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 2003–2006, the Robert Koch-Institute conducted a nationwide cross-sectional
Health Interview and Examination Survey for Children and Adolescents in Germany. Data
on age, gender, migrant background and socio-economic status were collected through
questionnaires. A child was defined as having a two-sided migrant background if both
parents, or the child and one parent, immigrated, and a one-sided migrant background
if only one parent immigrated. Among children with migrant background, a first generation
migrant was defined if born outside Germany; a second generation migrant was born
in Germany. Information on HB vaccination status was obtained from vaccination cards.
Serological samples from participants were tested for anti-HBc and HBsAg. We performed
weighted univariable and multivariable logistic regression analyses to assess determinants
for HB infection. Results: Of 13,065 participants aged 3–17 years, 0.5% (95%-CI: 0.4–0.7) were anti-HBc positive,
among whom 38.7% (95%-CI: 20.0–57.5) were HBsAg positive. Two-sided migrant background
and being first or second generation migrant were significantly associated with anti-HBc
positivity (OR: 10.5, 95%-CI: 5.1–21.5; OR: 11.4, 95%-CI: 3.4–38.6; 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, with
two-sided migrant background or being first generation migrant the most risky categories.
Targeted testing for HB infection and early HB vaccination should be provided to immigrants'
children.
