Successful hepatitis B and C screening in the health check-up in the German primary care setting

Background and Aims The World Health Organization aims at eliminating the chronic hepatitis C virus (HCV) infection. As part of its strategy the Federal Joint Committee decided to include hepatitis B and C screening in a preventive medical examination, which is performed at the primary care level in Germany.We investigated the results one year after implementation of the screening between October 2021 and September 2022. Methods HBsAg/HBV-DNA and anti-HCV/HCV-RNA screenings were identified by billing categories in 286,192 individuals of 11 ambulatory health care centers. Results Compared to 30,106 HBsAg and 31,266 anti-HCV laboratory requisitions in the year 2018 the number of tests increased to n=286,192 during the screening period.Compared to routine care, additional anti-HCV positive tests increased the tally age dependently by 98% (n=177 plus n=170, males) and 123% (n=96 plus n=118, females) in the age group 35-44 years up to 518% (n=17 plus n=88, males) and 514% (n=29 plus n=149, females) in the ages 75-84 years. Similar results were observed for HBsAg.Prevalence of HBsAg, anti-HCV and HCV-RNA were 0.54%, 0.79% and 0.13%, respectively. Conclusions A structured hepatitis screening program at the primary care level has been successfully established and leads to age- and-sex-dependent large additional effects compared to routine care. Impact and Implications Strategies to eliminate chronic hepatitis B and C virus infection are country specific and vary between clinical scenarios. Our analysis proves the efficacy of a screening program by primary care physicians compared to routine care in a low-prevalence country. This program should be accompanied by additional efforts in risk populations like people who inject drugs that are under-represented in the current screening approach.