Integrating HBV, HCV and HIV screening in tuberculosis entry screening for migrants in the Netherlands

Abstract We evaluated uptake and diagnostic outcomes of voluntary hepatitis B (HBV) and C virus (HCV) screening offered during routine tuberculosis entry screening to migrants in Gelderland and Amsterdam, the Netherlands, between 2013 and 2015. In Amsterdam, HIV screening was also offered. Overall, 54% (461/859) accepted screening. Prevalence of chronic HBV infection (HBsAg-positive) and HCV exposure (anti-HCVpositive) in Gelderland was 4.48% (9/201; 95% confidence interval (CI): 2.37-8.29) and 0.99% (2/203; 95% CI: 0.27-3.52), respectively, all infections were newly diagnosed. Prevalence of chronic HBV infection, HCV exposure and chronic HCV infection (HCV RNA-positive) in Amsterdam was 0.39% (1/256; 95% CI: 0.07-2.18), 1.17% (3/256; 95% CI: 0.40-3.39) and 0.39% (1/256; 95% CI: 0.07-2.18), respectively, with all chronic HBV/HCV infections previously diagnosed. No HIV infections were found. In univariate analyses, newly diagnosed chronic HBV infection was more likely in participants migrating for reasons other than work or study (4.35% vs 0.83%; odds ratio (OR) = 5.45; 95% CI: 1.12-26.60) and was less likely in participants in Amsterdam than Gelderland (0.00% vs 4.48%; OR = 0.04; 95% CI: 0.00-0.69). Regional differences in HBV prevalence might be explained by differences in the populations entering compulsory tuberculosis screening. Prescreening selection of migrants based on risk factors merits further exploration.

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Integrating hepatitis B, hepatitis C and HIV screening into tuberculosis entry screening for migrants in the Netherlands, 2013 to 2015

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.11.17-00491 ◽

2018 ◽

Vol 23 (11) ◽

Cited By ~ 7

Author(s):

Janneke P Bil ◽

Peter AG Schrooders ◽

Maria Prins ◽

Peter M Kouw ◽

Judith HE Klomp ◽

...

Keyword(s):

Hepatitis B ◽

The Netherlands ◽

Hiv Infections ◽

Hbv Infection ◽

Hcv Rna ◽

Hiv Screening ◽

Newly Diagnosed ◽

Tuberculosis Screening ◽

Chronic Hbv Infection ◽

Chronic Hbv

We evaluated uptake and diagnostic outcomes of voluntary hepatitis B (HBV) and C virus (HCV) screening offered during routine tuberculosis entry screening to migrants in Gelderland and Amsterdam, the Netherlands, between 2013 and 2015. In Amsterdam, HIV screening was also offered. Overall, 54% (461/859) accepted screening. Prevalence of chronic HBV infection (HBsAg-positive) and HCV exposure (anti-HCV-positive) in Gelderland was 4.48% (9/201; 95% confidence interval (CI): 2.37–8.29) and 0.99% (2/203; 95% CI: 0.27–3.52), respectively, all infections were newly diagnosed. Prevalence of chronic HBV infection, HCV exposure and chronic HCV infection (HCV RNA-positive) in Amsterdam was 0.39% (1/256; 95% CI: 0.07–2.18), 1.17% (3/256; 95% CI: 0.40–3.39) and 0.39% (1/256; 95% CI: 0.07–2.18), respectively, with all chronic HBV/HCV infections previously diagnosed. No HIV infections were found. In univariate analyses, newly diagnosed chronic HBV infection was more likely in participants migrating for reasons other than work or study (4.35% vs 0.83%; odds ratio (OR) = 5.45; 95% CI: 1.12–26.60) and was less likely in participants in Amsterdam than Gelderland (0.00% vs 4.48%; OR = 0.04; 95% CI: 0.00–0.69). Regional differences in HBV prevalence might be explained by differences in the populations entering compulsory tuberculosis screening. Prescreening selection of migrants based on risk factors merits further exploration.

