Epidemiologie der chronischen Hepatitis C in Deutschland

Abstract

D Background and Purpose: Little is known about the epidemiology of hepatitis C in Germany and in particular about the route of infection. The current study prospectively analyzed epidemiologic and clinical data of patients with chronic hepatitis C virus (HCV) infection. D Methods: A structured questionnaire was sent to primary care physicians in Germany. Of 13,287 questionnaires, 5,837 were sent back for analysis. D Results: Although the number of questionnaires sent out was proportional to the number of subjects living in the new and old states of Germany, only 9% were sent back from the new states; thus, the prevalence of hepatitis C is probably considerably lower in the new states compared with the old ones. The HCV-infected subjects originated from 92 different countries throughout the world: 63% were born in Germany, but 21% were from one of the former states of the USSR. Intravenous drug abuse was the most prevalent risk noted; there was a strong bias whereby physicians who cared for a large number of HCV-infected patients had a much higher proportion of subjects with i.v. drug abuse when compared to those who only cared for a few hepatitis C patients. In the latter group a history of infusion of blood products was approximately as frequent as a history of drug abuse. There was a high proportion of patients who had no risk factor for hepatitis C (25-42%). Fatigue was the most frequent symptom (nearly 60%), followed by loss of concentration and abdominal pain. The number of symptoms increased with a higher aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio and thus presumably with the stage of liver fibrosis. D Conclusion: Hepatitis C should be excluded in all patients with elevated liver enzymes. In risk groups with a high prevalence of hepatitis C, the infection should be looked for even when liver enzymes are normal.