Effectiveness of a screening program for HBV, HCV, and HIV infections in African migrants to Sicily

Dig Liver Dis. 2022 Jun;54(6):800-804. doi: 10.1016/j.dld.2021.08.024. Epub 2021 Oct 11.

Abstract

Background: Migrants from Africa are vulnerable to viral infections during their journey.

Methods: Migrants who arrived in western Sicily were offered early screening for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection. A questionnaire was administered to evaluate risk factors, and antiviral therapy was offered to subjects with active infection. A multiple regression analysis and adjusted odds ratio were obtained to evaluate risk factors.

Results: Overall, 2,639 of 2,751 (95.9%) migrants who arrived between 2015 and 2017 accepted screening and 1,911 (72.4%) completed the questionnaire. HBsAg was positive in 257 (9.7%) migrants, 24 (0.9%) were anti-HCV positive and 57 (2.2%) had HIV infection. The prevalence of HBV infection was higher in women (aOR 2.47,95%CI 1.90-3.20),p = 0.003) and in people who endured physical and/or sexual violence (aOR 2.24,95%CI 1.87-3.55,p<0.001), while HIV infection was more frequent in women (aOR 5.40,95%CI 3.09-9.43, p <0.001) who were in Libya for a long period (aOR 5.66,95%CI 2.90-10.70,p = 0.004) and endured physical and/or sexual violence (aOR 14.77,95%CI 8.34-22.11,p<0.001). Being older than 18 was associated with HCV infection (p<0.001). Overall, 77% of 57 subjects with HIV infection were retained in care, 79% of 70 chronic HBV hepatitis cases started nucleot(s)ide analogues and 61% of 18 HCV-RNA positive cases received direct-acting antiviral therapy.

Conclusions: These findings evidence the effectiveness and feasibility of infectious disease screening programs for migrants.

Keywords: HBV infection; HCV infection; HIV infection; Libya; Migrants; Physical tortures; Sexual violence; Sicily.

MeSH terms

  • Antiviral Agents / therapeutic use
  • Female
  • HIV Infections* / epidemiology
  • Hepacivirus / genetics
  • Hepatitis B virus / genetics
  • Hepatitis B* / diagnosis
  • Hepatitis B* / epidemiology
  • Hepatitis C* / diagnosis
  • Hepatitis C* / drug therapy
  • Hepatitis C* / epidemiology
  • Hepatitis C, Chronic* / epidemiology
  • Humans
  • Prevalence
  • Sicily / epidemiology
  • Transients and Migrants*

Substances

  • Antiviral Agents