Hepatitis B Virus Infections Among Children and Adolescents in...

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Pediatr Infect Dis J. 2010 Jul 29. [Epub ahead of print]

Hepatitis B Virus Infections Among Children and Adolescents in Germany:
Migration Background as a Risk Factor in a Low Seroprevalence Population.

Cai W, Poethko-Müller C, Hamouda O, Radun D.

From the *Departments of Infectious Disease Epidemiology and
daggerEpidemiology and Health Reporting, Robert Koch Institute, Berlin,
Germany.

Abstract

BACKGROUND:: Data on hepatitis B (HB) infection prevalence among children and
adolescents in Germany are scarce. We estimated seroprevalence of HB infection
and assessed determinants for HB infection among children and adolescents in
Germany from a representative population sample.

METHODS:: From 2003 to 2006, the Robert Koch Institute conducted a nationwide
cross-sectional Health Interview and Examination Survey for Children and
Adolescents in Germany. Data on age, gender, migration background, and
socioeconomic status were collected through questionnaires. A child was
defined as having a 2-sided migration background if both parents, or the child
and 1 parent, immigrated, and a 1-sided migration background if only 1 parent
immigrated. Among children with migration background, a first-generation
migrant was defined as born outside Germany; a second-generation migrant was
born in Germany. Information on HB vaccination status was obtained from
vaccination cards. Serologic samples from participants were tested for
anti-hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen. We
performed weighted univariable and multivariable logistic regression analyses
to assess determinants for HB infection.

RESULTS:: Of 13,065 participants (3-17 years), 0.5% (95% confidence interval
[CI], 0.4-0.7) were anti-HBc positive, among whom 38.7% (95% CI, 20.0-57.5)
were hepatitis B surface antigen positive. Two-sided migration background and
being a first- or second-generation migrant were significantly associated with
anti-HBc positivity (odds ratio [OR]: 8.3, 95% CI: 4.0-17.4; OR: 11.0, 95% CI:
3.5-35.0; OR: 3.0, 95% CI: 1.2-7.3). No further determinants were found.

CONCLUSIONS:: HB infection is rare among children and adolescents in Germany.
First- and second-generation migrant children can be considered to be at risk
for HB infection, 2-sided migration background or being a first-generation
migrant carried the greatest risk. Targeted testing for HB infection and early
HB vaccination should be provided to immigrants' children.

PMID: 20683220



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