Abstract:
BACKGROUND: More than 250 000 patients suffer from chronic hepatitis C in Germany. Several potent, direct-acting antiviral drugs have been approved since 2014. The aim of the German Hepatitis C-Registry (DHC-R) is to describe the epidemiology and patient care of hepatitis C and to investigate the efficacy and safety of new treatment options in real-world settings. METHODS: The DHC-R is a prospective multicenter non-interventional registry study that includes 327 centers throughout Germany. All approved treatment options have been documented. The current analysis differentiated 4 phases: 2/2014 - 12/2014, 1/2015 - 12/2015, 1/2016 - 7/2017 and 8/2017 - 7/2018. FINDINGS: Between February 2014 and July 2018, 12 170 patients were included in the registry (61.3 % male), and antiviral treatment was initiated in 11 268. The mean age declined from 52.3 years (phase 1) to 49.3 years (phase 4), while the proportion of patients with previous or ongoing drug abuse increased (26.3 % to 43.1 %). In 2014, 35.1 % of treated patients had liver cirrhosis, which declined to 16.5 % in phase 4. The HCV genotype distribution showed marked fluctuations, with most recent increases in HCV genotype 3 (30 % in phase 4). Per-protocol sustained virological response rates increased from 92.8 % in 2014 to 94.4 % in 2017/18 with excellent tolerability. SUMMARY: The DHC-R mirrors patient care of chronic hepatitis in the real-world setting in Germany and provides insights into epidemiology developments. It also confirms the high efficacy and safety of novel treatment options. EINLEITUNG: In Deutschland sind mehr als 250 000 Patienten an einer chronischen Hepatitis C (CHC) erkrankt. Seit 2014 sind zahlreiche potente direkt antivirale Substanzen gegen HCV zugelassen worden. Ziel des Deutschen Hepatitis-C-Registers (DHC-R) ist es, die Epidemiologie und Versorgung von Patienten mit CHC abzubilden und die Effektivität und Sicherheit der neuen Behandlungsmöglichkeiten im Praxisalltag zu untersuchen. METHODEN: Das DHC-R ist eine prospektive, multizentrische, nicht interventionelle Registerstudie. Bundesweit sind 327 Zentren für die Dokumentation freigeschaltet. Alle in Deutschland zugelassenen Medikamente wurden im DHC-R dokumentiert. Für die aktuelle Auswertung wurden 4 Phasen unterschieden: 2/2014 bis 12/2014, 1/2015 bis 12/2015, 1/2016 bis 7/2017 und 8/2017 bis 7/2018. ERGEBNISSE: Zwischen Februar 2014 und Juli 2018 wurden 12 170 Patienten in das Register eingeschlossen (61,3 % Männer), eine antivirale Therapie erhielten 11 268. Das Behandlungsalter sank von 52,3 (Phase 1) auf 49,3 Jahre (Phase 4), der Anteil der Behandelten mit einer Drogenanamnese nahm zu (von 26,9 auf 43,1 %). 2014 wurden viele Patienten mit Leberzirrhose (35,1 %) behandelt, deren Anteil im Verlauf deutlich abnahm (Phase 4: 16,5 %). Die HCV-Genotypenverteilung änderte sich im Zeitverlauf deutlich, zuletzt stieg der Anteil des HCV-Genotyps 3 (30 % in Phase 4). Die Ausheilungsrate (PP-Analyse) steigerte sich von 92,8 % im Jahre 2014 auf zuletzt 97,4 % bei sehr guter Verträglichkeit. ZUSAMMENFASSUNG: Das DHC-R beschreibt die Versorgungssituation der Patienten mit CHC in Deutschland, zeigt epidemiologische Tendenzen auf und belegt die ausgezeichneten Behandlungsmöglichkeiten.
