Z Gastroenterol 2018; 56(01): 29-35
DOI: 10.1055/s-0043-123830
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Time trend of reported cases and publications: hepatitis E in comparison to hepatitis A – D in Germany from 2001 to 2016

Zeitlicher Verlauf von gemeldeten Fällen und Publikationen: Hepatitis E im Vergleich zu Hepatitis A – D In Deutschland (2001 bis 2016)
Malte H. Wehmeyer*
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf
,
Johannes Hartl*
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf
,
Moritz von Wulffen
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf
,
Ansgar W. Lohse
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf
2   Deutsches Zentrum für Infektionsforschung (DZIF), Hamburg site
,
Sven Pischke
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf
2   Deutsches Zentrum für Infektionsforschung (DZIF), Hamburg site
› Author Affiliations
Further Information

Publication History

01 September 2017

22 November 2017

Publication Date:
09 January 2018 (online)

Abstract

Background The frequency of autochthonous hepatitis E virus (HEV) infections in Western countries has increased since the millennium, probably due to a higher awareness for HEV. The aim of this study was to analyze the epidemiological situation and regional distribution of HEV in comparison to hepatitis A – D in Germany.

Methods Data of the reported cases, patients’ travel histories, and the regional distribution of hepatitis A – E virus infections from 2001 to 2017 were extracted from databases of the Robert Koch Institute. The number of publications per year on each hepatitis virus was used as a surrogate parameter for scientific awareness.

Results The incidence of HEV infections increased from 31 reported cases in 2001 to 1991 cases in 2016 with a rate of autochthonous HEV infections of 44.4 % in 2001 and 83.9 % in 2016. In 2016, the HEV incidence was 4.4/100 000 in Eastern Germany and 2.0/100 000 in Western Germany. From 2001 to 2016, the numbers of hepatitis A and C virus infections decreased, while the number of hepatitis B virus infections initially decreased followed by an increase since 2014. The incidence of hepatitis D virus infections remained low. The incidence rates of hepatitis A – D virus infections were comparable between Eastern and Western Germany in 2016. There was a strong correlation between publications on HEV and reported HEV cases (Pearson r = 0.9803, p < 0.01).

Conclusions Especially in Eastern Germany, but also in Western Germany, the rate of reported HEV cases and the scientific awareness for this disease increased strongly since 2001.

Zusammenfassung

Hintergrund Die Häufigkeit autochthoner Hepatitis E Virus (HEV) Infektionen in der Westlichen Welt hat seit der Jahrtausendwende zugenommen, möglicherweise durch eine gesteigerte Aufmerksamkeit für HEV. Diese Studie sollte die epidemiologische Situation und die regionale Verteilung von HEV im Vergleich zu Hepatitis A-D in Deutschland untersuchen.

Methoden Daten der gemeldeten Fälle, Reiseanamnese und regionale Verteilung von Hepatitis A-E Fällen (2001 – 2017) wurden vom Robert-Koch-Institut bezogen. Die jährliche Anzahl an Publikationen über eines der Hepatitisviren wurde als Surrogatparameter für wissenschaftliches Interesse bewertet.

Ergebnisse Die Anzahl an HEV Infektionen stieg von 31 gemeldeten Fällen (2001) auf 1991 Fälle (2016) an. Die Rate autochthoner HEV Infektionen betrug 44,4 % 2001 und 83,9 % 2016. 2016 betrug die HEV Inzidenz 4,4/100 000 in Ost- und 2,0/100 000 in Westdeutschland. Zwischen 2001 und 2016 nahm die Zahl an HAV und HCV Virus Infektionen ab, während die Anzahl an Hepatitis B Virus Infektionen initial abfiehl und seit 2014 anstieg. Die Inzidenz an Hepatitis D Virus Infektionen blieb niedrig. Die Inzidenz an Hepatitis A - D Virus Infektionen war 2016 vergleichbar zwischen Ost- und Westdeutschland. Es gab eine starke Korrelation zwischen Publikationen über HEV und gemeldeten HEV Fällen (Pearson r = 0.9803; P < 0.01).

Schlußfolgerung Insbesondere in Ost- aber auch in Westdeutschland stiegen die Rate an gemeldeten HEV Fällen und die Aufmerksamkeit für diese Infektion seit 2001 an.

