Hepatitis B Virus Genotypes, Epidemiological Characteristics, and Clinical Presentation of HBV Chronic Infection in Immigrant Populations Living in Southern Italy

Abstract

Background: Information on hepatitis B virus (HBV) genotypes in immigrant populations living in Italy is scanty. Objectives: The current study aimed at assessing the epidemiological and clinical need to detect HBV genotypes in immigrants with HBV infection. Methods: A multicenter screening was performed in 5 first-level care facilities centers in Southern Italy to identify migrants with HBV infection. Hepatitis B surface antigen (HBsAg)-positive subjects were further investigated at a tertiary unit of infectious diseases. Results: Of the 1727 investigated immigrants, 170 (9.8%) were HBsAg-positive. These 170 subjects, prevalently males (86.5%), aged 31.0 ± 8.5 years and living in Italy for nearly 2.5 years, prevalently (80%) from sub-Saharan Africa. HBV DNA was detected in 113 (66.5%) and HBV genotypes in 109 subjects: genotype E in 69.9%, genotype A in 16.5%, genotype D in 11.9%, and genotype C in 2.7%. Genotype E was detected in 70 (83.3%) out of 84 migrants from sub-Saharan Africa and in 5 from the other areas. Of these 75, 16% were hepatitis B e antigen (HBeAg)-positive and none circulated anti-hepatitis D virus (HDV); 69.3% were inactive HBV carriers, 22.7% had chronic hepatitis and 8% cirrhosis with multifocal hepatocellular carcinoma (HCC) in 2 patients. Half of the 18 subjects with genotype A, prevalently from sub-Saharan Africa (61%), were inactive HBV carriers, 7 had chronic hepatitis, and 1 had liver cirrhosis. Of the 13 subjects with genotype D, prevalently from Eastern Europe or India-Pakistan subcontinent, 8 were HBV inactive carriers and 5 had chronic hepatitis. Conclusions: The data indicated the need to extend HBV screening and vaccination programs to all immigrants from areas of intermediate or high HBV endemicity.