journal_name
Z Gastroenteroljournal_title
Zeitschrift fur Gastroenterologieauthors
Hüppe D,Serfert Y,Buggisch P,Mauss S,Böker KHW,Müller T,Klinker H,Günther R,Berg T,Cornberg M,Niederau C,Sarrazin C,Simon KG,Zeuzem S,Manns MP,Wedemeyer Hdoi
10.1055/a-0821-7188subject
Has Abstractpub_date
2019-01-01 00:00:00pages
27-36issue
1eissn
0044-2771issn
1439-7803journal_volume
57pub_type
杂志文章abstract::Risk factors for cholangiocellular and gallbladder carcinomas are bile stones and chronic inflammation of the biliary system. Gallbladder cancer and intrahepatic cholangiocellular carcinomas can be diagnosed with a high sensitivity by ultrasonography, CT and MRI, while the most sensitive diagnostic methods for perihil...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2004-812701
更新日期:2004-05-01 00:00:00
abstract::Measurement of chromogranin A (CgA) level in blood can be used to monitor neuroendocrine tumours. However CgA level may also be elevated in several other endocrine and non-endocrine diseases. Here, we report on a patient with an incidental left-sided adrenal tumour and elevated CgA level. Adrenalectomy did not confirm...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0028-1109174
更新日期:2009-07-01 00:00:00
abstract::Approximately one third of all patients with Crohn's disease and ulcerative colitis suffer from extra-intestinal manifestations of their inflammatory bowel disease. Most commonly those symptoms occur simultaneously with the CED symptoms; they can, however, either precede them or appear later on in the course of the di...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2002-23621
更新日期:2002-04-01 00:00:00
abstract::The mechanism of the diarrheogenic effect of bile acids and fatty acids is incompletely understood. In order to study their effects on motility we tested sodium deoxycholate and sodium ricinoleate in their actions on the spontaneous mechanical and myoelectrical activity of the isolated circular muscle of the cat colon...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract::Endoscopic retrieval of proximally migrated biliary stents is sometimes challenging. We report on the successful use of a three-prong colon polyp retrieval device in a two year old child. ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0034-1366050
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:Gallstones are rarely mentioned in the medical texts of antiquity. The physician, Alexander of Tralles mentions-for the first time-stones in the gallbladder as a possible cause for obstructive jaundice. This designation is found in his textbook on medicine under the heading "obstruction of the liver". Base...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 历史文章,杂志文章
doi:10.1055/s-0043-120349
更新日期:2018-03-01 00:00:00
abstract::The effects of surgical and chemical sympathectomy on various gastric functions was studied in rats. From the results it is concluded that the sympatho-adrenal system inhibits gastric acid secretion and mucosal blood flow. The regulation of pepsin secretion by the sympathetic nervous system appears controversial: unde...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract::Indication and significance of roentgenological procedures referring to esophageal and gastric motility are discussed with special reference to a number of functional disorders. Cinematography and tape-recording are necessary for fast peristaltic motion as in vascular, neurological and myogenic diseases of the upper e...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract::In a 16 years old girl we found the syndrome of exsudative enteropathy with intestinal lymphangiectasy which differs from previous reported cases by several malformations of the lymphatic system. Besides changes in the intestinal lymphatics there was a retroperitoneal lymphangiodysplasia, a reduction and hypoplasia of...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1976-12-01 00:00:00
abstract::Iatrogenic perforation of the upper gastrointestinal tract is one of the most serious complications of upper gastrointestinal endoscopy, with high rates of morbidity and mortality. Treatment is challenging because stent placement or surgical repair of the perforation in this area is often impossible. We report on two ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0033-1356441
更新日期:2014-03-01 00:00:00
abstract::Introduction and aims High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0042-121267
更新日期:2017-02-01 00:00:00
abstract::Foreign bodies as a nucleus for precipitation of gall-stones are not frequently observed. The combination of primary immigrated foreign bodies into the bile ducts and following encasing by a gall-stone could be even more rarely found. A case report is presented concerning a patient, in whom a hemo-clip was fixed away ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::We have applied the ion sensitive analysis of hydrogen (H2) in expired air in intervals of five minutes for five hours to determine carbohydrate malabsorption. In 19 patients with lactose malabsorption the increase in hydrogen was prior (45, SE 13 min) to healthy volunteers (142, SD 71 min, p less than 0.01). In compa...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::On the basis of 3 of our own cases, we describe unusually intense forms of filiform polyposis and local giant polyposis as a consequence of chronic inflammatory bowel disease. The patients are: A 52-year-old woman who for 7 years has been known to have Crohn's disease (CD); a 55-year-old man who for 14 years has been ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2000-9994
更新日期:2000-10-01 00:00:00
abstract::Herbal drugs are widely used and often contain highly active pharmacological compounds. Recently, reports have mounted about hepatotoxicity of herbal remedies which ranges from mild liver enzyme alterations to chronic liver disease and liver failure. Hepatotoxicity of Chinese herbs has been recognized, e.g. during tre...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2001-11772
