Therapy
The therapy of the individual hepatitides is very different (see subchapter on hepatits). The most important thing in therapy is the elimination of the cause responsible for the hepatitis. In the case of alcoholic hepatitis, this means absolute abstinence from alcohol.The toxin must also be avoided in the case of drugs and other toxic hepatitides.
Antiviral therapy is possible for some viral hepatitis. Autoimmune liver inflammation is treated with immunosuppressive drugs (drugs that suppress the immune system). In cases of fulminant liver failure, congenital hepatitides and chronic hepatitides that have progressed to liver cirrhosis, often only liver transplantation is possible as a last resort.
The therapeutic options are constantly developing and in recent years have achieved a positive prognosis for patients, especially those infected with hepatitis C. New drugs have led to a cure rate of over 90%, which is a drastic improvement over the past. Hepatitis B-infected people get chronic hepatitis in about 30% of cases and are at risk of developing cirrhosis in a fifth of cases. On the other hand, hepatitis B-infected persons are very likely to heal themselves, so that often no direct therapy against the virus is recommended unless a serious course of the disease is evident. An infection with hepatitis A is generally considered to be non-chronic, so that a cure is very likely. Nevertheless, immunocompromised persons, for example, can experience a fulminant course of the disease, which can be life-threatening.
What vaccinations are available against hepatitis?
Currently, vaccinations against Hepatitis A and Hepatitis B are available, as well as combination vaccines of both. These are dead vaccines consisting of portions of dead pathogens or complete dead pathogens. Vaccination for basic immunization against hepatitis B is recommended by the Standing Vaccination Commission (STIKO) from the second month of life.
Vaccination against hepatitis A is recommended only for persons at risk who are in risk areas, as well as for medical personnel, people working in the food industry or as sewer workers. Vaccinations against hepatitis C or E are not available. Hepatitis D infection is only possible in combination with hepatitis B infection, so you have sufficient protection if hepatitis B immunity is present.
As mentioned above, the STIKO has issued a recommendation for vaccination against hepatitis A for persons at risk. This includes travellers in subtropical or tropical countries with high rates of hepatitis A infection. The vaccination consists of two injections at intervals of 6-12 months.
The vaccination protection lasts for at least ten years, but can also be checked at any time by a blood test. After ten years or insufficient vaccination protection, a booster can be given. As already mentioned, the hepatitis B vaccination is recommended by the STIKO from the second month of life and is given in combination with other vaccinations.
These are administered once in the second, once in the third and once in the fourth month of life as a 6-fold vaccination. Between the eleventh and fourteenth month, the last injection of the 6-fold vaccine necessary for basic immunization is administered. The success of the vaccination is then checked four to eight weeks after the last dose of the basic immunization.
If the values are sufficiently good, no booster is usually necessary. As with any medication, each vaccination can cause different side effects. Basically, the vaccinations against hepatitis A and hepatitis B are deadly vaccinations and are not contagious in their nature.
In general it can be said that headaches, dullness, pain and redness at the injection site can occur very frequently. This should not usually last longer than three days. Very common here means that one or more than one in ten vaccinated persons can express these symptoms.
Furthermore, diarrhoea or nausea may occur frequently, i.e. one in ten vaccinated persons. Swelling, bruising or itching at the injection site are also common. One in one hundred vaccinated persons may also develop dizziness, vomiting and abdominal pain or a slight infection of the upper respiratory tract with fever above 37.5°C.
There are also a number of other side effects, but these occur only rarely or very rarely. The manufacturers of these vaccines list these side effects in the package insert, which were found in large-scale studies. Of course, this does not mean that side effects must occur.After a vaccination, a blood test can be used to check the success of an acquired immunity against a certain disease.
For this purpose, one uses the so-called titer determination in which one determines how many effective antibodies are dissolved in the blood serum, which are just sufficient to be effective against the virus. Through the vaccinations, in this case possible against hepatitis A and B, the body produces so-called antibodies. These antibodies can dock to the virus when it comes into contact with it, thus marking it so that other cells of the immune system can then render it harmless.
The STIKO (Permanent Vaccination Commission of the Robert Koch Institute), for example, recommends vaccination against hepatitis B from the second month of life after birth in a 6-fold vaccination. After the basic immunization is completed after 4 doses and about one year, the immunity is then checked with a titer determination. This is necessary because experience has shown that there are people who react less strongly with the production of the above mentioned antibodies. In these cases, a further vaccination is necessary.
