CrossRef Foster GR, Afdhal N, Roberts SK et al. Sofosbuvir and Velpatasvir for HCV Genotype 2 and 3 Infection. N Engl J Med. 2015; 373:2608-17 41. Feld JJ, Jacobson IM, Hézode C et al. Sofosbuvir and Velpatasvir for HCV Genotype 1, 2, 4, 5, and 6 Infection. N Engl J Med. 2015; 373:2599–607CrossRef
42.
Zurück zum Zitat Curry MP, O’Leary JG, Bzowej N et al. Sofosbuvir and Velpatasvir for HCV in Patients with Decompensated Cirrhosis. N Engl J Med. 2015;373:2618–28CrossRefPubMed Curry MP, O’Leary JG, Bzowej N et al. Sofosbuvir and Velpatasvir for HCV in Patients with Decompensated Cirrhosis. N Engl J Med. 2015;373:2618–28CrossRefPubMed
Metadaten
Titel
Update 2016
Aktuelle Therapieoptionen bei chronischer Hepatitis C
verfasst von
Prof. Dr. med. Reinhart Zachoval
Prof. Dr. med. Maria-Christina Jung
Publikationsdatum
03.06.2016
Verlag
Springer Medizin
Erschienen in
MMW - Fortschritte der Medizin / Ausgabe Sonderheft 2/2016
Print ISSN: 1438-3276
Elektronische ISSN: 1613-3560
DOI
https://doi.org/10.1007/s15006-016-8329-3

Weitere Artikel der Sonderheft 2/2016

MMW - Fortschritte der Medizin 2/2016 Zur Ausgabe

AKTUELLE MEDIZIN . KONGRESSBERICHTE

Heilung von HIV: Berechtigte Hoffnung oder Utopie?

FORTBILDUNG . ÜBERSICHT

Das Phänomen des offenen Fensters

AKTUELLE MEDIZIN . KONGRESSBERICHTE

So funktioniert die „Genschere“ gegen HIV

FORTBILDUNG . ÜBERSICHT

HIV und Sport: Ist das gesund?

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.