更新日期:2001-03-01 00:00:00
abstract::The oesophagus, stomach and pancreas are primary target organs for ethanol-related diseases. In the oesophagus and stomach, ethanol induces motility disorders and mucosal lesions that are dose-dependent and reversible under acute conditions. Chronic consumption of alcohol causes a significant increase in the risk for ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2005-858257
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Today, endoscopic resection is a standard procedure for the resection of colonic polyps. Before the establishment of endoscopic techniques, the surgical approach was a clearly preferred method for removal of polyps with a size larger than three centimeters. The safety and effectiveness concerning endoscopic ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0028-1109971
更新日期:2010-07-01 00:00:00
abstract::Since 1977, 15 patients have undergone surgery for Zenker's diverticula at the University of Würzburg Department of Surgery. We were able to follow up 6 of them after an average of 4 years (5 months to 10.5 years). Preoperative manometric findings available on one patient revealed markedly impaired coordination betwee...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::For decades, methylene blue has been used in gastrointestinal endoscopy as an absorbing dye, it was, however, not approved for that purpose and has now been withdrawn from the market. A possible substitute is toluidine blue, an acidophilic, metachromatic dye that selectively stains cell nuclei; accordingly, since 2007...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0028-1110032
更新日期:2010-09-01 00:00:00
abstract::In a prospective study patients with bleeding from acute gastric mucosal lesions were treated by i.v. infusions of secretin. 67 patients received natural secretin (Karolinska-Institut Stockholm), 14 patients received synthetic secretin (Firma Hoechst Frankfurt). In 64 of the 67 patients (95%) who received natural secr...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1980-06-01 00:00:00
abstract::An improved technique was developed to measure intracellular pH-changes in in vitro duodenal mucosa. A confocal laserscan microscope was equipped with a second laser to permit dual wavelength excitation measurements employing BCECF (2'7'-bis-2-carboxyethyl-5-(and-6)carboxyfluorescein), a pH-sensitive fluorescent dye. ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract::Patients with portal hypertension may develop pulmonary complications such as hepatopulmonary syndrome (HPS) or portopulmonary hypertension (PPHT). PPHT is defined as elevated pulmonary pressure, elevated pulmonary vascular resistance, a normal pulmonary capillary wedge pressure, and portal hypertension in the absence...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2005-857926
更新日期:2005-07-01 00:00:00
abstract::Biopsy diagnosis of early and highly differentiated liver tumors is difficult and complex. Modern pathology has met this challenge by several different means; elaborate morphological algorithms and novel immunohistological markers support the differential diagnosis of highly differentiated HCC and a new, predictive mo...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1109088
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Living conditions (e. g. domestic crowding) may influence the infection rate. Some studies suggested that the reappearance of H. pylori in H. pylori positive patients after successful eradication therapy might be a result of transmission by H. pylori positive spouses. Therefore this study has been performe...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2002-32128
更新日期:2002-06-01 00:00:00
abstract::During the last years the per-capita-consumption of pure alcohol in the Federal Republic of Germany is slightly decreasing. In 1986 every person consumed an average of 11.5 litres of pure alcohol (146.4 litres of beer, 23.3 litres of wine and 6.1 litres of spirits). The amount of the alcohol addicts must be estimated ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract::This study evaluates the prevalence and significance of Helicobacter pylori (H. Pylori) infection in patients with portal hypertension. 118 patients were selected, i. e. 90 patients with portal hypertension (66 males, 24 females, mean age 49.1 +/- 2.1 years) and 28 noncirrhotic patients with nonulcerative dyspepsia as...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::Common causes of chronically elevated serum liver enzymes include fatty liver disease, chronic viral hepatitis, autoimmune hepatitis, or hereditary metabolic disorders. Adrenocortical insufficiency can also cause elevated liver enzymes. Since 1990 only 11 cases have been reported. We here report a 52-year-old man with...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2005-858976
更新日期:2006-02-01 00:00:00
abstract::The following publication is an overview looking at diagnostic and therapeutic possibilities related to interventional procedures for diseases of the pancreas. We emphasize the description of the technique and show meaningful indications and limitations. ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2000-10302
更新日期:2000-11-01 00:00:00
abstract::Irritable bowel syndrome is frequently encountered in clinical practice, and it has been repeatedly suggested that abnormal colonic motor activity is one of the major pathophysiological mechanisms responsible for the origin of symptoms in such disorder. If this statement is true, then high-amplitude propagated colonic...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::The retention of 75Se-homotaurocholic acid (75SeHCAT) was measured in 12 healthy controls and in 21 patients with Crohn's disease and compared with the maximum postprandial rise in the serum concentration of cholylglycine (CG) in order to detect bile acid malabsorption. The retention of 75SeHCAT was lowered in all pat...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00