title: Occult hepatitis B infection in the immigrant population of Sicily, Italy.
abstract: In Italy, about 7 % of the resident population is represented by immigrants originating from geographic regions at high endemicity for hepatitis B virus infection. This study aims to assess the prevalence of occult HBV infection (OBI) including the identification of HBV-genotypes in a population of immigrants serologically negative for hepatitis B surface antigen (HBsAg). Between May 2006 and May 2010, 339 immigrants were tested for markers of HBV, hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. HBV-DNA was tested by using nested-PCR assays on three different genetic region. HBV-DNA was detected in plasma samples of 11/339 (3.2 %) patients. Most of them had no serological markers of HBV infection, 3/58 (5.2 %) were anti-HBc-alone, and 4/13 (30.8 %) were anti-HIV positive. HIV positivity was the only factor independently associated with the higher probability of observing OBI (OR = 16.5, p < 0.001). No HCV co-infected patients were found. Genotype D was detected in 9/11 (81.8 %) OBI cases, while the remaining two (18.2 %) were classified as genotype E. Although OBI was found at lower rate than expected among immigrants from highly endemic countries, anti-HBc alone positivity was confirmed as a sentinel marker of occult HBV infection. Nevertheless, a marked heterogeneity of HBV markers was found among HBV-DNA positive subjects. Our finding evidenced the predominance of HBV-genotype D viral strains among OBI cases, also in those from geographical areas where overt HBV infections are mainly sustained by viral genotypes other than D.
authors.affiliation: Department of Sciences for Health Promotion G. D'Alessandro-Hygiene Section, University of Palermo, 133 via del Vespro, 90127, Palermo, Italy. fabio.tramuto@unipa.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Tramuto
authors.forename: Carmelo M
authors.initials: CM
authors.lastname: Maida
authors.forename: Giuseppina M E
authors.initials: GM
authors.lastname: Colomba
authors.forename: Paola
authors.initials: P
authors.lastname: Di Carlo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzola
authors.forename: Valentina
authors.initials: V
authors.lastname: Li Vecchi
authors.forename: Mario
authors.initials: M
authors.lastname: Affronti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montalto
authors.forename: Francesco
authors.initials: F
authors.lastname: Vitale
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005838:Genotype; D006679:HIV Seropositivity; D006509:Hepatitis B / Q000453:epidemiology* / Q000208:ethnology* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012802:Sicily / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens