Up to a million infected why hepatitis is no longer just a junkie disease focus onli

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dpa/Bodo Marks Vial with vaccine against hepatitis A and B: Up to one million people in Germany are infected with hepatitis viruses – but only very few know about it.

Hepatitis is still considered a disease of drug addicts, yet it is widespread. Promising drugs are now available against the insidious type C virus. One problem, however, is the cost.

It is a silent epidemic: up to one million people in Germany are infected with hepatitis viruses, but very few of them know about it. Only one-third of those affected develop the typical jaundice, one-third only notice flu symptoms, another third nothing at all.

Deadly late effects

But chronic viral hepatitis can lead to late complications such as liver cirrhosis and liver cancer, which can be fatal. Three years ago, the World Health Organization therefore established World Hepatitis Day (28. July) was introduced to raise awareness of the threat.

Members of at-risk groups should get tested

Liver specialist Michael Manns of the Hannover Medical School (MHH) appeals to high-risk groups such as drug addicts, migrants from certain countries, and medical personnel to get tested. The same is true for people who received or had frequent surgeries before 1991. Manns estimates that only ten to 20 percent of hepatitis B and C cases are currently diagnosed. "Elevated liver values are often considered a trivial offense, but they need to be clarified," says the gastroenterologist.

New treatment options replace liver transplants

While patients with chronic hepatitis B have to take medication for the rest of their lives, similar to HIV-infected patients, a complete cure is possible in the case of chronic hepatitis C. Since the beginning of the year, two new active ingredients have been on the market that help a larger group of patients and have far fewer side effects than the previous standard therapy. MHH physicians were involved in approval studies for the new agents. For Manns, it is an "incredible, rare medical success story" that the infectious disease can now be cured in almost 90 percent of cases. This would make about a quarter of all liver transplants avoidable in the future.

Since the beginning of the year, many hepatitis C patients have contacted Deutsche Leberhilfe in the hope of receiving the new drugs. "It's a treatment revolution," says self-help organization spokesman Ingo van Thiel. "However, drug costs are still a major obstacle." A 24-week therapy currently costs around 120.000 euros to.

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Patient care in Germany is lagging behind

The Joint Federal Committee, the highest decision-making body in the German healthcare system, recently voted by a narrow majority to grant the new active ingredient sofosbuvir slightly more additional benefit over the older drugs than the hesitant health insurance companies originally wanted to do.

According to studies, Germany is a leader in hepatitis research, but it has a lot of catching up to do when it comes to patient care. A year ago, an alliance of physicians and affected persons' associations submitted a national action plan to the federal government. "Neither the systematic examination of risk groups nor a check of liver values during preventive medical checkups are standard in this country," criticizes van Thiel.

Prominent victims could help with social education

A national action plan could have the side effect of reducing prejudice. "Liver diseases as a whole have a muckraking image. Are equated with "alcohol sick. This is one of the major obstacles why these diseases are not recognized and treated more frequently," believes Manns, who co-founded the German Liver Foundation. The organization is still looking for a known representative. Unlike breast cancer, says the liver expert, there is no celebrity with hepatitis C in Germany who has come out of the closet so far.

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