Prevalence and factors associated with hepatitis B and D virus infections among migrant sex workers in Chiangmai, Thailand: A cross-sectional study in 2019

Abstract

To determine the prevalence of hepatitis B surface antigen (HBsAg) and antibody to hepatitis delta virus (anti-HDV) and associated factors among migrant sex workers in Chiangmai, Thailand. Methods: This cross-sectional study was conducted at various sexual entertainment venues in Chiangmai, Thailand, in 2019. Consenting participants were interviewed using a questionnaire, and plasma was tested for hepatitis B virus (HBV) markers (DiaSorin, Italy) and anti-HDV antibody (DIA.PRO Diagnostic Bioprobes, Italy), if HBsAg-positive. Associations between HBsAg positivity or HDV antibody and potential factors were examined using univariable and multivariable logistic regression analysis. Results: A total of 396 migrant sex workers, half of them female, were recruited between February and September 2019. Their median age was 25 years (interquartile range 22-30 years) and 95% were Burmese. Overall, HBsAg prevalence was 11.4%; 8.1% in females and 14.7% in males (Chi-square, p = 0.040). One-third were still susceptible to HBV. No HBsAg-positive participants had anti-HDV antibodies. HBsAg positivity was associated with being male (adjusted odds ratio (aOR) 3.01, 95% confidence interval (CI) 1.25-7.68, p = 0.014), having attended school (aOR 4.50, 95% CI 1.26-15.98, p = 0.020), being separated/ divorced/widowed (aOR 5.77, 95% CI 1.48-22.52, p = 0.012), and having unprotected sex (aOR 3.38, 95% CI 1.31-8.71, p = 0.012). Conclusions: In this young population, higher HBsAg prevalence in males may be related to sexual transmission, indicating the need for HBV screening programs linked with HBV prevention and care.

The changing context of hepatitis D

“…12,25,26 On the other hand, although mercenary sex was considered an important risk factor for HDV transmission in the 1990s, 27 it has not been reported in the literature of the last decade, except in a recent study from Thailand that found no HDV marker in HBsAgpositive migrant sex workers. 28 In Europe, the demise of HDV in domestic populations has been offset by new infections introduced by immigrants from areas where HDV remains endemic. 29 The relative proportion of HDV-infected migrants is increasing compared to HDV-infected native populations 30 ; migratory flows have interrupted the decline in infections, whose prevalence in HBsAg carriers stabilised in the last decade at 8-10% in Germany, Italy, Spain and France.…”

Seroprevalence of Hepatitis B Virus and Associated Factors Among Female Sex Workers Using Respondent-Driven Sampling in Hawassa City, Ethiopia

“… 10 From limited studies in Ethiopia, the highest prevalences were reported from Gondar (28.9%), 11 Mekelle (6%), 12 and Dessie (13.1%). 13 In other developed countries such as Brazil, 14 China, 15 Thailand, 16 and India 17 the prevalence of HBV among Female sex workers (FSWs) was 23.6%, 10.7%, 11.4%, and 3.6%, respectively.…”

Uncommon hepatitis C virus among migrant sex workers in Chiangmai, Thailand

“…Their median age was 25 years (interquartile range: 22-30 years old), and 91.7% were Shan/Tai-Yai. Sociodemographic, health and medical histories, and sexual practices of the study population have been reported in a previous study [1]. Interestingly, a large majority (87.9%) reported always using condoms while having sex with their clients whereas 17% reported using condoms with their spouses.…”

“…Evidence of sexual transmission of HCV in this population remains limited. We conducted an analysis of HCV seroprevalence among a group of migrants working in the sex industry in Chiangmai, with a high prevalence of HBsAg [1] and assessed the risk factors for HCV infection.…”