意大利南部移民队列中肝炎病毒合并感染的特征分析

Characterization of hepatitis virus co-infections in a cohort of immigrants living in southern Italy.

作者信息

Pisaturo Mariantonietta, Alessio Loredana, Starace Mario, Macera Margherita, Occhiello Laura, Cordua Emanuele, Capuano Salvatore, Onorato Lorenzo, Scotto Gaetano, Di Caprio Giovanni, Calò Federica, Monari Caterina, Sagnelli Caterina, Coppola Nicola

机构信息

Department of Mental Health and Public Medicine, Section of Infectious Diseases, Università degli studi della Campania Luigi Vanvitelli, Caserta, Italy.

Medical Center, Centro Sociale ex Canapificio, Caserta, Italy.

出版信息

J Med Virol. 2023 Mar;95(3):e28665. doi: 10.1002/jmv.28665.

DOI:10.1002/jmv.28665

PMID:36905118

Abstract

To characterize viral hepatitis co-infections in a cohort of immigrants living in southern Italy. In a prospective multicenter study, all undocumented immigrants and low-income refugees consecutively evaluated for a clinical consultation at one of the five first-level clinical centers in southern Italy from January 2012 to February 2020 were enrolled. All subjects included in the study were screened for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV) and anti-HIV; the HBsAg-positive were screened also for anti-delta. Of the 2923 subjects enrolled, 257 (8%) were HBsAg-positive alone (Control group B), 85 (2.9%) only anti-HCV-positive (Control group C), 16 (0.5%) HBsAg/anti-HCV-positive (Case group BC), and 8 (0.2%) HBsAg/anti-HDV-positive (Case group BD). Moreover, 57 (1.9%) subjects were anti-HIV-positive. HBV-DNA positivity was found less frequently in the 16 subjects in Case group BC (43%) and in the 8 in Case group BD (12.5%) than in the 257 in Control group B (76%; p = 0.03 and 0.0000, respectively). Similarly, HCV-RNA positivity was more frequent in Case group BC than in Control group C (75% vs. 44.7% p = 0.02). The subjects in Group BC had a lower prevalence of asymptomatic liver disease (12.5%) than Control group B (62.2%, p = 0.0001) and Control group C (62.3%, p = 0.0002). Conversely, liver cirrhosis was more frequently identified in Case group BC (25%) than in Control groups B and C (3.11% and 2.35%, p = 0.0000 and 0.0004, respectively). The present study contributes to the characterization of hepatitis virus co-infections in the immigrant population.

摘要

旨在描述居住在意大利南部的一组移民中的病毒性肝炎合并感染情况。在一项前瞻性多中心研究中，纳入了2012年1月至2020年2月期间在意大利南部五个一级临床中心之一因临床会诊而连续接受评估的所有无证移民和低收入难民。对纳入研究的所有受试者进行了乙肝表面抗原（HBsAg）、抗丙型肝炎病毒（HCV）和抗HIV筛查；HBsAg阳性者还进行了抗丁型肝炎病毒筛查。在纳入的2923名受试者中，257名（8%）仅HBsAg阳性（B对照组），85名（2.9%）仅抗HCV阳性（C对照组），16名（0.5%）HBsAg/抗HCV阳性（BC病例组），8名（0.2%）HBsAg/抗HDV阳性（BD病例组）。此外，57名（1.9%）受试者抗HIV阳性。BC病例组的16名受试者（43%）和BD病例组的8名受试者（12.5%）中HBV-DNA阳性的发生率低于B对照组的257名受试者（76%；p分别为0.03和0.0000）。同样，BC病例组中HCV-RNA阳性的发生率高于C对照组（75%对44.7%，p = 0.02）。BC组无症状肝病的患病率（12.5%）低于B对照组（62.2%，p = 0.0001）和C对照组（62.3%，p = 0.0002）。相反，BC病例组中肝硬化的确诊率（25%）高于B对照组和C对照组（分别为3.11%和2.35%，p分别为0.0000和0.0004）。本研究有助于描述移民人群中肝炎病毒合并感染的特征。