High prevalence of hepatitis markers in immigrant populations: a prospective screening approach in a real-world setting

Eur J Gastroenterol Hepatol. 2014 Oct;26(10):1090-7. doi: 10.1097/MEG.0000000000000164.


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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Cost-Benefit Analysis
  • DNA, Viral / blood
  • Early Diagnosis
  • Emigrants and Immigrants*
  • Emigration and Immigration*
  • Female
  • General Practice
  • Germany / epidemiology
  • Health Care Costs
  • Hepatitis B Antibodies / blood
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / diagnosis*
  • Hepatitis B, Chronic / economics
  • Hepatitis B, Chronic / ethnology*
  • Hepatitis C Antibodies / blood
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / diagnosis*
  • Hepatitis C, Chronic / economics
  • Hepatitis C, Chronic / ethnology*
  • Humans
  • Male
  • Mass Screening* / economics
  • Mass Screening* / methods
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Primary Health Care
  • Prospective Studies
  • Risk Factors
  • Serologic Tests
  • Socioeconomic Factors
  • Viral Load


  • Biomarkers
  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis C Antibodies