[Prevac B: prevention of hepatitis B among migrants from subsaharian Africa and Asia].
BACKGROUND
In 2004, 22% of French citizen were vaccinated against Hepatitis B Virus (HBV), 7.3% had previously been protected by a contact with HBV, and 0.65% were carriers of HBV Those rates are not known among migrant people, especially if they have no health insurance. It is not known whether those people have adequate personal strategies of prevention.


OBJECTIVE
Prospective study to assess the effectiveness of an internet-accessible expert system in helping the GP to determine the most accurate strategy of prevention, related to the serologic HBV profile of each patient, and to apply this strategy, among migrant people coming from subsaharian Africa and Asia, attending their GP. The prevalence of each serologic profile was measured.


RESULTS
From 11.5.2007 to 12.31.2008, 28 GPs included 547 migrant people. 8% are HBV carriers, 33% have been protected by a contact with HBV, 16% are vaccinated, and 23% have had no contact with virus nor vaccination. A full accurate preventive information strategy could be carried out with help of the expert system, respectively among 100% of HBV carriers, 100% of vaccinated people, 98% of people protected by HBV contact, and 40% of people who had no marker A vaccination has been done among 64% of people who required it. For people whose only marker of HBV infection was anti HBc, 41% was considered protected by HBV contact, 48% was vaccinated, this result can be related to a lack of accuracy in international guidelines in this situation.


CONCLUSIONS
Prevalence of contact with HBV is much higher in migrant people coming from subsaharian Africa and Asia, than in the average French population. An internet-accessible expert system is a useful tool for GPs in order to enhance strategies of prevention in HBV infection.
Aubert
Jean-Pierre
JP
Département de médecine générale, université Paris-Diderot, Groupe d'etudes et de recherches ville-hôpital (GERVIH), réseau de santé Paris-Nord. aubert.petrequin@wanadoo.fr
Catrice
Maxime
M
Bouée
Stéphane
S
Di Pumpo
Alexandrine
A
Santana
Pascale
P
Gervais
Anne
A
Wajsbro
Alain
A
Gelly
Julien
J
Nougairède
Michel
M
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D001208:Asia; D005194:Family Practice; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014171:Transients and Migrants; D055815:Young Adult
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines