Hepatitis A, B, and C infection in a community of sub-Saharan immigrants living in Verona (Italy)

BACKGROUND: In Italy, about 5% of the population is represented by immigrants. The epidemiology of hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection in Africa is very different from Europe; the present study aimed to assess the seroprevalence of viral hepatitis infections in sub-Saharan African immigrants living in Verona. METHODS: A total of 182 illegal immigrants were interviewed concerning sociodemographic characteristics and epidemiological information. Their serum was tested for anti-HAV [immunoglobulin (Ig) G and IgM], HBV (HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe), and HCV (anti-HCV) markers. RESULTS: The immigrants (age: 3 mo-60 y) were mostly single and males, with a higher education; only 50% of them declared having a regular job. Anti-IgG HAV+ prevalence was 99.5% (100% HAV positivity in the younger age bracket). As for HBV, 67.6% (123) of the immigrants were naturally infected and 9.3% had chronic infection; 4.4% were anti-HBs+ isolated (vaccinated). For HBV infection (any HBV marker), a significant difference was only found for increasing age ( p < 0.01) and married people ( p < 0.001). A statistically significant prevalence of HBsAg was found among the unemployed ( p < 0.001) and those with a lower education ( p < 0.05). Five cases (2.7%) resulted in HCV+ with no reported specific risk factors and with no significantly different sociodemographic features; these people tended to report a low level of education and unemployment. CONCLUSIONS: HAV and HBV positivity is higher than in the autochthonous population. While HAV positivity merely represents past infection, the high prevalence of HBsAg in immigrants and the presence of HBsAg/HBeAg in the same group may represent a risk for HBV transmission. The HCV positivity rate resulted similar to the prevalence of the Italian population.