Hepatitis A, B, and C infection in a community of sub-Saharan immigrants living in Verona (Italy).
BACKGROUND
In Italy, about 5% of the population is represented by immigrants. The epidemiology of hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection in Africa is very different from Europe; the present study aimed to assess the seroprevalence of viral hepatitis infections in sub-Saharan African immigrants living in Verona.


METHODS
A total of 182 illegal immigrants were interviewed concerning sociodemographic characteristics and epidemiological information. Their serum was tested for anti-HAV [immunoglobulin (Ig) G and IgM], HBV (HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe), and HCV (anti-HCV) markers.


RESULTS
The immigrants (age: 3 mo-60 y) were mostly single and males, with a higher education; only 50% of them declared having a regular job. Anti-IgG HAV+ prevalence was 99.5% (100% HAV positivity in the younger age bracket). As for HBV, 67.6% (123) of the immigrants were naturally infected and 9.3% had chronic infection; 4.4% were anti-HBs+ isolated (vaccinated). For HBV infection (any HBV marker), a significant difference was only found for increasing age ( p < 0.01) and married people ( p < 0.001). A statistically significant prevalence of HBsAg was found among the unemployed ( p < 0.001) and those with a lower education ( p < 0.05). Five cases (2.7%) resulted in HCV+ with no reported specific risk factors and with no significantly different sociodemographic features; these people tended to report a low level of education and unemployment.


CONCLUSIONS
HAV and HBV positivity is higher than in the autochthonous population. While HAV positivity merely represents past infection, the high prevalence of HBsAg in immigrants and the presence of HBsAg/HBeAg in the same group may represent a risk for HBV transmission. The HCV positivity rate resulted similar to the prevalence of the Italian population.
Majori
Silvia
S
Dipartimento di Medicina e Sanità Pubblica, Sezione di Igiene e Medicina Preventiva Ambientale e Occupazionale, Università degli Studi di Verona, Verona, Italy. silvia.majori@univr.it
Baldo
Vincenzo
V
Tommasi
Irene
I
Malizia
Maria
M
Floreani
Annarosa
A
Monteiro
Geraldo
G
Ferrari
Aladino
A
Accordini
Augusto
A
Guzzo
Patrizia
P
Baldovin
Tatjana
T
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006506:Hepatitis A / Q000175:diagnosis / Q000453:epidemiology*; D035921:Hepatitis A Antigens / Q000097:blood; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology*; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors
D035921:Hepatitis A Antigens; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens