High prevalence of chronic hepatitis B and C virus infection in a population of a German metropolitan area: a prospective survey including 10 215 patients of an interdisciplinary emergency unit

Eur J Gastroenterol Hepatol. 2016 Nov;28(11):1246-52. doi: 10.1097/MEG.0000000000000702.

Abstract

Purpose: The prevalence of chronic hepatitis B virus- and hepatitis C virus-infections in the general German population has been estimated to be 0.6-0.7 and 0.3-0.4%, respectively. The population of Frankfurt/Main is multicultural and marked by different risks of chronic viral hepatitis. The aim of this prospective study was to define epidemiologic data for hepatitis B and C from consecutive patients of an interdisciplinary emergency unit in Frankfurt.

Patients and methods: Over a period of 12 months, 10 215 patients of an interdisciplinary emergency unit in Frankfurt/Main were screened for hepatitis B surface-antigen (HBsAg) and hepatitis C virus-antibodies (HCV-Ab). In case of positive HBsAg or HCV-Ab, a quantitative PCR analysis of virus was carried out.

Results: The prevalence of HBsAg and HCV-Ab in the study population was 1.32% (n=135; group 1) and 2.70% (n=276; group 2), respectively, with a sex ratio close to 1. Quantitative PCR tests of virus load were performed in 72.59% (group 1) and in 82.61% (group 2), with confirmed viremia in 54.08% (group 1) and 41.67% (group 2), and correlated to elevated liver enzymes in 49.05% (group 1) and in 75.78% (group 2) of the cases. The ethnic distribution was 87.09% White (n=8897; group A) versus 12.90% other ethnic groups (n=1318; group B), with a prevalence of HBsAg-positive and HCV-Ab-positive cases of 1.08 and 2.76% (group A) and 2.96 and 2.28% (group B).

Conclusion: The results show that in multicultural areas, the prevalence of chronic viral hepatitis is increased. Because of the potential of progressive liver damage in viral hepatitis, field screening in specific populations at high risk for hepatitis should be performed.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • DNA, Viral / blood
  • Emergency Service, Hospital
  • Female
  • Germany / epidemiology
  • Health Surveys
  • Hepacivirus / isolation & purification
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B virus / isolation & purification
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / epidemiology*
  • Hepatitis B, Chronic / virology
  • Hepatitis C Antibodies / blood
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / epidemiology*
  • Hepatitis C, Chronic / virology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • RNA, Viral / blood
  • Sex Distribution
  • Urban Health / statistics & numerical data
  • Viral Load
  • Young Adult

Substances

  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B Surface Antigens
  • Hepatitis C Antibodies
  • RNA, Viral