title: [Current seroprevalence, vaccination and predictive value of liver enzymes for hepatitis B among refugees in Germany].
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.
  
  
  OBJECTIVE
  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.affiliation: Klinik für Anästhesie, Notfallmedizin, Operative Intensivmedizin und Schmerztherapie, Klinikum Wolfsburg, Wolfsburg, Deutschland.
authors.forename: Annika
authors.initials: A
authors.lastname: Hampel
authors.affiliation: Klinik für Gastroenterologie, Hepatologie, Endokrinologie, Medizinische Hochschule Hannover, Hannover, Deutschland.|Standort Hannover-Braunschweig, Deutsches Zentrum für Infektionsforschung (DZIF), Braunschweig, Deutschland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Solbach
authors.affiliation: Klinik für Gastroenterologie, Hepatologie, Endokrinologie, Medizinische Hochschule Hannover, Hannover, Deutschland.|Standort Hannover-Braunschweig, Deutsches Zentrum für Infektionsforschung (DZIF), Braunschweig, Deutschland.
authors.forename: Markus
authors.initials: M
authors.lastname: Cornberg
authors.affiliation: Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.|Standort Hannover-Braunschweig, Deutsches Zentrum für Infektionsforschung (DZIF), Braunschweig, Deutschland.
authors.forename: Reinhold E
authors.initials: RE
authors.lastname: Schmidt
authors.affiliation: Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.|Standort Hannover-Braunschweig, Deutsches Zentrum für Infektionsforschung (DZIF), Braunschweig, Deutschland.
authors.forename: Georg M N
authors.initials: GM
authors.lastname: Behrens
authors.affiliation: Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. jablonka.alexandra@mh-hannover.de.|Standort Hannover-Braunschweig, Deutsches Zentrum für Infektionsforschung (DZIF), Braunschweig, Deutschland. jablonka.alexandra@mh-hannover.de.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Jablonka
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004796:Clinical Enzyme Tests / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006509:Hepatitis B / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008111:Liver Function Tests / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012036:Refugees / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D017678:Sex Distribution; D000637:Transaminases / Q000097:blood*; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D017325:Hepatitis B Vaccines; D000637:Transaminases
keywords: Asylum seeker; Hepatitis B; Liver enzymes; Refugees; Vaccination