Prevalence of Hepatitis B, C, and D in Germany: Results From a Scoping Review.

Ida Sperle,Gyde Steffen,Sandra Beermann,Yanita Simeonova,Heiner Wedemeyer,Ruth Zimmermann,Roma Thamm,Siv Aina Leendertz,Sandra Dudareva,Navina Sarma,Markus Cornberg,Viviane Bremer

doi:10.3389/fpubh.2020.00424

Abstract

Background: One of the five strategic directions in the World Health Organization global health sector strategy on viral hepatitis 2016–2021 is to generate strong strategic information for focused action to understand the viral hepatitis epidemic and focus the response. Knowledge of national prevalence is a cornerstone of strategic information. Germany is considered to be a low prevalence country for viral hepatitis B, C, and D, however the prevalence is likely to be higher among at-risk groups.Methods: The aim of this work was to give a detailed overview of the prevalence of viral hepatitis B (HBsAg, anti-HBc), C (anti-HCV, HCV RNA), and D (anti-HDV, HDV RNA) in different population groups in Germany. Therefore, we analyzed the results of a comprehensive literature search on various aspects of the epidemiological situation of hepatitis B, C, and D in Germany. Eligible publications including information on hepatitis B, C, and D prevalence were extracted from the overall spreadsheet table and summarized and analyzed based on virus and different population groups. A quality appraisal was performed using a checklist developed by Hoy et al. to assess risk of bias in prevalence studies.Results: Overall, 51 publications were identified through the literature search. The overall prevalence of HBsAg in the general (and proxy) population ranged from 0.3 to 1.6%. Among at-risk groups, including clinical populations and health care workers, the HBsAg prevalence ranged from 0.2% (among rheumatic patients) to 4.5% among HIV positive patients. The overall prevalence of anti-HCV in the general (and proxy) population ranged from 0.2 to 1.9%. Among at-risk groups, including clinical populations and health care workers, the anti-HCV prevalence ranged from 0.04% (among health care workers) to 68.0% among people who inject drugs.Conclusions: The hepatitis B and C prevalence in the general population in Germany is low. Prevalence is high to very high among at-risk populations, however for some groups evidence was incomplete or missing completely. To reach the elimination goals in Germany and implement a targeted response, more research among at-risk groups is needed.

Highlights

Viral hepatitis (VH) is a major global public health concern
The aim of the overall scoping review was operationalised into 13 specific research questions to identify available evidence in the form of published literature on VH epidemiology in Germany
One of the 13 questions was “What is the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and HDV in Germany?”

Summary

Introduction

Viral hepatitis (VH) is a major global public health concern. Worldwide, an estimated number of 257 and 71 million people are chronically infected with hepatitis B virus (HBV) and hepatitis C virus (HCV), respectively [1]. The WHO global health sector strategy for VH (2016–2021) [3], the WHO European level action plan (2016) [2] and the German integrated national strategy for HIV, HBV, and HCV and other sexually transmitted diseases (2016) [4] represent steps forward in terms of elimination of VH. They shed light on the lack of comprehensive data to monitor progress and to identify where intensified efforts are needed. Germany is considered to be a low prevalence country for viral hepatitis B, C, and D, the prevalence is likely to be higher among at-risk groups

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