HEPATITIS-A, HEPATITIS-B, HEPATITIS-C, AND HEPATITIS-D IN A COMMUNITYIN ITALY OF IMMIGRANTS FROM NORTH-EASTERN AFRICA

A total of 213 subjects from a community in Italy of immigrants from S omalia and other NE African countries were enrolled in this study to e valuate the prevalence of HAV, HBV, HCV and HDV infections and to asse ss 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 wa s from 1 to 67 years and the mean age was 24 years. Eighty-three per c ent (177 subjects) were born in Somalia, 10 per cent (21 subjects) in Ethiopia, and the rest in Djibouti, Egypt or Saudi Arabia. The 213 sub jects were administered a questionnaire which covered socio-demographi c characteristics and risk factors resulting from Western medical prac tice, 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 result s of this study show an HAV prevalence of 96 per cent (an 87.5 per cen t prevalence in children under 12), and an HBV prevalence of 32 per ce nt (a 3.3 per cent prevalence of HBsAg carriers). No subject under 11 was HBV positive and no woman tested positive for HBeAg, confirming th e extreme unlikelihood of vertical transmission of HBV. The prevalence of HBV is closely correlated with age (ranging from 2 per cent in tho se under 12 to 59 per cent in subjects over 39). Of the risk factors f or hepatitis B, chronic ulcers, frequent visits to the barber and the dentist, having been in boarding school and having been through more t han two African countries before coming to Italy emerged as particular ly significant. Among the subjects from Somalia there was a significan tly lower HBV prevalence in those from Mogadishu than in those from th e rest of the country (OR=2.04, 95 per cent CI=0.93-4.5). HCV prevalen ce was 2 per cent (five cases). It was restricted to subjects over 25, and there was no significant gender prevalence. Of the anti-HBc-posit ive subjects, no one tested positive for HDV. As the final stage of th e study, HBV vaccine was made available to HBV-negative subjects, with particular attention to children under 12.