Epidemiology of hepatitis B in Germany].

Little is known about the epidemiology of chronic hepatitis B virus (HBV) infection in Germany. The present study analyzes demographic, socioeconomic and virologic data of a cohort of German HBV-infected patients. As a project of the Hepatitis Competence Network, 250 outpatients with chronic HBV infection were included during the last 5 years. Mean age was 40.5+/-14.6 years; 63.2% were men. HBV-DNA was negative by polymerase chain reaction in 12.8%; alanine aminotransferase ALT) was normal in 56.3%; even at DNA levels>1 million copies/ml ALT was normal in 38% ("immunotolerance"). About one third of patients were born in Germany, Turkey or one of 34 other countries. The unemployment rate in migrants from Turkey and other countries was more than three times the rate of subjects born in Germany; this difference, however, is the same in non-HBV-infected subjects. In the total cohort HBeAg-negative subjects were more frequent than HBeAg-positive subjects (66.4% vs. 33.6%). About 40% of patients with a liver biopsy had significant fibrosis (F2-4). Multivariate regression showed that significant fibrosis was associated only with age and ALT, but not with HBV-DNA or other variables. 38.4% of subjects had antiviral therapy; the rate of therapy increased with increasing DNA and ALT. The majority of treated patients received lamivudine (58%), adefovir (31%), or both (5%). Only 3% each received interferon or other antivirals. The present cohort study shows that about two thirds of HBV-infected subjects who live in the Ruhrgebiet originate from migrants many of whom have significant economic problems. Special programs should be designed for migrants in order to detect HBV infection and to inform infected subjects about their individual and infectious risks.

Citation

Claus Niederau. Epidemiology of hepatitis B in Germany]. Medizinische Klinik (Munich, Germany : 1983). 2007 May 15;102(5):351-7

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PMID: 17497085

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