Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort

Abstract

Background: Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCVinfected migrants vs. natives consecutively enrolled in the PITER cohort. Methods: Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used. Results: Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, ( p < 0.001), females 56.5% vs. 45.3%, ( p < 0.001), HBsAg positivity 3.8% vs. 1.4%, ( p < 0.05). Genotype 1b was prevalent in both groups, whereas genotype 4 was more prevalent in migrants ( p < 0.05). Liver disease severity and sustained virologic response (SVR) were similar. A higher prevalence of comorbidities was reported for natives compared to migrants ( p < 0.05). Liver disease progression cofactors (HBsAg, HIV coinfection, alcohol abuse, potential metabolic syndrome) were present in 39.1% and 47.1% ( p > 0.05) of migrants and natives who eradicated HCV, respectively.

Facing HCV as a Major Public Healthcare Threat in Italy: Epidemiology and Micro-Elimination Pathways among Underserved Populations

“…The study was conducted in the pre-DAA era, with treatments ranging from 6 to 12 months based on peg-IFN and ribavirin. Consistent data regarding DAAs were reported from the PITER cohort, which also reported no differences in liver injury between native and migrants [43]. On this regard, Prestileo et al reported no liver cirrhosis among 18 patients evaluated by ultrasound or fibroscan ® .…”

“…Unfortunately, the legal status of the subjects was not reported [42]. However, data from the Italian PITER cohort (Italian platform for the study of viral hepatitis therapy) report a higher number of positive females among migrants when compared to natives [43]. Thus, the burden of HCV on female migrants deserves further studies and should better define epidemiology according to Nationality.…”

Epidemiological and molecular characterization of HBV and HCV infections in HIV-1-infected inmate population in Italy: a 2017–2019 multicenter cross-sectional study

“…Regarding HBV infection, the most frequent genotypes in the Italian population are D and A 21 , although other genotypes have been introduced due to immigration, mainly from Africa 22 , 23 . Concerning the HCV genotype, distribution of variants differs between Italian and non-Italian national populations, genotype 4 is much more prevalent among non-Italian residents whereas genotypes 1b and 2 are the most frequent ones among Italian natives 24 .…”