Abstract Background Hepatitis B virus (HBV) infection remains one of the most common infectious diseases globally and can be exacerbated by coinfection with hepatitis D virus (HDV). In Germany, the incidence of hepatitis is reported annually through mandatory notification data. Nevertheless, these data lack information on hepatitis prevalence and testing coverage. We evaluated whether statutory health insurance claims data are suitable for continuous monitoring of key hepatitis indicators and whether they can complement existing HBV and HDV surveillance with reliable, population-based estimates. Methods We conducted a population-based cohort study using anonymised claims data from an age- and gender-representative sample from the InGef (Institute for Applied Health research) database between 2016 and 2021. We retrospectively analysed monitoring indicators for HBV and HDV -including annual prevalent infections within the respective analysis year, incidence of newly detected HBV infections (defined using a 3-year diagnosis-free interval) and the number of persons tested- based on coded diagnoses among individuals with access to healthcare services. Results were extrapolated to the German total population. Results Between 1,996 and 2,066 persons per 100,000 population were tested annually for at least one HBV marker (HBsAg or Anti-HBc), with 97% undergoing HBsAg testing only. The proportion of annual prevalent HBV infections ranged from 0.14% to 0.15% between 2016 and 2020. Incidence of newly detected HBV infections (3-year diagnosis-free interval) declined from 13.5 per 100,000 in 2019 to 8.9 per 100,000 in 2020. The proportion of prevalent HDV infections among HBV-positive persons varied from 4.5 to 6.4%. Conclusions Claims data provide a viable basis for continuous monitoring of selected hepatitis indicators in Germany. The number of prevalent and incident infections is consistent with other data sources and we were able to estimate the number of persons tested for hepatitis, addressing an important data gap. Claims data complement current surveillance systems and provide information for targeted public health action. The established approach should be applied to generate further hepatitis monitoring indicators. Trial registration Clinical trial number: Not applicable.
Branke et al. (Tue,) studied this question.