HBV and HCV testing outcomes among marginalized communities in Italy, 2019-2024: a prospective study.

Autor:	Monti M; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Caruso T; MASVE 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, Italy., Castellaccio A; San Jacopo Hospital, Infectious Disease Unit, Pistoia, Italy., De Giorgi I; MASVE 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, Italy., Cavallini G; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy., Manca ML; Department of Clinical and Experimental Medicine and Department of Mathematics, University of Pisa and University Hospital of Pisa, Pisa, Italy., Lorini S; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Marri S; Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, Italy., Petraccia L; Poison Control Center Unit, Department of Emergency, Anesthesia and Critical Care Medicine, Policlinico Umberto I Hospital - Sapienza, University of Rome, Rome, Italy., Madia F; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Stasi C; Regional Health Agency of Tuscany, Florence, Italy.; Department of Life Science, Health, and Health Professions - Link Campus University, Roma, Italy., Carraresi L; Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Florence, Italy., Lorefice E; San Giuseppe Hospital, Gastroenterology Unit, Empoli, Italy., Bonelli SI; San Jacopo Hospital, Infectious Disease Unit, Pistoia, Italy., Nerli A; Santo Stefano Hospital, Infectious Disease Unit, Prato, Italy., Mudalal MMA; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Martini L; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Gitto S; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Carradori E; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Xheka A; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Bendini I; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Lukolic' S; Department of Health Sciences, University of Florence, Florence, Italy., Latella L; Department of Health Sciences, University of Florence, Florence, Italy., Aquilini D; Santo Stefano Hospital, Infectious Disease Unit, Prato, Italy., Blanc P; San Jacopo Hospital, Infectious Disease Unit, Pistoia, Italy., Zignego AL; MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence, Center for Research and Innovation CRIA-MASVE, Firenze, Italy., Gragnani L; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Europe [Lancet Reg Health Eur] 2024 Dec 09; Vol. 49, pp. 101172. Date of Electronic Publication: 2024 Dec 09 (Print Publication: 2025).
DOI:	10.1016/j.lanepe.2024.101172
Abstrakt:	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. Competing Interests: Stefano Gitto: Gilead, speaker honoraria (2, year 2024), consultant fee (1, year 2024). All other authors declare no competing interests. (© 2024 The Author(s).)
Databáze:	MEDLINE
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