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

• Published in: Digestive and liver disease Vol. 54; no. 6; pp. 800 - 804
• Main Authors: Prestileo, Tullio, Di Marco, Vito, Dino, Ornella, Sanfilippo, Adriana, Tutone, Marco, Milesi, Maurizio, Di Marco, Lorenza, Picchio, Camila A., Craxì, Antonio, Lazarus, Jeffrey V.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2022
• Subjects: Antiviral Agents - therapeutic use; Female; HBV infection; HCV infection; Hepacivirus - genetics; Hepatitis B - diagnosis; Hepatitis B - epidemiology; Hepatitis B virus - genetics; Hepatitis C - diagnosis; Hepatitis C - drug therapy; Hepatitis C - epidemiology; Hepatitis C, Chronic - epidemiology; HIV infection; HIV Infections - epidemiology; Humans; Libya; Migrants; Physical tortures; Prevalence; Sexual violence; Sicily; Sicily - epidemiology; Transients and Migrants; Sicily; Sicily; Migrants; Sexual violence; HCV infection; HBV infection; HIV infection; Libya; Physical tortures
• ISSN: 1590-8658; 1878-3562; 1878-3562
• DOI: 10.1016/j.dld.2021.08.024

Migrants from Africa are vulnerable to viral infections during their journey. 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. 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. These findings evidence the effectiveness and feasibility of infectious disease screening programs for migrants.