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 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.