Hepatitis A, B, C and D in a community in Italy of immigrants from NE Africa

A total of 213 subjects from a community in Italy of immigrants from Somalia and other NE African countries were enrolled in this study to evaluate the prevalence of HAV, HBV, HCV and HDV infections and to assess their possible risk factors. Of the subjects, 45 per cent (96) were female and 24 per cent (52) were under 12 years old. The age range was from 1 to 67 years and the mean age was 24 years. Eighty-three per cent (177 subjects) were born in Somalia, 10 per cent (21 subjects) in Ethiopia, and the rest in Djibouti, Egypt or Saudi Arabia. The 213 subjects were administered a questionnaire which covered socio-demographic characteristics and risk factors resulting from Western medical practice, traditional medicine, personal behaviour and living conditions. Blood was drawn from 209 subjects to ascertain the presence of HbsAg, HBeAg, anti-HAV, anti-HBc, anti-HBs, anti-HCV and anti-HDV. The results of this study show an HAV prevalence of 96 per cent (an 87·5 per cent prevalence in children under 12), and an HBV prevalence of 32 per cent (a 3·3 per cent prevalence of HBsAg carriers). No subject under 11 was HBV positive and no woman tested positive for HBeAg, confirming the extreme unlikelihood of vertical transmission of HBV. The prevalence of HBV is closely correlated with age (ranging from 2 per cent in those under 12 to 59 per cent in subjects over 39). Of the risk factors for hepatitis B, chronic ulcers, frequent visits to the barber and the dentist, having been in boarding school and having been through more than two African countries before coming to Italy emerged as particularly significant. Among the subjects from Somalia there was a significantly lower HBV prevalence in those from Mogadishu than in those from the rest of the country (OR = 204,95 per cent CI=0-93-4-5). HCV prevalence was 2 per cent (five cases). It was restricted to subjects over 25, and there was no significant gender prevalence. Of the antiHBc-positive subjects, no one tested positive for HDV. As the final stage of the study, H BV vaccine was made available to HBV-negative subjects, with particular attention to children under 12.