• Claus Niederau and Christiane Kapagiannidis.
• Katholische Kliniken Oberhausen gGmbH, Klinik für Innere Medizin, St. Josef Hospital Oberhausen, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen, Duisburg-Essen. claus.niederau@st-josef.de
• Med Klin. 2006 Jun 15; 101 (6): 448-57.

Background And PurposeLittle is known about the epidemiology of hepatitis C in Germany and in particular about the route of infection. The current study prospectively analyzed epidemiologic and clinical data of patients with chronic hepatitis C virus (HCV) infection.MethodsA structured questionnaire was sent to primary care physicians in Germany. Of 13,287 questionnaires, 5,837 were sent back for analysis.ResultsAlthough the number of questionnaires sent out was proportional to the number of subjects living in the new and old states of Germany, only 9% were sent back from the new states; thus, the prevalence of hepatitis C is probably considerably lower in the new states compared with the old ones. The HCV-infected subjects originated from 92 different countries throughout the world: 63% were born in Germany, but 21% were from one of the former states of the USSR. Intravenous drug abuse was the most prevalent risk noted; there was a strong bias whereby physicians who cared for a large number of HCV-infected patients had a much higher proportion of subjects with i.v. drug abuse when compared to those who only cared for a few hepatitis C patients. In the latter group a history of infusion of blood products was approximately as frequent as a history of drug abuse. There was a high proportion of patients who had no risk factor for hepatitis C (25-42%). Fatigue was the most frequent symptom (nearly 60%), followed by loss of concentration and abdominal pain. The number of symptoms increased with a higher aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio and thus presumably with the stage of liver fibrosis.ConclusionHepatitis C should be excluded in all patients with elevated liver enzymes. In risk groups with a high prevalence of hepatitis C, the infection should be looked for even when liver enzymes are normal.

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