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Screening for chronic hepatitis B and C in migrants from Afghanistan, Iran, Iraq, the former Soviet Republics, and Vietnam in the Arnhem region, The Netherlands

Epidemiology and Infection ◽

10.1017/s0950268813003415 ◽

2014 ◽

Vol 142 (10) ◽

pp. 2140-2146 ◽

Cited By ~ 23

Author(s):

C. RICHTER ◽

G. TER BEEST ◽

E. H. GISOLF ◽

P. VAN BENTUM ◽

C. WAEGEMAEKERS ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hepatitis B ◽

Risk Groups ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

Increased Risk ◽

Chronic Hbv ◽

First Generation Migrants ◽

Chronic Hcv ◽

Former Soviet Republics

SUMMARYMigrants born in hepatitis B virus (HBV) and hepatitis C virus (HCV) endemic countries are at increased risk of being infected with these viruses. The first symptoms may arise when liver damage has already occurred. The challenge is to identify these infections early, since effective treatment has become available. In 2011 we conducted a screening project in first-generation migrants (FGMs) born in Afghanistan, Iran, Iraq, the former Soviet Republics, and Vietnam and living in Arnhem and Rheden. All participants were offered free blood screening for HBV and HCV. In total 959 participants were tested, with the country of origin known for 927, equating to 28·7% of all registered FGMs from the chosen countries. Nineteen percent (n = 176) had serological signs of past or chronic HBV infection and 2·2% (n = 21) had chronic HBV infection. The highest prevalence of chronic HBV infection was found in the Vietnamese population (9·5%, n = 12). Chronic HCV was found in two persons from the former Soviet Republics and one from Vietnam. Twenty-four percent (n = 5) of the newly identified patients with chronic HBV and one of the three patients with chronic HCV received treatment. Three of the patients, two with HCV and one with HBV, already had liver cirrhosis. The highest (9·5%) HBV prevalence was found in FGMs from Vietnam, indicating a high need for focusing on that particular immigrant population in order to identify more people with silent HBV infection. The fact that three patients already had liver cirrhosis underlines the necessity of early identification of HBV and HCV infection in risk groups.

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A Case of Acute Autoimmune Hepatitis Superimposed on Chronic Hepatitis B Infection

Case Reports in Gastrointestinal Medicine ◽

10.1155/2018/2139607 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Vanessa Sostre ◽

Hiren G. Patel ◽

Abdalla Mohamed ◽

Ariy Volfson

Keyword(s):

Autoimmune Hepatitis ◽

Liver Enzymes ◽

Young Male ◽

Normal Liver ◽

Hbv Infection ◽

Laboratory Findings ◽

Chronic Hbv Infection ◽

Elevated Liver Enzymes ◽

Chronic Hbv ◽

Chronic Hcv

Autoimmune hepatitis has been associated with chronic HCV infection, but there are only few cases reported of HBV infection as a possible trigger. We present a case of a young male who was diagnosed with acute autoimmune hepatitis superimposed on existent chronic HBV infection. A 30-year-old Hispanic male with no past medical history presented to the hospital with complaints of few days of generalized weakness. Laboratory findings were significant for elevated liver enzymes: AST, 1164 U/L; ALT, 1461 U/L; total bilirubin, 2 MG/DL; and alkaline phosphatase, 75 IU/L. Extensive workup was done to find the etiology for elevated liver enzymes. Only blood work that came back positive was for chronic HBV infection and elevated immunoglobulin G (IgG) level 1937 mg/dL. HBV viral load was 42,900,000 IU/mL. The patient was started on tenofovir 300 mg daily. Liver biopsy was done which was consistent with autoimmune hepatitis. Prednisone 60 mg daily was started. Six months later, blood work showed completely normal liver enzymes and total IgG. Hepatotropic viruses have been proposed as triggering factors for several autoimmune diseases. There are theories suggesting that similarity in viral epitope and self-proteins expression on liver cells’ surface causes a cross-reactive immunologic response and possible viral-induced autoimmune hepatitis.

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Correlation Between Liver Cirrhosis and Risk of Cardiac Arrhythmias

Revista de Chimie ◽

10.37358/rc.18.6.6361 ◽

2018 ◽

Vol 69 (6) ◽

pp. 1527-1532

Author(s):

Veronica Calborean ◽

Silvia Alina Miscoci ◽

Octavian Istratoaie ◽

Oana Galceava ◽

Dragos Ovidiu Alexandru ◽

...

