Hepatitis B Virus Genotypes, Epidemiological Characteristics, and Clinical Presentation of HBV Chronic Infection in Immigrant Populations Living in Southern Italy

Information on hepatitis B virus (HBV) genotypes in immigrant populations living in Italy is scanty.
The current study aimed at assessing the epidemiological and clinical need to detect HBV genotypes in immigrants with HBV infection.
A multicenter screening was performed in 5 first-level care facilities centers in Southern Italy to identify migrants with HBV infection. Hepatitis B surface antigen (HBsAg)-positive subjects were further investigated at a tertiary unit of infectious diseases.
Of the 1727 investigated immigrants, 170 (9.8%) were HBsAg-positive. These 170 subjects, prevalently males (86.5%), aged 31.0 ± 8.5 years and living in Italy for nearly 2.5 years, prevalently (80%) from sub-Saharan Africa. HBV DNA was detected in 113 (66.5%) and HBV genotypes in 109 subjects: genotype E in 69.9%, genotype A in 16.5%, genotype D in 11.9%, and genotype C in 2.7%. Genotype E was detected in 70 (83.3%) out of 84 migrants from sub-Saharan Africa and in 5 from the other areas. Of these 75, 16% were hepatitis B e antigen (HBeAg)-positive and none circulated anti-hepatitis D virus (HDV); 69.3% were inactive HBV carriers, 22.7% had chronic hepatitis and 8% cirrhosis with multifocal hepatocellular carcinoma (HCC) in 2 patients. Half of the 18 subjects with genotype A, prevalently from sub-Saharan Africa (61%), were inactive HBV carriers, 7 had chronic hepatitis, and 1 had liver cirrhosis. Of the 13 subjects with genotype D, prevalently from Eastern Europe or India-Pakistan subcontinent, 8 were HBV inactive carriers and 5 had chronic hepatitis.
The data indicated the need to extend HBV screening and vaccination programs to all immigrants from areas of intermediate or high HBV endemicity.