Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) infections among undocumented migrants and uninsured legal residents in the Netherlands: A cross-sectional study, 2018-2019

• Published in: PloS one Vol. 16; no. 10; p. e0258932
• Main Authors: Klok, Sarineke, van Dulm, Eline, Boyd, Anders, Generaal, Ellen, Eskander, Sally, Joore, Ivo Kim, van Cleef, Brigitte, Siedenburg, Evelien, Bruisten, Sylvia, van Duijnhoven, Yvonne, Tramper-Stranders, Gerdien, Prins, Maria
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 29.10.2021; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Antibodies; Antigens; Biology and life sciences; Chronic infection; Consent; Cross-Sectional Studies; Exposure; Female; Health care; Health care facilities; Health risks; Health services; Hepatitis; Hepatitis B; Hepatitis B - epidemiology; Hepatitis B surface antigen; Hepatitis C; Hepatitis C - epidemiology; HIV; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Immune system; Infections; Infectious diseases; Laboratories; Male; Medical diagnosis; Medically Uninsured; Medicine and Health Sciences; Middle Aged; Migrants; Netherlands - epidemiology; Participation; People and places; Population studies; Prevalence; Public health; Questionnaires; Transients and Migrants; Undocumented immigrants; Uninsured people; Viruses; Netherlands; Italy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0258932

Migrants are not routinely screened for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in the Netherlands. We estimated the prevalence and determined factors associated with HBV, HCV and/or HIV infections among undocumented migrants and uninsured legal residents. In this cross-sectional study, undocumented migrants and uninsured legal residents were recruited at a non governmental organization (NGO), healthcare facility in the Netherlands and were invited to be tested for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibodies (anti-HBcAb), HCV-RNA, and anti-HIV antibodies or HIV antigen at a local laboratory. Of the 1376 patients invited, 784 (57%) participated. Participants originated from Africa (35%), Asia (30%) and North/South America (30%). 451/784 (58%) participants went to the laboratory for testing. Of participants 30% were HBV exposed (anti-HBcAb-positive), with 27% (n = 119/438, 95% CI 23.1% to 31.6%) having resolved HBV infection (HBsAg-negative) and 2.5% (n = 11/438, 95%CI 1.3% to 4.5%, 64% new infection) having chronic HBV infection (HBsAg-positive). Compared to HBV non-exposed, HBV exposed individuals were older (p = 0.034) and more often originated from Africa (p<0.001). Prevalence of chronic HCV infection (HCV-RNA-positive) was 0.7% (n = 3/435, 95%CI 0.1% to 2.0%, all new infections) and HIV infection 1.1% (n = 5/439, 95%CI 0.04% to 2.6%, 40% new infection). Prevalence of chronic HBV, chronic HCV and HIV infections in our study population is higher compared to the Dutch population, thus emphasizing the importance of case finding for these infections through primary care and public health in this specific group of migrants. Screening uptake could be improved by on-site testing.