, Volume 40, Issue 6, pp 621-625
Date: 01 Jul 2012

Hepatitis delta: on soft paws across Germany

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Globally, more than 350 million people are considered to be chronic carriers of the hepatitis B virus (HBV) infection; thereof, 15–20 million of these individuals are thought to be coinfected with hepatitis delta virus (HDV). The clinical course depends on the mode of transmission; whereas coinfection commonly resolves, superinfection aggravates the disease and progresses to chronicity in over 90 % of the cases, which, again, results in cirrhosis.


Although many tests are performed in HBV carriers, data on the prevalence of anti-HDV-IgG in Germany are only rarely available and outdated. Therefore, we retrospectively evaluated the seroprevalence of anti-HDV-IgG from the results of our routine service.

Materials and methods

Between January 2000 and October 2011, serum samples from 2,844 patients (carrying hepatitis B surface antigen) admitted to University Hospital Frankfurt am Main, Frankfurt, Germany, were tested for anti-HDV-IgG by enzyme-linked immunosorbent assay (ELISA).


The overall seroprevalence of anti-HDV-IgG in the collective of Frankfurt (n = 2,844) is 7.4 % [95 % confidence interval (CI): 6.4–8.4]. The amount of seropositive men (8.3 %, 95 % CI: 6.9–10) significantly exceeds the female proportion (5.7 %, 95 % CI: 4.3–7.5). The rate of seropositivity to anti-HDV-IgG in this collective of Frankfurt reached a maximum in the year 2003 (10.1 %, 95 % CI: 8.9–11.1). The lowest rate was observable in 2004, where 5.4 % were positive to anti-HDV-IgG.


Of the HBV carriers in Germany, 5–8 % reveal serologic evidence of coinfection with HDV. The vaccination against HBV is the key to prevent HDV infection; therefore, vaccination must strongly be propagated further on.