Keyword(s):

Atrial Fibrillation ◽

Liver Cirrhosis ◽

Cardiac Arrhythmias ◽

Hcv Infection ◽

Hbv Infection ◽

Alcoholic Liver Cirrhosis ◽

Chronic Hbv Infection ◽

Chronic Hcv Infection ◽

Chronic Hbv ◽

Chronic Hcv

There are few studies analyzing the correlation between liver cirrhosis and cardiac arrhythmias. Still, factors triggering cardiac arrhythmias occur in many instances in liver cirrhosis.We studied a cohort with patientsdiagnosed with liver cirrhosis hospitalized to Cardiology Department, to the County Hospital of Craiova, between January 2017 and January 2018. We wanted to study the frequency of cardiac arrhythmias at the patients diagnosed with liver cirrhosis and also to evaluate several associated factors.The frequency of cardiac arrhythmias in the presence of risk factors was analysed using x2 test and statistical models.We analized multiple variable including demographics and clinical and biochemical characteristics, frequency of type of arrhythmias and evaluation of the associated factors like diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia ,hyper/hypokalemia and hyper/hyponatremia. From our group, after exclusion criteria, we have a total of 34 patients with alcoholic liver cirrhosis, 37 patients with chronic HCV infection and 36 patients with HBV infection. From 34 patients with alcoholic liver cirrhosis, 23 patients presented atrial fibrillation(67.65%), from 37 patients with chronic HCV infection 21 were diagnosed with atrial fibrillation(56.76%) and from the patients with HBV infection 19 patients were known with atrial fibrillation(52.78%).We have encounter atrial flutter at 2 patients (5.56%) with chronic HBV infection. Atrial extrasystole was found at 7 patients with chronic HBV infection (19.44%), 4 patients with chronic HCV infection (10.81%) and 1 patients with alcoholic liver cirrhosis (2.94%). Ventricular extrasystole was found at 12 patients with chronic HBV infection (33.33%), 3 patients with chronic HCV infection (8.11%) and 5 patients with alcoholic liver cirrhosis (14.71%).We have also correlate the arrhythmias with different biochemical variables from our cohort. In our study there were many association between hepatic cirrhosis and cardiac abnormalities, which is concordant to reports from literature. Compared to population without liver cirrhosis, the prevalence of arrhythmias was increased in our cohort.

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Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) infections among undocumented migrants and uninsured legal residents in the Netherlands: A cross-sectional study, 2018–2019

PLoS ONE ◽

10.1371/journal.pone.0258932 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258932

Author(s):

Sarineke Klok ◽

Eline van Dulm ◽

Anders Boyd ◽

Ellen Generaal ◽

Sally Eskander ◽

...

Keyword(s):

Hepatitis B ◽

The Netherlands ◽

Hiv Infections ◽

Cross Sectional Study ◽

Hcv Rna ◽

Undocumented Migrants ◽

Cross Sectional ◽

B Virus ◽

Immunodeficiency Virus ◽

Chronic Hcv

Background Migrants are not routinely screened for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in the Netherlands. We estimated the prevalence and determined factors associated with HBV, HCV and/or HIV infections among undocumented migrants and uninsured legal residents. Methods In this cross-sectional study, undocumented migrants and uninsured legal residents were recruited at a non governmental organization (NGO), healthcare facility in the Netherlands and were invited to be tested for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibodies (anti-HBcAb), HCV-RNA, and anti-HIV antibodies or HIV antigen at a local laboratory. Results Of the 1376 patients invited, 784 (57%) participated. Participants originated from Africa (35%), Asia (30%) and North/South America (30%). 451/784 (58%) participants went to the laboratory for testing. Of participants 30% were HBV exposed (anti-HBcAb-positive), with 27% (n = 119/438, 95% CI 23.1% to 31.6%) having resolved HBV infection (HBsAg-negative) and 2.5% (n = 11/438, 95%CI 1.3% to 4.5%, 64% new infection) having chronic HBV infection (HBsAg-positive). Compared to HBV non-exposed, HBV exposed individuals were older (p = 0.034) and more often originated from Africa (p<0.001). Prevalence of chronic HCV infection (HCV-RNA-positive) was 0.7% (n = 3/435, 95%CI 0.1% to 2.0%, all new infections) and HIV infection 1.1% (n = 5/439, 95%CI 0.04% to 2.6%, 40% new infection). Conclusion Prevalence of chronic HBV, chronic HCV and HIV infections in our study population is higher compared to the Dutch population, thus emphasizing the importance of case finding for these infections through primary care and public health in this specific group of migrants. Screening uptake could be improved by on-site testing.

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