HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in context

Summary: Background: The health of the marginalized populations is crucial for public health and inequalities. The World Health Organization (WHO) Global Hepatitis Report 2024 stated that over 304 million people were living with Hepatitis B Virus (HBV)/Hepatitis C Virus (HCV) infection in 2022. We...

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Main Authors: Monica Monti, Teresita Caruso, Alice Castellaccio, Irene De Giorgi, Gabriella Cavallini, Maria Laura Manca, Serena Lorini, Silvia Marri, Luisa Petraccia, Francesco Madia, Cristina Stasi, Laura Carraresi, Elisabetta Lorefice, Sara Irene Bonelli, Alessandro Nerli, Mouheb M.A. Mudalal, Lorenzo Martini, Stefano Gitto, Eleonora Carradori, Adela Xheka, Irene Bendini, Samuele Lukolic’, Lorenzo Latella, Donatella Aquilini, Pierluigi Blanc, Anna Linda Zignego, Laura Gragnani
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:The Lancet Regional Health. Europe
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666776224003417
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author Monica Monti
Teresita Caruso
Alice Castellaccio
Irene De Giorgi
Gabriella Cavallini
Maria Laura Manca
Serena Lorini
Silvia Marri
Luisa Petraccia
Francesco Madia
Cristina Stasi
Laura Carraresi
Elisabetta Lorefice
Sara Irene Bonelli
Alessandro Nerli
Mouheb M.A. Mudalal
Lorenzo Martini
Stefano Gitto
Eleonora Carradori
Adela Xheka
Irene Bendini
Samuele Lukolic’
Lorenzo Latella
Donatella Aquilini
Pierluigi Blanc
Anna Linda Zignego
Laura Gragnani
author_facet Monica Monti
Teresita Caruso
Alice Castellaccio
Irene De Giorgi
Gabriella Cavallini
Maria Laura Manca
Serena Lorini
Silvia Marri
Luisa Petraccia
Francesco Madia
Cristina Stasi
Laura Carraresi
Elisabetta Lorefice
Sara Irene Bonelli
Alessandro Nerli
Mouheb M.A. Mudalal
Lorenzo Martini
Stefano Gitto
Eleonora Carradori
Adela Xheka
Irene Bendini
Samuele Lukolic’
Lorenzo Latella
Donatella Aquilini
Pierluigi Blanc
Anna Linda Zignego
Laura Gragnani
author_sort Monica Monti
collection DOAJ
description Summary: Background: The health of the marginalized populations is crucial for public health and inequalities. The World Health Organization (WHO) Global Hepatitis Report 2024 stated that over 304 million people were living with Hepatitis B Virus (HBV)/Hepatitis C Virus (HCV) infection in 2022. We performed HBV/HCV screenings among marginalized communities to reveal hidden infections and link-to-care positive participants. Methods: From January 2019 to May 2024, finger-prick tests were used to conduct on-site screenings at non-profit organizations in Tuscany, Italy. Positive participants were referred to the closest outpatient clinic. Findings: Eighty/1812 (4.4%) participants were Hepatitis B surface Antigen (HBsAg)+, mostly men (p < 0.001) and non-Italian natives compared to those HBsAg- (p < 0.001). Fifty-two/1812 (2.9%) were anti-HCV+ with a higher proportion of Italians (p < 0.001) and lower education level (p < 0.01) compared to the anti-HCV-. Intravenous drug use was an independent factor for being anti-HCV+ (p < 0.0001). Among the HBsAg + individuals, 66.3% (53/80) were linked and 90.4% (48/53) retained in care (treated/monitored). Of the anti-HCV participants requiring clinical evaluation, 37.8% (14/37) were linked to care, and all the 11/14 (88.6%) viremic patients were successfully treated. Interpretation: We found higher HBV/HCV positivity compared to national prevalences. Participation and linkage to care were successful. The young mean age (33.6 yrs) of HBsAg + individuals, primarily from regions with low vaccinal adherence, indicated geographical origin as a key risk factor. HCV positivity was associated with extreme marginality. The results stress the need to implement marginalized groups screening to target HBV/HCV hidden infections, reducing disparities in healthcare and advancing towards the WHO 2030 elimination goal. Funding: Gilead Sciences; Fondazione Cassa di Risparmio di Pistoia e Pescia; Regione Toscana.
