PLoS ONE (Jan 2012)

High prevalence of anti-HCV antibodies in two metropolitan emergency departments in Germany: a prospective screening analysis of 28,809 patients.

  • Johannes Vermehren,
  • Beate Schlosser,
  • Diana Domke,
  • Sandra Elanjimattom,
  • Christian Müller,
  • Gudrun Hintereder,
  • Karin Hensel-Wiegel,
  • Rudolf Tauber,
  • Annemarie Berger,
  • Norbert Haas,
  • Felix Walcher,
  • Martin Möckel,
  • Ralf Lehmann,
  • Stefan Zeuzem,
  • Christoph Sarrazin,
  • Thomas Berg

DOI
https://doi.org/10.1371/journal.pone.0041206
Journal volume & issue
Vol. 7, no. 7
p. e41206

Abstract

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BACKGROUND AND AIMS: The prevalence of hepatitis C virus (HCV) antibodies in Germany has been estimated to be in the range of 0.4-0.63%. Screening for HCV is recommended in patients with elevated ALT levels or significant risk factors for HCV transmission only. However, 15-30% of patients report no risk factors and ALT levels can be normal in up to 20-30% of patients with chronic HCV infection. The aim of this study was to assess the HCV seroprevalence in patients visiting two tertiary care emergency departments in Berlin and Frankfurt, respectively. METHODS: Between May 2008 and March 2010, a total of 28,809 consecutive patients were screened for the presence of anti-HCV antibodies. Anti-HCV positive sera were subsequently tested for HCV-RNA. RESULTS: The overall HCV seroprevalence was 2.6% (95% CI: 2.4-2.8; 2.4% in Berlin and 3.5% in Frankfurt). HCV-RNA was detectable in 68% of anti-HCV positive cases. Thus, the prevalence of chronic HCV infection in the overall study population was 1.6% (95% CI 1.5-1.8). The most commonly reported risk factor was former/current injection drug use (IDU; 31.2%) and those with IDU as the main risk factor were significantly younger than patients without IDU (p<0.001) and the male-to-female ratio was 72% (121 vs. 46 patients; p<0.001). Finally, 18.8% of contacted HCV-RNA positive patients had not been diagnosed previously. CONCLUSIONS: The HCV seroprevalence was more than four times higher compared to current estimates and almost one fifth of contacted HCV-RNA positive patients had not been diagnosed previously.