Z Gastroenterol 2013; 51 - P_5_23
DOI: 10.1055/s-0032-1332137

Individuals with migrational background showed high prevalence of hepatitis marker: A prospective screening approach in primary care centers

B Heidrich 1, A Cetindere 2, M Beyaz 2, MM Basaran 2, B Braynis 2, R Raupach 1, M Darnedde 1, B Bremer 1, MP Manns 1, H Wedemeyer 1, M Bastürk 2
  • 1Hannover Medical School, Dpt. of Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
  • 2Medical Practice, Medical Practice, Hannover/Stadthagen, Germany

Background and aims: Immigrant populations are believed to be more frequently infected with hepatitis viruses which can have important clinical consequences as access to diagnosis and therapy might be limited. However, limited unbiased data is available on the true prevalence of HBV and HCV infections in migrants outside of academic centers. Therefore, the aim of this study was to perform a large scale screening for hepatitis markers in primary care centers treating mainly individuals with migrational background in Germany. In addition, each individual was interviewed with a structured questionnaire about knowledge of viral hepatitis and prevention.

Methods: Between November 2010 and January 2012 we prospectively screened 1313 individuals treated by general practitioners in 8 primary care centers. Centers were located in Northern and Western Germany. All patients were asked to participate if they were not born in Germany or if their parents were not born in Germany. Serological screening for anti-HBc, HBsAg and anti-HCV was performed in each individual. HBsAg and anti-HCV positive patients were further tested for molecular markers of viral replication.

Results: The median age of the cohort was 47.0±15.2 years (9–87). 46% of the patients were male. 89% migrated to Germany from the Eastern Mediterranean (EM) area and 5% from Eastern Europe (EE). Anti-HBc tested positive in 32,3% of patients (EM 91% n=162, EE 4% n=7). HBsAg was found in 3.6% of patients. The majority of HBsAg+ patients was HBeAg-negative. Markers for hepatitis C virus infection were found in an almost similar high frequency (2.06%). Individuals with migrational background showed significant deficits in knowledge on the possible clinical consequences of infections with hepatitis viruses. In addition, several individuals were not aware of their viral hepatitis and the far majority did not know the possible way of infection.

Conclusions: Hepatitis virus infections are about six fold more prevalent in immigrant populations as compared with the general German population. EM patients did not only show high exposure to HBV but also to HCV. The data underline the importance of introducing screening programs in this particular risk group.