* These authors contributed equally


 
  • References

  • 1 Wedemeyer H, Pischke S, Manns MP. Pathogenesis and treatment of hepatitis e virus infection. Gastroenterology 2012; 142: 1388-1397
  • 2 Rein DB, Stevens GA, Theaker J. et al. The global burden of hepatitis E virus genotypes 1 and 2 in 2005. Hepatology 2012; 55: 988-997
  • 3 Pischke S, Wedemeyer H. Hepatitis E virus infection: multiple faces of an underestimated problem. J Hepatol 2013; 58: 1045-1046
  • 4 Pischke S, Behrendt P, Bock CT. et al. Hepatitis E in Germany – an under-reported infectious disease. Dtsch Arztebl Int 2014; 111: 577-583
  • 5 Pischke S, Heim A, Bremer B. et al. Hepatitis E: an emerging infectious disease in Germany?. Z Gastroenterol 2011; 49: 1255-1257
  • 6 Adlhoch C, Avellon A, Baylis SA. et al. Hepatitis E virus: Assessment of the epidemiological situation in humans in Europe, 2014/15. J Clin Virol 2016; 82: 9-16
  • 7 Hewitt PE, Ijaz S, Brailsford SR. et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet 2014; 384: 1766-1773
  • 8 Hartl J, Wehmeyer MH, Pischke S. Acute hepatitis E: two sides of the same coin. Viruses 2016; 8: E299
  • 9 Hartl J, Kreuels B, Polywka S. et al. Comparison of autochthonous and imported cases of hepatitis A or hepatitis E. Z Gastroenterol 2015; 53: 639-643
  • 10 Wenzel JJ, Preiss J, Schemmerer M. et al. Test performance characteristics of anti-HEV IgG assays strongly influence hepatitis E seroprevalence estimates. J Infect Dis 2013; 207: 497-500
  • 11 Hartl J, Otto B, Madden RG. et al. Hepatitis E seroprevalence in Europe: a meta-analysis. Viruses 2016; 8: E211
  • 12 Statistische Ämter des Bundes und der Länder. Agrarstrukturen in Deutschland. Einheit in Vielfalt. Regionale Ergebnisse der Landwirtschaftszählung. 2010
  • 13 Bundesministerium für Ernährung, Landwirtschaft und Verbraucherschutz. Nationale Verzehrsstudie II. Ergebnisbericht Teil 2.
  • 14 Wenzel JJ, Sichler M, Schemmerer M. et al. Decline in hepatitis E virus antibody prevalence in southeastern Germany, 1996–2011. Hepatology 2014; 60: 1180-1186
  • 15 Dalton HR, Bendall R, Ijaz S. et al. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis 2008; 8: 698-709
  • 16 Dalton HR, Stableforth W, Thurairajah P. et al. Autochthonous hepatitis E in southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease. Eur J Gastroenterol Hepatol 2008; 20: 784-790
  • 17 Wenzel JJ, Preiss J, Schemmerer M. et al. Detection of hepatitis E virus (HEV) from porcine livers in southeastern Germany and high sequence homology to human HEV isolates. J Clin Virol 2011; 52: 50-54
  • 18 Szabo K, Trojnar E, Anheyer-Behmenburg H. et al. Detection of hepatitis E virus RNA in raw sausages and liver sausages from retail in Germany using an optimized method. Int J Food Microbiol 2015; 215: 149-156
  • 19 Werber D, Michaelis K, Hausner M. et al. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 – linked to other German cities and European countries. Euro Surveill 2017; 22: 30457
  • 20 de Laar T, Pybus O, Bruisten S. et al. Evidence of a large, international network of HCV transmission in HIV-positive men who have sex with men. Gastroenterology 2009; 136: 1609-1617
  • 21 Kauhl B, Heil J, Hoebe CJ. et al. The spatial distribution of hepatitis C virus infections and associated determinants – an application of a geographically weighted Poisson regression for evidence-based screening interventions in hotspots. PLoS One 2015; 10: e0135656
  • 22 Jablonka A, Solbach P, Wobse M. et al. Seroprevalence of antibodies and antigens against hepatitis A-E viruses in refugees and asylum seekers in Germany in 2015. Eur J Gastroenterol Hepatol 2017; 29: 939-945
  • 23 Wedemeyer H, Heidrich B, Manns MP. Hepatitis D virus infection – not a vanishing disease in Europe!. Hepatology 2007; 45: 1331-1332
  • 24 Wedemeyer H, Manns MP. Epidemiology, pathogenesis and management of hepatitis D: update and challenges ahead. Nat Rev Gastroenterol Hepatol 2010; 7: 31-40
  • 25 Cornberg M, Manns MP. Current guidelines for treatment of hepatitis B. Correct diagnosis is the prerequisite. Pharm Unserer Zeit 2011; 40: 45-51
  • 26 Cornberg M, Protzer U, Dollinger MM. et al. Prophylaxis, diagnosis and therapy of hepatitis B virus (HBV) infection: the German guidelines for the management of HBV infection. Z Gastroenterol 2007; 45: 1281-1328