Blood-borne chronic viral infections in a large cohort of immigrants in southern Italy: A seven-centre, prospective, screening study

Background: Aim of this study was to evaluate the prevalence of blood-borne chronic viral infections in immigrants living in southern Italy and identify factors associated to viral infections. Methods: A prospective screening program was performed in seven clinical centers operating in Campania, Apulia and Calabria regions in southern Italy, in order to identify immigrants with HBV, HCV or HIV infections. Results: Of 4,125 immigrants observed in the study period, 3,839 (93.0%) agreed to be screened: 381 (9.9%) resulted HBsAg-positive, 136 (3.5%) anti-HCV, 62 (1.6%) anti-HIV and 1,448 (37.7%) HBsAg-negative and anti-HBc-positive. Ongoing or previous HBV infection was observed more frequently in males (p = 0.02 and p < 0.001, respectively), whereas HIV infection in females (p = 0.01). Immigrants from western Africa showed a higher rate of HBsAg positivity (p < 0.0001), HBsAg negativity/anti-HBc positivity (p < 0.0001) and anti-HIV positivity (p = 0.004) compared with those from other geographical areas. At multivariate analysis, ongoing HBV infection was associated with male sex (OR 1.49, 95% CI: 1.04–2.14) and origin from western Africa (OR 4.67, 95% CI: 1.70–12.80) and eastern Europe (OR 3.44, 95% CI: 1.17–10.08). HCV infection showed the tendency to be more frequent among males (OR 1.84, 95% CI: 0.99–3.42). HIV infection was associated with an older age (OR 1.04, 95% CI: 1.01–1.06), origin from western Africa (OR 4.09, 95% CI: 1.26–13.29) and female sex (OR 2.38, 95% CI: 1.29–4,39; p = 0.006). Conclusions: The high prevalence of HBV, HCV and HIV infections in our large cohort of immigrants should definitively prompt Italian Healthcare Authorities to develop adequate cost-effective screening policies