title: HBsAg and anti-HCV screening in elderly hospitalized patients of a German tertiary referral centre.
abstract: BACKGROUND
  Elderly patients are under-represented in hepatitis B and C screening approaches, but may be at increased risk for advanced liver disease. We therefore screened a hospitalized elderly population.
  
  
  METHODS
  6011 admissions to the department of internal medicine and neurology within one year were screened for HBsAg and anti-HCV (Elecsys(®)-HBsAg and -anti-HCV). Positive anti-HCV results were confirmed with the INNO-LIA™ assay. HCV-RNA was analyzed by real-time PCR in the case of confirmed positive anti-HCV results, HBV-DNA in the confirmed HBsAg positive individuals.
  
  
  RESULTS
  Patient´s mean age (62.4 years) was 19 years above that of the average German population. The confirmed HBsAg prevalence was 0.6 %. 34 % (n = 12/35) of HBsAg positive cases were newly diagnosed, three of them presented with HBV-DNA levels > 2000 IU/mL. The confirmed anti-HCV prevalence was 0.9 %. 14 % (n = 8/56) of anti-HCV positive patients were previously undiagnosed. HCV-RNA was positive in three of them. In newly diagnosed individuals cirrhosis was present in 1/12 of the HBsAg and in 3/8 of the anti-HCV positive individuals. Compared to non-infected controls, the following risk factors were significantly more frequent in infected patients: (i) HBsAg: sexual exposure (20 % vs. 2 %), blood transfusion before 1992 (13 % vs. 6 %), referrals from nursing homes (10 % vs. 1 %). (ii) Anti-HCV: blood transfusion before 1992 (41 % vs. 6 %), IVDU (25 % vs. 0.5 %), organ transplantation (20 % vs. 5 %), hemodialysis (11 % vs. 3 %).
  
  
  CONCLUSIONS
  HBsAg and anti-HCV were underdiagnosed in a senescent population, however, only few cases presented with advanced liver disease. Referrals from nursing homes were at increased risk for HBV infection.
authors.affiliation: Department of Internal Medicine, Dermatology, and Neurology, Clinic of Gastroenterology and Rheumatology, Section of Hepatology, University of Leipzig, Leipzig, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kant
authors.affiliation: Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kratzsch
authors.affiliation: Institute of Virology, University of Leipzig, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Maier
authors.affiliation: Institute of Virology, University of Leipzig, Leipzig, Germany.
authors.forename: U G
authors.initials: UG
authors.lastname: Liebert
authors.affiliation: Department of Internal Medicine, Dermatology, and Neurology, Clinic of Gastroenterology and Rheumatology, Section of Hepatology, University of Leipzig, Leipzig, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Berg
authors.affiliation: Department of Internal Medicine, Dermatology, and Neurology, Clinic of Gastroenterology and Rheumatology, Section of Hepatology, University of Leipzig, Leipzig, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Wiegand
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood* / Q000276:immunology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D017678:Sex Distribution; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies