title: Hepatitis delta: on soft paws across Germany.
abstract: BACKGROUND
  Globally, more than 350 million people are considered to be chronic carriers of the hepatitis B virus (HBV) infection; thereof, 15-20 million of these individuals are thought to be coinfected with hepatitis delta virus (HDV). The clinical course depends on the mode of transmission; whereas coinfection commonly resolves, superinfection aggravates the disease and progresses to chronicity in over 90 % of the cases, which, again, results in cirrhosis.
  
  
  OBJECTIVE
  Although many tests are performed in HBV carriers, data on the prevalence of anti-HDV-IgG in Germany are only rarely available and outdated. Therefore, we retrospectively evaluated the seroprevalence of anti-HDV-IgG from the results of our routine service.
  
  
  METHODS
  Between January 2000 and October 2011, serum samples from 2,844 patients (carrying hepatitis B surface antigen) admitted to University Hospital Frankfurt am Main, Frankfurt, Germany, were tested for anti-HDV-IgG by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  The overall seroprevalence of anti-HDV-IgG in the collective of Frankfurt (n = 2,844) is 7.4 % [95 % confidence interval (CI): 6.4-8.4]. The amount of seropositive men (8.3 %, 95 % CI: 6.9-10) significantly exceeds the female proportion (5.7 %, 95 % CI: 4.3-7.5). The rate of seropositivity to anti-HDV-IgG in this collective of Frankfurt reached a maximum in the year 2003 (10.1 %, 95 % CI: 8.9-11.1). The lowest rate was observable in 2004, where 5.4 % were positive to anti-HDV-IgG.
  
  
  CONCLUSIONS
  Of the HBV carriers in Germany, 5-8 % reveal serologic evidence of coinfection with HDV. The vaccination against HBV is the key to prevent HDV infection; therefore, vaccination must strongly be propagated further on.
authors: Institute of Medical Virology, Hospital of the Johann Wolfgang Goethe University, 60596, Frankfurt am Main, Germany. claudia.reinheimer@kgu.de
authors: C
authors: C
authors: Reinheimer
authors: H W
authors: HW
authors: Doerr
authors: A
authors: A
authors: Berger
mesh_terms: D060085:Coinfection / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005858:Germany / Q000453:epidemiology; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D003699:Hepatitis D / Q000150:complications / Q000276:immunology; D003698:Hepatitis Delta Virus / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies
chemical_list: D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D007074:Immunoglobulin G