Background and objective: Germany is one of the low endemic areas for hepatitis B. There are 7.3 million foreign citizens and 3.2 million migrants from the former USSR and Eastern Europe with German roots, the "Resettlers" (Aussiedler), who migrated to Germany mostly from countries with moderate or high HBsAg prevalence. The aim of this study was to determine the HBsAg prevalence in adult foreign citizens and resettlers compared with that among the adult German population. Methods: Adult foreign citizens and resettlers were categorized according to their country of origin into groups with low, intermediate or high HBsAg prevalence, using data from the WHO. Statistics of the Federal Office for Statistics, the Federal Office for Administration and the Federal Ministry of the Interior were used for the demographic analysis. The number of chronic HBsAg carriers for the different population groups and the whole population was then calculated. Results: 84% of the adult migrant population in Germany migrated from countries with intermediate and high HBsAg endemicity. For 2003 we calculated 503 040 HBsAg carriers in Germany. 42% of these have a migratory background, even though migrants represent only 12.7% of the whole population. The risk for chronic infection with HBsAg is 7.1 (4.8 - 13.2) for the resettlers and is 4.3 (3.0 - 8.1) times higher for foreign citizens than for the German population. Conclusions: These remarkable differences in prevalence make it important that migrants and their close contacts be vaccinated properly, pregnant women be included in screening programs and cases of chronic hepatitis B be treated adequately.

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