From A to E: New strategies against chronic hepatitis in Germany

From A to E: New strategies against chronic hepatitis in Germany

from A to E: Hepatitis successfully combat

In the case of cirrhosis of the liver, high alcohol consumption or liver diseases are often suspected as the cause. But there is another possible cause of a scarred liver: hepatitis viruses. Hepatitis is liver inflammation that can be acute or chronic depending on the form. Together with scientific institutions, the pharmaceutical industry is working to successfully treat chronic hepatitis-B, -c and D infections. This progress is particularly important because chronic hepatitis can lead to serious liver damage. On the occasion of the world hepatitis tag we look forward to these positive developments!

There are five well-known hepatitis viruses: Hepatitis A, B, C, D and E. Although they are not related, they all trigger liver inflammation. The hepatitis-B, -c- and -D viruses are particularly dangerous because they can lead to chronic diseases. Liver cirrhosis or even liver cancer can result from years of destruction of liver cells. In some cases, a liver transplant is required. However, these life -threatening consequences of chronic hepatitis can be prevented by timely diagnosis and early treatment. This is not only important for the patients in order to maintain their quality of life, but often also in order to continue to be able to stand in working life, explains Dr. Matthias Wilken from the Federal Association of Pharmaceutical Industry (BPI) e.V.

In Germany, almost 200,000 people are infected with the Hepatitis C virus (HCV) and several hundred thousand with the Hepatitis B virus (HBV). According to estimates by the World Health Organization (WHO), 354 million people live worldwide with hepatitis B or C infection. The problem is that not all those affected have typical symptoms such as yellowish discolored skin or eyes, loss of appetite, nausea, vomiting, joint pain and fever. Many affected people do not even notice that they have hepatitis while their liver cells are further destroyed. Therefore, the new treatment strategies are particularly important to help people with chronic hepatitis or cirrhosis of the liver.

Pharmaceutical research has long focused on the treatment of hepatitis-C infections, as these are chronic in most cases. There is no vaccination against hepatitis C, in contrast to the hepatitis A and B-viruses. 25 years ago, the healing rate for chronic hepatitis C was five to ten percent. Thanks to new medicines, the so -called "Direct Acting Antiviral Agents" (DAA), over 95 percent of those affected can now be healed. These medicines work directly in the liver cells, prevent the formation of required virus proteins and block their increase. They are very effective and well tolerated.

A hepatitis B infection is not as often chronic as hepatitis-C infection. Most chronic cases occur in older or multimorbid people. In infants who are infected by their mother during birth, the infection becomes 90 percent chronic. Hygiene defects in tattooing and piercings, the common use of injection injections and sexual contacts are typical transmission paths for hepatitis B. Antiviral medication are standard therapy against chronic hepatitis B and inhibit the virus increase directly. A therapeutic vaccine that strengthens the body's immune system could contribute to healing existing infections in the future. A clinical study is currently underway.

The Hepatitis D virus (HDV) can only exist in connection with the hepatitis B virus. Co-infection with hepatitis D damages the liver much faster than sole hepatitis B infection. A first antiviral drug for chronic hepatitis D has been approved since 2020. This drug blocks the entry of hepatitis B and D viruses into the liver cells and improves the liver function. A preventive vaccination against hepatitis B also protects against hepatitis d.

The new therapy approaches to chronic hepatitis are a great success because they prevent liver damage and concern those affected to infect other people. However, vaccination against hepatitis A and B. against hepatitis A and B remains the best provision in Germany. In addition, legally insured persons from the age of 35 are entitled to a health check-up that also tests on hepatitis B and C.

The ABC of hepatitis:

• hepatitis A: The "most harmless" hepatitis virus. Occurs especially in warmer countries with poor hygienic conditions. A secure vaccination is available.
• hepatitis B: is transmitted via body fluids and blood. Safe vaccination is available. About five to ten percent of patients develop chronic infection.
• hepatitis C: causes a chronic infection in about 70 percent of cases. Is mostly transmitted by contact with infected blood, for example when sharing injections or in immersioned needles for tattoos or piercings. No vaccination available.
• hepatitis D: only occurs as a co-infection with hepatitis B. Vaccination against hepatitis B also protects against hepatitis d.
• hepatitis e: mainly transmit by consuming insufficiently cooked pig or wild meat. In most cases heals by itself. No approved vaccination available in Europe.