Annals of Hepatology
Volume 17, Issue 1, 2018, Pages 47-53

Clinical findings of HCV chronic infection in undocumented immigrants and low-income refugees in three areas of southern Italy (Article) (Open Access)

Sagnelli E. , Alessio L. , Sagnelli C.* , Gualdieri L. , Pisaturo M. , Minichini C. , Di Caprio G. , Starace M. , Onorato L. , Scotto G. , Macera M. , Coppola N.
  • a Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy
  • b Medical Center, Centro Sociale ex Canapificio, Caserta, Italy, Medical Center, Centro di Accoglienza “La tenda di Abramo”, Caserta, Italy
  • c Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy, Medical Center, Centro Sociale ex Canapificio, Caserta, Italy, Medical Center, Centro di Accoglienza “La tenda di Abramo”, Caserta, Italy, Medical center, Centro Suore Missionarie della Carità, Naples, Italy
  • d Medical Center, Centro per la Tutela della Salute degli Immigrati, Naples, Italy
  • e Medical Center, Centro Sociale ex Canapificio, Caserta, Italy, Medical Center, Centro di Accoglienza “La tenda di Abramo”, Caserta, Italy, Infectious Diseases Unit, AORN Sant’Anna e San Sebastiano, Caserta, Italy, Medical center, Centro Suore Missionarie della Carità, Naples, Italy
  • f Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy
  • g Medical Center, Centro Sociale ex Canapificio, Caserta, Italy, Medical Center, Centro di Accoglienza “La tenda di Abramo”, Caserta, Italy
  • h Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy
  • i Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy, Medical Center, Centro Sociale ex Canapificio, Caserta, Italy, Medical Center, Centro di Accoglienza “La tenda di Abramo”, Caserta, Italy
  • j Infectious Diseases Unit, Foggia, Italy
  • k Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy, Medical Center, Centro Sociale ex Canapificio, Caserta, Italy, Medical Center, Centro di Accoglienza “La tenda di Abramo”, Caserta, Italy
  • l Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy

Abstract

Introduction and aim. In recent decades, Italy has become a land of immigration from countries suffering a socio-economic crisis. The aim of this study was to perform an organized screening to identify and offer care to immigrants with HCV infection. Material and methods. The screening, performed from 2012 to 2015, involved 1,727 immigrants in the Campania and Apulia regions in southern Italy. Results. Screening was accepted by 1,727 (85%) out of 2,032 immigrants interviewed; 70 (4.1%) of the 1,727 were anti-HCV-positive, all unaware of their serological condition, 31 (44.3%) of whom were HCV-RNA-positive and 39 negative. The 31 HCV-RNA-positive immigrants were further investigated at a third-level clinic of infectious diseases. The HCV viral load was 2.6 x 10 7 ± 7.7 x10 7 IU/mL, and 35.5% showed HCV-genotype 1a or 1b, 23.8% genotype 2 and 22.6% genotype 3. Two immigrants had liver cirrhosis and, in accordance with the Italian Healthcare Authority guidelines, received an interferon-free regimen and achieved a sustained virological response (SVR); 18 had chronic hepatitis, 6 of whom with a high risk of progression and received interferon-based therapy, with SVR in 4, whereas 12 at low risk were put on a waiting list for future interferon-free treatment, once licensed. The remaining 11 HCV-RNA-positive immigrants were considered HCV inactive chronic carriers and were included in a long-term observational program. Conclusion. The screening program can be considered successful since it was accepted by 85% of the subjects interviewed and identified 70 anti-HCV-positive immigrants, all unaware of their clinical and virological condition. © 2018, Fundacion Clinica Medica Sur. All rights reserved.

Author Keywords

HCV infection Cirrhosis Immigration Chronic hepatitis C

Index Keywords

genetics genotype prospective study immigrant refugee multicenter study lowest income group mass screening clinical trial poverty follow up Prospective Studies human liver cirrhosis Refugees middle aged Serologic Tests sustained virologic response low risk patient Antiviral Agents Clinical Decision-Making Viral Load Biomarkers Hepatitis C virus chronic hepatitis C Hepatitis C, Chronic Aged interferon screening test nonhuman procedures RNA, Viral Undocumented Immigrants disease course Young Adult Humans undocumented immigrant Treatment Outcome Adolescent male female risk factor Risk Factors virus RNA immunology Article blood program evaluation adult major clinical study serology biological marker virus load hepatitis C antibody Italy Hepatitis C Antibodies drug effect high risk patient clinical decision making Hepacivirus antivirus agent Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85039859027&doi=10.5604%2f01.3001.0010.7534&partnerID=40&md5=9aab42923cfa4ffb5f03790502021b50
DOI: 10.5604/01.3001.0010.7534
ISSN: 16652681
Cited by: 9
Original Language: English