title: High prevalence of hepatitis markers in immigrant populations: a prospective screening approach in a real-world setting.
abstract: BACKGROUND
  Immigrant populations are believed to be more frequently infected with hepatitis viruses. However, limited unbiased data are available on immigrants outside of academic centres. Therefore, the aim of this study was to perform large-scale screening for hepatitis markers in primary care centres treating mainly individuals with a migrational background in Germany.
  
  
  METHODS
  Between November 2010 and January 2012, we prospectively screened 1313 individuals treated by general practitioners at eight primary care centres in North-western Germany. Patients were eligible if they or their parents were not born in Germany. Serological screening for hepatitis B core protein antibodies, hepatitis B surface antigens (HBsAgs), and anti-hepatitis C virus antibodies was performed in each individual. HBsAg-positive and anti-hepatitis C virus-positive patients were further tested for molecular markers of viral replication.
  
  
  RESULTS
  The mean age was 49.1±15.8 years. Of the patients, 45.7% were male; 87.3% had migrated to Germany from the Eastern Mediterranean area and 12.0% from Eastern Europe. Of the patients, 32.5% tested positive for hepatitis B core protein antibodies. HBsAgs were found in 3.6% of patients. Overall, hepatitis B virus DNA was detected in 2.2% of patients. Markers for hepatitis C virus infection were found in an almost similar high frequency (1.9%). Individuals with migrational background showed significant deficits in knowledge on general routes of transmission.
  
  
  CONCLUSIONS
  Hepatitis virus infections are indeed significantly more prevalent in immigrant populations as compared with the general German population. These data underline the importance of introducing screening programs in this particular risk group.
authors: aDepartment of Gastroenterology, Hepatology and Endocrinology bInstitute of Epidemiology, Social Medicine and Health System Research cIntegrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School dMedical Practice eGerman Center for Infection Research (DZIF), Hannover fMedical Practice, Bad Eilse gMedical Practice, Rinteln hMedical Practice, Bückeburg, Germany.
authors: Benjamin
authors: B
authors: Heidrich
authors: Ahmet
authors: A
authors: Cetindere
authors: Mustafa
authors: M
authors: Beyaz
authors: Jona T
authors: JT
authors: Stahmeyer
authors: Michael M
authors: MM
authors: Basaran
authors: Boris
authors: B
authors: Braynis
authors: Regina
authors: R
authors: Raupach
authors: Birgit
authors: B
authors: Bremer
authors: Michael P
authors: MP
authors: Manns
authors: Heiner
authors: H
authors: Wedemeyer
authors: Murat
authors: M
authors: Bastürk
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003362:Cost-Benefit Analysis; D004279:DNA, Viral / Q000097:blood; D042241:Early Diagnosis; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005260:Female; D058006:General Practice; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis* / Q000191:economics / Q000208:ethnology*; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis* / Q000191:economics / Q000208:ethnology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D012698:Serologic Tests; D012959:Socioeconomic Factors; D019562:Viral Load
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies