Epidemiological and Clinical Features of Hepatitis B Virus Genotypes among Immigrants in Southern Italy

Abstract

Background/aims. This study aims to determine the distribution and clinical features of HBV-genotypes in a population of immigrants affected by HBV-infection. Methods. Between 01/2003 and 03/2009, 1623 immigrants were tested for HBV-infection. Biochemical and virological activities were determined in HBsAg-positive patients; HBV-genotypes were determined, by the INNO-LiPA HBV Genotyping, in the subjects with HBV DNA detectable. In every patient we evaluated the stage and classified the infection as inactive carrier, mild or moderate/severe chronic hepatitis, cirrhosis, and/or HCC. Results. Among the tested subjects, 191 (11.7%) resulted HBsAg-positive, and in 144/191 (75.4%) serum HBV-DNA was detectable. The genotype distribution was as follows: 45,13% genotype E, 18,1% genotype D, 15,3% genotype B, 13,2% genotype C, 4,9% genotype A, 3,5% mixed genotypes (A–D). The evaluation of liver disease degree showed that 24.6% patients were inactive carriers of HBV infection, 19.4% presented a immunotolerance phase, 34.5% had mild chronic hepatitis, 13.6% had a moderate/severe chronic hepatitis, 6.3% had cirrhosis, and 1.6% presented HCC. Conclusions. Our study evidences a high prevalence of HBV-infection in immigrants, and the potentiality of migratory flow in the introduction of genotype non-D hepatitis B virus. The Hepatitis B virus genotypes presented significant differences in epidemiological and clinical characteristics.

Serological Pattern of Hepatitis B, C, and HIV Infections Among Immigrants in Sicily: Epidemiological Aspects and Implication on Public Health

“…On the other hand, positivity to markers of active HBV infection (acute or chronic carrier) among immigrants was equivalent to that reported in Spain [11], but it was about tenfold higher than that described in the Italian population (10.4% vs. 1.5%) [12], and also in other studies conducted in Southern Italy [13,14]. In our country, HBsAg positivity had a consistent downward trend over the past 30 years as a result of the improvement in the social-economical conditions, the decreased intrafamilial spread, a better knowledge of both transmission routes and prevention measures.…”

“…In conclusion, migration flows from highly endemic countries, that are constantly increasing in our region, could play a role to determine a partial but progressive modification of the local HBV/HCV/HIV epidemiology, as well as the introduction of viral genotypes that are actually not common for our geographical area but potentially correlated with a greater liver disease severity/progression and a worse pharmacologic treatment response [14,[37][38][39][40].…”

Molecular and Immunological Study of Hepatitis B virus infection in Samara City, Iraq.

“…In a recent study [35] that determine HBV genotype among immigrants to Italy (East Europe, sub-Saharan Africa, East -Asia, Central Africa, and Middle East], indicated that genotype E forms 45.13%, while 18.1% genotype D, 15.3% genotype B, 13.2% genotype C, 4.9% genotype A and 3.5% mixed genotypes (A-D). They found that genotype A was associated to Somali, B and C to Chinese, D to Pakistani, E to Eritrean, A-D mixed genotypes to Pakistani.…”

“…But immigrants modify the normal geographical distribution of hepatitis B virus genotype, with the introduction of non D genotype [35]. Thus population movement within the same country and migration between countries must be taken into consideration and follow up studies for genotyping at time interval is essential global issue.…”

Introduction of an Automated System for the Diagnosis and Quantification of Hepatitis B and Hepatitis C Viruses

“…The cccDNA (co-valently closed circular DNA), which acts as the major transcriptional template for the virus, is central to the durability of HBV infection and persists as an episome in infected hepatocytes. It can persist after antiviral therapy and even after the apparent clearance of the infection [5]. …”