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spelling doaj-art-cd3aa069565e4fe2afe1406e5b17d9f52024-12-10T04:14:45ZengElsevierThe Lancet Regional Health. Europe2666-77622025-02-0149101172HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in contextMonica Monti0Teresita Caruso1Alice Castellaccio2Irene De Giorgi3Gabriella Cavallini4Maria Laura Manca5Serena Lorini6Silvia Marri7Luisa Petraccia8Francesco Madia9Cristina Stasi10Laura Carraresi11Elisabetta Lorefice12Sara Irene Bonelli13Alessandro Nerli14Mouheb M.A. Mudalal15Lorenzo Martini16Stefano Gitto17Eleonora Carradori18Adela Xheka19Irene Bendini20Samuele Lukolic’21Lorenzo Latella22Donatella Aquilini23Pierluigi Blanc24Anna Linda Zignego25Laura Gragnani26MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, ItalySan Jacopo Hospital, Infectious Disease Unit, Pistoia, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, ItalyDepartment of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, ItalyDepartment of Clinical and Experimental Medicine and Department of Mathematics, University of Pisa and University Hospital of Pisa, Pisa, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyDepartment of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, ItalyPoison Control Center Unit, Department of Emergency, Anesthesia and Critical Care Medicine, Policlinico Umberto I Hospital - Sapienza, University of Rome, Rome, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyRegional Health Agency of Tuscany, Florence, Italy; Department of Life Science, Health, and Health Professions - Link Campus University, Roma, ItalyDepartment of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, ItalySan Giuseppe Hospital, Gastroenterology Unit, Empoli, ItalySan Jacopo Hospital, Infectious Disease Unit, Pistoia, ItalySanto Stefano Hospital, Infectious Disease Unit, Prato, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyDepartment of Health Sciences, University of Florence, Florence, ItalyDepartment of Health Sciences, University of Florence, Florence, ItalySanto Stefano Hospital, Infectious Disease Unit, Prato, ItalySan Jacopo Hospital, Infectious Disease Unit, Pistoia, ItalyMASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, ItalyDepartment of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Corresponding author. Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56126, Italy.Summary: Background: The health of the marginalized populations is crucial for public health and inequalities. The World Health Organization (WHO) Global Hepatitis Report 2024 stated that over 304 million people were living with Hepatitis B Virus (HBV)/Hepatitis C Virus (HCV) infection in 2022. We performed HBV/HCV screenings among marginalized communities to reveal hidden infections and link-to-care positive participants. Methods: From January 2019 to May 2024, finger-prick tests were used to conduct on-site screenings at non-profit organizations in Tuscany, Italy. Positive participants were referred to the closest outpatient clinic. Findings: Eighty/1812 (4.4%) participants were Hepatitis B surface Antigen (HBsAg)+, mostly men (p < 0.001) and non-Italian natives compared to those HBsAg- (p < 0.001). Fifty-two/1812 (2.9%) were anti-HCV+ with a higher proportion of Italians (p < 0.001) and lower education level (p < 0.01) compared to the anti-HCV-. Intravenous drug use was an independent factor for being anti-HCV+ (p < 0.0001). Among the HBsAg + individuals, 66.3% (53/80) were linked and 90.4% (48/53) retained in care (treated/monitored). Of the anti-HCV participants requiring clinical evaluation, 37.8% (14/37) were linked to care, and all the 11/14 (88.6%) viremic patients were successfully treated. Interpretation: We found higher HBV/HCV positivity compared to national prevalences. Participation and linkage to care were successful. The young mean age (33.6 yrs) of HBsAg + individuals, primarily from regions with low vaccinal adherence, indicated geographical origin as a key risk factor. HCV positivity was associated with extreme marginality. The results stress the need to implement marginalized groups screening to target HBV/HCV hidden infections, reducing disparities in healthcare and advancing towards the WHO 2030 elimination goal. Funding: Gilead Sciences; Fondazione Cassa di Risparmio di Pistoia e Pescia; Regione Toscana.http://www.sciencedirect.com/science/article/pii/S2666776224003417Hepatitis B virusHepatitis C virusMarginalized populationsHealthcare disparitiesWorld Health Organization
spellingShingle Monica Monti
Teresita Caruso
Alice Castellaccio
Irene De Giorgi
Gabriella Cavallini
Maria Laura Manca
Serena Lorini
Silvia Marri
Luisa Petraccia
Francesco Madia
Cristina Stasi
Laura Carraresi
Elisabetta Lorefice
Sara Irene Bonelli
Alessandro Nerli
Mouheb M.A. Mudalal
Lorenzo Martini
Stefano Gitto
Eleonora Carradori
Adela Xheka
Irene Bendini
Samuele Lukolic’
Lorenzo Latella
Donatella Aquilini
Pierluigi Blanc
Anna Linda Zignego
Laura Gragnani
HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in context
The Lancet Regional Health. Europe
Hepatitis B virus
Hepatitis C virus
Marginalized populations
Healthcare disparities
World Health Organization
title HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in context
title_full HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in context
title_fullStr HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in context
title_full_unstemmed HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in context
title_short HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective studyResearch in context
title_sort hbv and hcv testing outcomes among marginalized communities in italy 2019 2024 a prospective studyresearch in context
topic Hepatitis B virus
Hepatitis C virus
Marginalized populations
Healthcare disparities
World Health Organization
url http://www.sciencedirect.com/science/article/pii/S2666776224003417
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