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SDG 3: Hepatitis

Abstract

BACKGROUND

Chronic hepatitis C (HCV) and hepatitis B (HBV) viruses remain major causes of liver-related morbidity and mortality. Despite a low prevalence in Germany, migration from higher-endemic regions and screening gaps may hinder progress towards World Health Organization (WHO) 2030 elimination targets. Population-based data are needed for surveillance, screening and elimination.

AIM

We aimed to estimate prevalence of HCV, HBV and hepatitis D virus (HDV) in adults in Germany.

METHODS

We retrospectively analysed 10,000 serum samples from the Multilocal and Serial Prevalence Study of Antibodies against SARS-CoV-2 in Germany (MuSPAD, 2020–2021), by age and gender distribution. Samples were pooled and tested for HCV and HBV by PCR, for HBV surface antigen (HBsAg) and for antibodies against HCV and HBV. Samples positive for HBsAg were analysed for HDV.

RESULTS

Active HCV infection (HCV RNA) was detected in four (0.04%; 95% CI: 0.02–0.1) persons. Seroprevalence for HCV was 0.17% (95% CI: 0.11–0.27), highest among 60–69-year-olds (0.53%). Active HBV infection (HBV DNA and/or HBsAg) was detected in 21 participants (0.21%; 95% confidence interval (CI): 0.14–0.32), peaking at 0.44% among 30–39-year-olds. No HDV infection was confirmed.

CONCLUSION

Recognising that relevant high-risk groups may be underrepresented in our data, the overall HCV and HBV prevalence in Germany appears low but non-negligible. Adults under 35 years are not covered by the national health check programme for all adults aged ≥ 35 years, suggesting potential screening gaps. Systematic HDV testing among HBV-positive individuals and targeted testing strategies may support progress towards WHO elimination goals.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2026-06-25
2026-07-18
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Population-based prevalence and screening gaps of hepatitis C, B and D, Germany, 2020 to 2021
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Zahra+Ghodratian&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ghodratian Zahra</a>, <a href="/search?value1=Katharina+Grikscheit&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Grikscheit Katharina</a>, <a href="/search?value1=Loraine+Busetto&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Busetto Loraine</a>, <a href="/search?value1=Benjamin+Marx&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marx Benjamin</a>, <a href="/search?value1=Niko+Kohmer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kohmer Niko</a>, <a href="/search?value1=Arne+Auste&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Auste Arne</a>, <a href="/search?value1=Raphael+Scheu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Scheu Raphael</a>, <a href="/search?value1=Manuela+Harries&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Harries Manuela</a>, <a href="/search?value1=Vanessa+Melhorn&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Melhorn Vanessa</a>, <a href="/search?value1=Thomas+Illig&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Illig Thomas</a>, <a href="/search?value1=Monika+Strengert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Strengert Monika</a>, <a href="/search?value1=Annemarie+Berger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Berger Annemarie</a>, <a href="/search?value1=Berit+Lange&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lange Berit</a>, <a href="/search?value1=Sandra+Ciesek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ciesek Sandra</a></span>. Population-based prevalence and screening gaps of hepatitis C, B and D, Germany, 2020 to 2021. <a href="/content/ecdc">Euro Surveill.</a> 2026;31(25):pii=2500864. <a href="https://doi.org/10.2807/1560-7917.ES.2026.31.25.2500864" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2026.31.25.2500864</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 12 Nov 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 20 Feb 2026 </span> </p>
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