Successful Hepatitis B and C Screening in the Health Check-Up in the German Primary Care Setting

Background and AimsThe World Health Organization aims at eliminating the chronic hepatitis C virus (HCV) infection. As part of its strategy the Federal Joint Committee decided to include hepatitis B and C screening in a preventive medical examination, which is performed at the primary care level in Germany.We investigated the results one year after implementation of the screening between October 2021 and September 2022.MethodsHBsAg/HBV-DNA and anti-HCV/HCV-RNA screenings were identified by billing categories in 286,192 individuals of 11 ambulatory health care centers.ResultsCompared to 30,106 HBsAg and 31,266 anti-HCV laboratory requisitions in the year 2018 the number of tests increased to n=286,192 during the screening period.Compared to routine care, additional anti-HCV positive tests increased the tally age dependently by 98% (n=177 plus n=170, males) and 123% (n=96 plus n=118, females) in the age group 35-44 years up to 518% (n=17 plus n=88, males) and 514% (n=29 plus n=149, females) in the ages 75-84 years. Similar results were observed for HBsAg.Prevalence of HBsAg, anti-HCV and HCV-RNA were 0.54%, 0.79% and 0.13%, respectively.ConclusionsA structured hepatitis screening program at the primary care level has been successfully established and leads to age- and-sex-dependent large additional effects compared to routine care.Impact and ImplicationsStrategies to eliminate chronic hepatitis B and C virus infection are country specific and vary between clinical scenarios. Our analysis proves the efficacy of a screening program by primary care physicians compared to routine care in a low-prevalence country. This program should be accompanied by additional efforts in risk populations like people who inject drugs that are under-represented in the current screening approach.