Therapiestrategien bei Patienten mit Hepatitis-C-Virusinfektion an der Universitätsmedizin Göttingen: Eine retrospektive Analyse von Therapieergebnissen

Mathes, Sarah

dc.contributor.advisor	Mihm, Sabine Prof. Dr.
dc.contributor.author	Mathes, Sarah
dc.date.accessioned	2016-06-07T09:07:19Z
dc.date.available	2016-07-27T22:50:05Z
dc.date.issued	2016-06-07
dc.identifier.uri	http://hdl.handle.net/11858/00-1735-0000-0028-876F-B
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-5676
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-5676
dc.language.iso	deu	de
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc	610	de
dc.title	Therapiestrategien bei Patienten mit Hepatitis-C-Virusinfektion an der Universitätsmedizin Göttingen: Eine retrospektive Analyse von Therapieergebnissen	de
dc.type	doctoralThesis	de
dc.title.translated	Therapeutic strategies in patients with hepatitis C virus infection at the University Medical Center Göttingen: a retrospective analysis of therapeutic results	de
dc.contributor.referee	Scheithauer, Simone Prof. Dr.
dc.date.examination	2016-06-30
dc.description.abstracteng	Worldwide 80-160 million people are estimated to be chronically infected with the hepatitis C virus (HCV), a single stranded RNA virus. Chronic HCV infection is a leading cause of liver specific morbidity and mortality including progressive liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). It is transmitted by exposure to infectious blood or blood-derived body fluids. The primary goal is the eradication of the HCV by antiviral therapy. The purpose of this retrospective study was to investigate epidemiological, clinical-chemical and histological parameters, information regarding the course of therapy, treatment response and potential side effects during treatment from 550 patients suffering from chronic HCV infection of University Medical Center Göttingen (UMG) from 1994 to 2009. Furthermore, the influence of virus- and patient-specific factors on the success of antiviral treatment was discussed. Mean age of patients was 40.5 (± 14.06) years, 61.72% were male. The infection was transmitted in 26.90% of cases by application of blood products. 25.81% of patients acquired HCV by injecting drug use. 49.63% of the patients were infected with genotype 1, 2.72% with genotype 2 and 12.54% with genotype 3. HCC occurred on average 10.66 (± 8.77) years after initial diagnosis of infection in 12.54% of the untreated patients, 10.23% of the nonresponders and 3.57% of the responders. 4.18% of all patients died due to complications of HCV infection or HCC. 66.24% of the responders and 48.79% of the nonresponders conducted a dual combination therapy of PEG-interferon alpha and ribavirin and overall 46.86% of all treated patients achieved sustained virologic response (SVR), which was significantly associated with the level of γ-GT/ALT ratio before treatment and HCV genotype 1. New direct-acting antivirals (DAA) allow to achieve SVR in approximately 90% of cases, even in difficult to treat patients, but are not available to a majority of HCV-infected patients who often cannot afford these drugs. By detecting and combining valid, effective and noninvasive pretreatment predictors, the predictive power for the eradication of HCV infection can be increased and patients who will benefit from the more readily available dual combination therapy can thus be identified.	de
dc.contributor.coReferee	Schön, Margarete Prof. Dr.
dc.subject.ger	Hepatitis C Virus	de
dc.subject.ger	chronische Lebererkrankung	de
dc.subject.ger	hepatozelluläres Karzinom	de
dc.subject.ger	antivirale Therapie	de
dc.subject.ger	Vor-Therapie-Prädiktoren	de
dc.subject.ger	direct-acting antiviral	de
dc.subject.eng	hepatitis c virus	de
dc.subject.eng	chronic liver disease	de
dc.subject.eng	hepatocellular carcinoma	de
dc.subject.eng	antiviral therapy	de
dc.subject.eng	pretreatment predictors	de
dc.subject.eng	direct-acting antiviral	de
dc.identifier.urn	urn:nbn:de:gbv:7-11858/00-1735-0000-0028-876F-B-7
dc.affiliation.institute	Medizinische Fakultät	de
dc.subject.gokfull	Innere Medizin - Allgemein- und Gesamtdarstellungen (PPN619875747)	de
dc.description.embargoed	2016-07-07
dc.identifier.ppn	860626687

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