[Hepatitis B and risk in insurance medicine]

Hepatitis B is one of the best-researched infectious diseases, both as regards the structure of the virus and in terms of diagnostic possibilities for identifying its stages, tracing its course and, perhaps most importantly, prognosing its development. Even though the range of test methods and supplementary analyses available is extensive and complex, it is nevertheless well worthwhile applying them selectively, as they allow the risk to be defined with relatively good accuracy. Of particular importance is the ability to distinguish between acute and chronic courses and, within the chronic course, between chronic persistent and chronic active hepatitis. Another major benefit is the possibility of predicting in good time malignant degeneration in the form of hepatocellular carcinoma. Though by contrast with South-East Asia and especially Central Africa, where the Hepatitis B morbidity rate can attain 80 to 90 per cent in some regions, the proportion of the population affected in Central Europe is relatively low (a figure of 5 per cent is quoted for West Germany), this disease is of particular significance because of its concentration among certain professional and risk groups and because a not inconsiderable proportion of policyholders are recruited from these groups.