title: High prevalence of anti-HCV antibodies in two metropolitan emergency departments in Germany: a prospective screening analysis of 28,809 patients.
abstract: OBJECTIVE
  The prevalence of hepatitis C virus (HCV) antibodies in Germany has been estimated to be in the range of 0.4-0.63%. Screening for HCV is recommended in patients with elevated ALT levels or significant risk factors for HCV transmission only. However, 15-30% of patients report no risk factors and ALT levels can be normal in up to 20-30% of patients with chronic HCV infection. The aim of this study was to assess the HCV seroprevalence in patients visiting two tertiary care emergency departments in Berlin and Frankfurt, respectively.
  
  
  METHODS
  Between May 2008 and March 2010, a total of 28,809 consecutive patients were screened for the presence of anti-HCV antibodies. Anti-HCV positive sera were subsequently tested for HCV-RNA.
  
  
  RESULTS
  The overall HCV seroprevalence was 2.6% (95% CI: 2.4-2.8; 2.4% in Berlin and 3.5% in Frankfurt). HCV-RNA was detectable in 68% of anti-HCV positive cases. Thus, the prevalence of chronic HCV infection in the overall study population was 1.6% (95% CI 1.5-1.8). The most commonly reported risk factor was former/current injection drug use (IDU; 31.2%) and those with IDU as the main risk factor were significantly younger than patients without IDU (p<0.001) and the male-to-female ratio was 72% (121 vs. 46 patients; p<0.001). Finally, 18.8% of contacted HCV-RNA positive patients had not been diagnosed previously.
  
  
  CONCLUSIONS
  The HCV seroprevalence was more than four times higher compared to current estimates and almost one fifth of contacted HCV-RNA positive patients had not been diagnosed previously.
authors: Medizinische Klinik 1, Klinikum der J. W. Goethe-Universität, Frankfurt am Main, Germany. Johannes.Vermehren@kgu.de
authors: Johannes
authors: J
authors: Vermehren
authors: Beate
authors: B
authors: Schlosser
authors: Diana
authors: D
authors: Domke
authors: Sandra
authors: S
authors: Elanjimattom
authors: Christian
authors: C
authors: Müller
authors: Gudrun
authors: G
authors: Hintereder
authors: Karin
authors: K
authors: Hensel-Wiegel
authors: Rudolf
authors: R
authors: Tauber
authors: Annemarie
authors: A
authors: Berger
authors: Norbert
authors: N
authors: Haas
authors: Felix
authors: F
authors: Walcher
authors: Martin
authors: M
authors: Möckel
authors: Ralf
authors: R
authors: Lehmann
authors: Stefan
authors: S
authors: Zeuzem
authors: Christoph
authors: C
authors: Sarrazin
authors: Thomas
authors: T
authors: Berg
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D005858:Germany; D016174:Hepacivirus; D006526:Hepatitis C / Q000097:blood* / Q000453:epidemiology* / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D016036:Seroepidemiologic Studies
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral