targeted screening for viral hepatitis among various ethnic groups in amsterdam, the netherlands

Background: a significant portion of individuals with hepatitis b virus (hbv) or hepatitis c virus (hcv) in the netherlands remain undiagnosed, with a majority from migrant backgrounds. objectives: this study explored whether targeting hbv/hcv screening among individuals with metabolic risk factors enhances screening efficacy within a diverse ethnic cohort. methods: participants from six ethnic backgrounds were enlisted from the population-based, prospective helius study in the netherlands. included were participants at elevated risk for non-alcoholic fatty liver disease (nafld), identified by elevated non-invasive tests (nits) and/or metabolic risk factors, who were then tested for hbv/hcv. we evaluated screening efficiency, defined as the prevalence of hbv/hcv, by implementing two targeted screening strategies: (1) testing individuals with elevated nits; and (2) those with metabolic risk factors. these strategies were compared to a generic testing approach previously utilized in a subset of helius participants. for non-dutch origin participants, analyses were stratified based on the hbsag-prevalence in their region of origin: low (< 2%) and intermediate (2 - 8%). results: the study included 346 participants at risk for nafld, predominantly of surinamese (n = 180; 45%), dutch (n = 103; 26%), or ghanaian (n = 63; 16%) origin. the generic testing approach encompassed 3,050 individuals. among individuals from low and intermediate hbv-endemic countries, hbsag-prevalence was 4.7% and 5.3% for those with elevated nits, 3.9%, and 3.5% for those with metabolic risk factors, and 0.8% and 3.7% for generic testing, respectively. regarding hcv, two individuals were anti-hcv-positive, with none being hcv-rna-positive. conclusions: targeted screening based on metabolic risk factors or elevated nits may be more efficient than generic screening among migrants from regions with low hbv prevalence.