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Objective:  Alveolar echinococcosis (AE) is a rare disease in Austria, Switzerland and Germany (DACh) caused by an infection with the parasite Echinococcus multilocularis. The aim of the study was to describe differences in the detection and reporting systems of alveolar echinococcosis in Austria, Switzerland and Germany and to describe epidemiological trends., Methodology:  As part of an epidemiological update on 6 th September 2019 in Ulm, Germany, experts and representatives discussed differences in the reporting and recording systems as well as the current epidemiological situation., Results:  Since 2004, Austria has had an obligation to report suspected cases, diseases and deaths of alveolar echinococcosis by name in accordance with §1 Para. 1 of the Epidemiegesetz 1950 (EpidemieG) and the Ordinance on Notifiable Communicable Diseases. According to §7 Para. 3 of the German Infection Protection Act (IfSG), Germany has also been subject to a reporting obligation since 2001, but not by name. In addition, national registers are available in both countries, which can be used to answer scientific questions. In Switzerland, there is no obligation to report human alveolar echinococcosis since 1997. Efforts are currently being made to implement a national register for alveolar echinococcosis in Switzerland. Despite different reporting and recording systems, a similar epidemiological trend can be observed for DACh., Conclusions:  In Austria, Switzerland and Germany there is a slightly increasing trend of human cases with alveolar echinococcosis. The direct comparability is limited due to different reporting obligations. The structures often do not allow a joint answering of scientific questions concerning diagnostics, treatment and care., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenskonflikt besteht., (Thieme. All rights reserved.)

Treatment of hepatitis C is approaching a revolution. During the last years, many agents have been developed that directly interfere with the viral replication cycle. Therapy of hepatitis C will no longer need Interferon in the future. The new therapies will be shorter, more efficient and with fewer side effects. For patients, the burden of treatment will drop substantially. Even patients are traditionally classified who as "difficult to treat", such as cirrhotic patients, HIV/hepatitis C coinfected patients and patients after liver transplantation will have better chances of cure. For more patients to benefit from the new therapies, identification of infected individuals and diagnostic investigations have to be improved.

Blood analysis for the purpose of monitoring liver enzymes in the serum is a frequent laboratory examination in everyday clinical practice. Liver values are determined not only in the context of specific liver diseases, but often for the clarification of an unexplained illness, and sometimes in asymptomatic patients as part of a check-up. An evidenced based work-up of abnormal liver values is not easy to perform as there are no controlled clinical trials, on which we can rely for the rational use of further investigations. In the first introductory section of this article we will discuss possible algorithms used for the investigation of elevated liver tests, in the second section, four case reports from daily practice illustrate possible causes for elevated liver enzymes.

Liver transplantation is the only curative therapy for many liver diseases, mostly chronic liver diseases, occasionally also in acute or fulminant liver failure. Currently, about 100 liver transplantatations are performed each year in Switzerland. Clichy criteria are used for acute liver failure. Liver transplantation for liver cirrhosis improves survival if the Meld-Score is above 15. 5- and 10-year-survival after liver transplantation are 71% and 61%, respectively. With increasing survival after liver transplantation, the management of drug side effects in the late postoperative course becomes important.