[Seroprevalence of chronic viral hepatitis markers in 791 recent immigrants in Catalonia, Spain. Screening and vaccination against hepatitis B recommendations].
BACKGROUND
The prevalence of chronic viral hepatitis in the European Union (EU) will vary because of the immigrants coming from countries having an elevated with a higher endemicity of hepatitis B (HBV) and C virus (HCV). Serologic screening in healthy immigrants is a subject that has been discussed in the areas of feasibility, ethics and cost-effectiveness. The main study aims were: a) to know the prevalence of chronic hepatitis markers and, b) to determine the best cost-effectiveness strategy of vaccination against hepatitis B.


METHODS
An observational, perspective and multicenter study was performed on the Primary Care level in Catalonia (Spain) among healthy immigrants who had lived in the EU for less than 5 years.


RESULTS
Data from 791 individuals were analyzed. They presented anti-HBc+ 33% (95% CI 29.6 -36.1), and anti-HBs+ 16.1% (95% CI 11.4 -20.8). HBsAg+ was 5.9% (95% CI 3-8.7), of those were HBeAg+ 15.62% (95% CI 5.3-32.8). The sub-Saharan group presented the higher prevalence of anti-HBc+ (77.3%) and HBsAg+ (18.2%), whereas the Latin American-origin population displayed the lowest one (12.5% and 1.2%, respectively). Determination of antibodies prior to vaccination was found as cost-effective from a seroprevalence anti-HBc+> 48.72%; only overcome by the CI of sub-Saharan population (95% CI 5.3-32.8). The prevalence of anti-HC+ was 6.1% (95% CI 4.3-7.8), especially high among the Eastern European (19.6%) and Indostanic (14.9%) population. The Latin American group had the lowest prevalence (1.4%).


CONCLUSIONS
The prevalence of chronic viral hepatitis markers is found to be at an intermediate level between those described by primary and specialized care levels. The prevalences of HBsAg+ and anti-HC+ in the immigrant population, on the whole, are such that it is advisable to screening for them, with the exception of the Latin American community. Previous serologic determination of markers is only cost-effective among the sub-Saharan community.
Valerio
Ll
L
Medicina Familiar y Comunitaria, Unidad de Salut Internacional del Barcelonès nord i Maresme, Santa Coloma de Gramenet, ICS, Barcelona, España. lvalerio.bnm.ics@gencat.net
Barro
S
S
Pérez
B
B
Roca
C
C
Fernández
J
J
Solsona
L
L
Aguilar
A
A
Escribà
J M
JM
D000328:Adult; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D013030:Spain / Q000453:epidemiology; D014171:Transients and Migrants
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D018937:Hepatitis C Antibodies