This article is more than 5 years old. Information may no longer be current.
HBV more prevalent among refugees in Germany vs. general population
Click Here to Manage Email Alerts
BARCELONA — Prevalence of hepatitis B virus infection in refugees in Germany surpassed that of the general population, according to new data presented at the International Liver Congress.
“Nineteen percent of Germans have a history of immigration. … [We found] the prevalence of hepatitis B surface antigen is higher in refugees than the German population,” Philipp Solbach, MD, department of gastroenterology, hepatology and endocrinology, Medizinsche Hochschule Hannover in Germany, said during a press conference.
Philipp Solbach
Solbach and colleagues performed a cross-sectional study in 793 refugees from all age groups and tested for serological markers of HBV, including hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core (anti-HBc) and various liver enzymes. The study was conducted in August 2015 across reception centers in northern Germany. A total of 258 patients’ antibodies to hepatitis B surface (anti-HBs) were assessed.
Solbach said a majority of the refugees were male (77%). The prevalence of HBV, as measured by HBsAg, was found in 2.3% of refugees compared with 0.7% in the general German population. Anti-HBc were found in 14.4% of refugees. However, Solbach stated these percentages were not higher than other migrant populations already working and living in Germany or higher in their country of origin.
HBsAg prevalence was higher in males (2.5%) and middle-aged to older patients (3.1%) compared with female and younger patients. In addition, male patients were also more likely to have anti-HBc compared with females (14.5% vs. 13.5%). The highest levels of anti-HBc were observed in patients older than 50 years of age (38%). Seroprevalence of anti-HBs was 18.6%.
Solbach noted that viral loads were not measured in patients.
Nearly 6% of refugees had elevated aspartate aminotransferase and 15.9% had elevated alanine aminotransferase. However, in 18 patients positive for HBsAg, none had elevated AST and only two had elevated ALT. These measurements led to a positive predictive value of 0 for AST and .016 for ALT.
“These are not appropriate screening markers for HBV,” Solbach said.
Solbach concluded: “The immunization status was poor, especially in patients aged [older than] 18 years. Liver enzymes are not an appropriate tool to screen for HBV.”
In a press release from EASL, Tom Hemming-Karlsen, MD, PhD, EASL vice-secretary, said, “This new research demonstrates the potential impact of health policy across Europe. Understanding implications of large scale migratory rends like the one Europe is currently experiencing can be challenging, however it is urgently needed. While this study looks at hepatitis B markers in isolation, there are potential implications for surveillance of communicable diseases across the board.” – by Melinda Stevens
Reference:
Solbach P, et al. Abstract PS137. Presented at: International Liver Congress; April 13-17, 2016; Barcelona.
Disclosure: The researchers report no relevant financial disclosures.