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

Background: Information on hepatitis B virus (HBV) genotypes in immigrant populations living in Italy is rare. Objectives: This study aimed at assessing the epidemiological and clinical needs to detect HBV genotypes in immigrants with HBV infection. Methods: Amulticenter screening to identifymigrantswithHBV infectionwas performed in 5 first-level clinical centers insouthern Italy. HBsAg-positive subjects were further investigated at a tertiary unit of infectious diseases. Results: Of 1727 immigrants investigated, 170 (9.8%) were HBsAg-positive. These 170 subjects were prevalently males (86.5%), aged 31.0-8.5 years and living in Italy for nearly 2.5 years, andmost commonly (80%) fromsub-Saharan Africa. TheHBVDNAwas detected in 113 (66.5%) andHBV genotype in 109 cases: genotype-Ewas found in 69.9%, genotype-A in 16.5%, genotype-Din 11.9%, and genotype-C in 2.7%. Genotype-E was detected in 70 (83.3%) of 84 migrants from sub-Saharan Africa and in 5 of the other areas. Of these 75, 16% were HBeAg-positive (hepatitis B e antigen) and none circulated anti-HDV, 69.3% were inactive HBV carriers, and 22.7% were chronic hepatitis and 8% cirrhosis patients (withmultifocal hepatocellular carcinoma (HCC) in 2 patients). The 18 subjects with genotype-A were commonly from sub-Saharan Africa (61%); half of them were inactive HBV carriers, 7 had chronic hepatitis, and 1 had liver cirrhosis. Of the 13 subjects with genotype-D, commonly fromEastern-Europe or India-Pakistani subcontinent, 8 were HBV inactive carriers and 5 had chronic hepatitis. Conclusions: The data indicate the need to extend HBV screening and vaccination programs to all immigrants fromareas at intermediate or high HBV endemicity. [ABSTRACT FROM AUTHOR]