Annika Hampel1, Philipp Solbach2,3, Markus Cornberg2,3, Reinhold E Schmidt4,3, Georg M N Behrens4,3, Alexandra Jablonka5,6. 1. Klinik für Anästhesie, Notfallmedizin, Operative Intensivmedizin und Schmerztherapie, Klinikum Wolfsburg, Wolfsburg, Deutschland. 2. Klinik für Gastroenterologie, Hepatologie, Endokrinologie, Medizinische Hochschule Hannover, Hannover, Deutschland. 3. Standort Hannover-Braunschweig, Deutsches Zentrum für Infektionsforschung (DZIF), Braunschweig, Deutschland. 4. Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. 5. Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. jablonka.alexandra@mh-hannover.de. 6. Standort Hannover-Braunschweig, Deutsches Zentrum für Infektionsforschung (DZIF), Braunschweig, Deutschland. jablonka.alexandra@mh-hannover.de.
Abstract
BACKGROUND: Currently only vague estimates exist for the seroprevalence and vaccination status for viral hepatitis B (HBV) in refugees arriving in Germany during the current refugee crisis. OBJECTIVES: To assess the prevalence of hepatitis B in refugees arriving in northern Germany in 2015. METHODS: In a cross-sectional study in 793 patients from all age groups tests for serological markers of hepatitis B virus infection (HBsAg, anti-HBc) and liver enzymes (ALT, AST, bilirubin, γGT, alkaline phosphatase) were performed in August 2015 at six reception centers in northern Germany. In 258 patients anti-HBs antibodies were assessed additionally. RESULTS: Of the tested refugees, 76.7 % were male, the median age was 28.8 ± 11.4 years, and 7.8 % were children under the age of 18. The overall prevalence of HBsAg and total anti-HBc was 2.3 % and 14.0 % respectively (2.5 % and 14.5 % in men; 1.2 % and 13.5 % in women). Prevalence was highest in 35 to 49-year-old patients for HBsAg (3.1 %) and for refugees over 50 years for anti-HBc (38 %). No immunity to Hepatitis B was found in 62 %, 18.6 % had been vaccinated against Hepatitis B, while 50 % of children aged up to 15 years (n = 12) had been vaccinated. Positive predictive values of elevated AST and ALT for detection of HBsAg was 0 and 0.016, respectively. Only two patients with a positive HBsAg had elevated transaminases. CONCLUSIONS: This study showed a high prevalence of HBsAg in a German refugee sample in comparison to the general German population. Liver enzymes are not an appropriate tool for screening for hepatitis B virus infection.
BACKGROUND: Currently only vague estimates exist for the seroprevalence and vaccination status for viral hepatitis B (HBV) in refugees arriving in Germany during the current refugee crisis. OBJECTIVES: To assess the prevalence of hepatitis B in refugees arriving in northern Germany in 2015. METHODS: In a cross-sectional study in 793 patients from all age groups tests for serological markers of hepatitis B virus infection (HBsAg, anti-HBc) and liver enzymes (ALT, AST, bilirubin, γGT, alkaline phosphatase) were performed in August 2015 at six reception centers in northern Germany. In 258 patients anti-HBs antibodies were assessed additionally. RESULTS: Of the tested refugees, 76.7 % were male, the median age was 28.8 ± 11.4 years, and 7.8 % were children under the age of 18. The overall prevalence of HBsAg and total anti-HBc was 2.3 % and 14.0 % respectively (2.5 % and 14.5 % in men; 1.2 % and 13.5 % in women). Prevalence was highest in 35 to 49-year-old patients for HBsAg (3.1 %) and for refugees over 50 years for anti-HBc (38 %). No immunity to Hepatitis B was found in 62 %, 18.6 % had been vaccinated against Hepatitis B, while 50 % of children aged up to 15 years (n = 12) had been vaccinated. Positive predictive values of elevated AST and ALT for detection of HBsAg was 0 and 0.016, respectively. Only two patients with a positive HBsAg had elevated transaminases. CONCLUSIONS: This study showed a high prevalence of HBsAg in a German refugee sample in comparison to the general German population. Liver enzymes are not an appropriate tool for screening for hepatitis B virus infection.
Authors: Apostolos Koffas; Manoj Kumar; Upkar S Gill; Ankur Jindal; Patrick T F Kennedy; S K Sarin Journal: Hepatol Int Date: 2021-02-27 Impact factor: 6.047
Authors: A Jablonka; P Solbach; C Happle; A Hampel; R E Schmidt; G M N Behrens Journal: Med Klin Intensivmed Notfmed Date: 2016-07-25 Impact factor: 0.840
Authors: Alexandra Jablonka; Georg M N Behrens; Marcus Stange; Christian Dopfer; Ulrike Grote; Gesine Hansen; Reinhold Ernst Schmidt; Christine Happle Journal: Infection Date: 2016-08-19 Impact factor: 3.553
Authors: Ida Sperle; Gyde Steffen; Siv Aina Leendertz; Navina Sarma; Sandra Beermann; Roma Thamm; Yanita Simeonova; Markus Cornberg; Heiner Wedemeyer; Viviane Bremer; Ruth Zimmermann; Sandra Dudareva Journal: Front Public Health Date: 2020-08-28
Authors: Hyung Joon Yim; Won Kim; Sang Hoon Ahn; Jin Mo Yang; Jae Young Jang; Yong Oh Kweon; Yong Kyun Cho; Yoon Jun Kim; Gun Young Hong; Dong Joon Kim; Young Kul Jung; Soon Ho Um; Joo Hyun Sohn; Jin Woo Lee; Sung Jae Park; Byung Seok Lee; Ju Hyun Kim; Hong Soo Kim; Seung Kew Yoon; Moon Young Kim; Kwan Sik Lee; Young Suk Lim; Wan Sik Lee; Kwang-Hyub Han Journal: Am J Gastroenterol Date: 2020-08 Impact factor: 12.045
Authors: Christian Dopfer; Annabelle Vakilzadeh; Christine Happle; Evelyn Kleinert; Frank Müller; Diana Ernst; Reinhold E Schmidt; Georg M N Behrens; Sonja Merkesdal; Martin Wetzke; Alexandra Jablonka Journal: Int J Environ Res Public Health Date: 2018-09-05 Impact factor: 3.390
Authors: Masayoshi Harigai; Kevin Winthrop; Tsutomu Takeuchi; Tsu-Yi Hsieh; Yi-Ming Chen; Josef S Smolen; Gerd Burmester; Chad Walls; Wen-Shuo Wu; Christina Dickson; Ran Liao; Mark C Genovese Journal: RMD Open Date: 2020-02