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. 2020 Aug 28:8:424.
doi: 10.3389/fpubh.2020.00424. eCollection 2020.

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

Ida Sperle  1   2 , Gyde Steffen  1   3 , Siv Aina Leendertz  1   3 , Navina Sarma  4 , Sandra Beermann  3   5 , Roma Thamm  3   4 , Yanita Simeonova  1 , Markus Cornberg  6   7 , Heiner Wedemeyer  6 , Viviane Bremer  1 , Ruth Zimmermann  1 , Sandra Dudareva  1
Affiliations

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

Ida Sperle et al. Front Public Health. .

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.

Keywords: epidemiology; hepatitis B; hepatitis C; hepatitis D; prevalence; scoping review.

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Figures

Figure 1
Figure 1
Study flow of study selection.
Figure 2
Figure 2
Hepatitis B prevalence in Germany by study population and marker, 2005–2017.
Figure 3
Figure 3
Hepatitis B prevalence in Germany by study population (at-risk) and marker, 2005–2017.
Figure 4
Figure 4
Hepatitis C prevalence in Germany by study population and marker, 2005–2017.
Figure 5
Figure 5
Hepatitis C prevalence in Germany by study population (at-risk) and marker, 2005–2017.
See this image and copyright information in PMC

References

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    1. WHO Regional Office for Europe Action Plan for the Health Sector Response to Viral Hepatitis in the WHO European Region. Denmark: WHO Regional Office for Europe; (2016). p. 36.
    1. World Health Organization Global Health Sector Strategy on Viral Hepatitis 2016–2021. Geneva: (2016)
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