MHH in charge of new hepatitis guideline
Viral and non-viral liver diseases are often detected late or not at all. As the symptoms are mostly unspecific, the disease progresses in secret and is only diagnosed when the stage of liver cirrhosis or liver cell cancer is reached. In order to detect and treat infections with hepatitis B and hepatitis C viruses as early as possible, the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) has included screening for both viruses as a statutory health insurance benefit in the health check for people with statutory health insurance as of 1 October 2021. The guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases provide information on what doctors should pay attention to in screening, diagnosis and therapy. The recommendations on hepatitis B virus infection are completely new and have now been completely reviewed and updated after ten years under the leadership of the Hannover Medical School (MHH).
Have pregnant women screened for hepatitis B at an early stage
"We have re-evaluated 165 recommendations and adapted them to the current situation," says Professor Dr Markus Cornberg, Deputy Director of the MHH Clinic for Gastroenterology, Hepatology and Endocrinology and coordinator of the S3 guideline on hepatitis B virus infection. "The updates cover all areas from diagnostics and therapy to organ transplantation and therapy for children and adolescents," emphasises the gastroenterologist and infectiologist. Another important new recommendation concerns the screening of pregnant women, which should now already take place from the 32nd week of pregnancy. If an infection with a very high viral load is detected in the mother, antiviral therapy is required. Otherwise, the virus can be transmitted to the child - even if it is vaccinated after birth. "We therefore recommend screening as early as possible at the beginning of pregnancy and not only in the 32nd week of pregnancy, as stipulated in the maternity guidelines," emphasises Professor Cornberg. "Early antiviral therapy can lower the mother’s viral load and thus prevent chronic infection of the newborn," explains the physician.
Detect symptomless patients early
With the inclusion of hepatitis B and hepatitis C screening in the preventive health check-up, the guideline takes on even greater significance. "Due to the screening, we will now detect more infected people who are as yet asymptomatic and can prevent a severe course of the disease in them," says Professor Cornberg. Hepatitis B can be treated well at an early stage, hepatitis C can even be cured.Michael P. Manns, MHH President and Chairman of the Board of the German Liver Foundation, also assumes that many people affected in Germany are unaware of their disease. "The liver suffers silently," says the physician. "It is therefore to be welcomed that those with statutory health insurance are now entitled to a one-off screening from the age of 35."