Current trends in access to treatment for hepatitis B in immigrants vs non-immigrants.

access to treatment hepatitis B immigration prevalence

Journal

Gastroenterology report
ISSN: 2052-0034
Titre abrégé: Gastroenterol Rep (Oxf)
Pays: England
ID NLM: 101620508

Informations de publication

Date de publication:
Oct 2020
Historique:
received: 07 08 2019
revised: 27 09 2019
accepted: 20 10 2019
entrez: 9 11 2020
pubmed: 10 11 2020
medline: 10 11 2020
Statut: epublish

Résumé

Universal vaccination for hepatitis B virus (HBV) and migratory movements have changed the demographic characteristics of this disease in Spain and in Europe. Therefore, we evaluated the characteristics of the disease and the possible differences according to origin (immigrants vs non-immigrants) and access to treatment. This is a multicenter cross-sectional study (June 2014 to May 2015) in which outpatients with a positive HBsAg were seen and followed in four Hepatology units. Demographic and clinical data and indication and access to treatment were collected in two different regions of Catalonia (Spain) where there are no barriers to treatment due to a comprehensive coverage under the National Health System. A total of 951 patients were evaluated (48.1% men). Of these, 46.6% were immigrants (58.7% of them were born in Africa) and were significantly younger compared to non-immigrants. The proportions of patients with alcohol consumption, being overweight, and other indicators of metabolic co-morbidities were significantly higher in non-immigrants. Among the 937 patients receiving HBeAg examination, 91.7% were HBeAg-negative. Chronic HBeAg-positive infection was significantly higher in immigrants (3.9% vs 0.6%, The immigrant population with HBV is younger and has a lower prevalence of metabolic co-morbidities and a higher frequency of chronic HBeAg infection. Despite having access to care and an indication for treatment, some do not get adequately treated due to several factors including local adaptation that precludes access to treatment.

Sections du résumé

BACKGROUND BACKGROUND
Universal vaccination for hepatitis B virus (HBV) and migratory movements have changed the demographic characteristics of this disease in Spain and in Europe. Therefore, we evaluated the characteristics of the disease and the possible differences according to origin (immigrants vs non-immigrants) and access to treatment.
METHODS METHODS
This is a multicenter cross-sectional study (June 2014 to May 2015) in which outpatients with a positive HBsAg were seen and followed in four Hepatology units. Demographic and clinical data and indication and access to treatment were collected in two different regions of Catalonia (Spain) where there are no barriers to treatment due to a comprehensive coverage under the National Health System.
RESULTS RESULTS
A total of 951 patients were evaluated (48.1% men). Of these, 46.6% were immigrants (58.7% of them were born in Africa) and were significantly younger compared to non-immigrants. The proportions of patients with alcohol consumption, being overweight, and other indicators of metabolic co-morbidities were significantly higher in non-immigrants. Among the 937 patients receiving HBeAg examination, 91.7% were HBeAg-negative. Chronic HBeAg-positive infection was significantly higher in immigrants (3.9% vs 0.6%,
CONCLUSIONS CONCLUSIONS
The immigrant population with HBV is younger and has a lower prevalence of metabolic co-morbidities and a higher frequency of chronic HBeAg infection. Despite having access to care and an indication for treatment, some do not get adequately treated due to several factors including local adaptation that precludes access to treatment.

Identifiants

pubmed: 33163191
doi: 10.1093/gastro/goaa010
pii: goaa010
pmc: PMC7603864
doi:

Types de publication

Journal Article

Langues

eng

Pagination

362-366

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University.

Références

Enferm Infecc Microbiol Clin. 2015 Feb;33(2):113-8
pubmed: 25620127
J Viral Hepat. 2012 Dec;19(12):881-9
pubmed: 23121367
Rev Esp Salud Publica. 2014 Nov-Dec;88(6):687-701
pubmed: 25418561
BMC Public Health. 2012 Aug 06;12(1):614
pubmed: 22867276
BMC Res Notes. 2013 Apr 17;6:153
pubmed: 23594964
J Hepatol. 2015 Aug;63(2):515-22
pubmed: 25962882
J Gastrointestin Liver Dis. 2010 Mar;19(1):43-8
pubmed: 20361074
Vaccine. 2007 Dec 17;25(52):8726-31
pubmed: 18045753
Vaccine. 2012 Oct 5;30(45):6347-58
pubmed: 22940378
Liver Int. 2012 Apr;32(4):612-21
pubmed: 22103765
Hum Vaccin Immunother. 2017 Feb;13(2):435-439
pubmed: 28027005
J Hepatol. 2017 Aug;67(2):370-398
pubmed: 28427875
PLoS One. 2018 Jan 23;13(1):e0191732
pubmed: 29360874
World J Hepatol. 2015 Dec 28;7(30):2955-61
pubmed: 26730274
Med Clin (Barc). 2002 Jun 22;119(3):90-5
pubmed: 12106536
World J Gastroenterol. 2015 Nov 14;21(42):11941-53
pubmed: 26576083
Rev Clin Esp. 2016 Jun-Jul;216(5):248-52
pubmed: 26995326
Rev Esp Salud Publica. 2014 Nov-Dec;88(6):811-8
pubmed: 25418570
PLoS One. 2017 Dec 28;12(12):e0189196
pubmed: 29283994
Enferm Infecc Microbiol Clin. 2016 Apr;34(4):261-9
pubmed: 26851978

Auteurs

Mireia Miquel (M)

Liver Unit, Gastroenterology Department, Parc Taulí University Hospital, Institut d'Investigacio i Innovació Parc Taulí I3PT, Autonomous University of Barcelona, Sabadell, Spain.

Albert Pardo (A)

Gastroenterology Department, University Hospital Joan XXIII, Tarragona, Spain.

Montse Forné (M)

Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.

Gemma Martínez-Alpin (G)

Liver Unit, Gastroenterology Department, Consorci Sanitari de Terrassa, Terrassa, Spain.

Adrià Rodríguez-Castellano (A)

Gastroenterology Department, University Hospital Joan XXIII, Tarragona, Spain.

Meritxell Casas (M)

Liver Unit, Gastroenterology Department, Parc Taulí University Hospital, Institut d'Investigacio i Innovació Parc Taulí I3PT, Autonomous University of Barcelona, Sabadell, Spain.

Mercè Rosinach (M)

Liver Unit, Gastroenterology Department, University Hospital Mútua Terrassa, Barcelona, Spain.

Mercè Roget (M)

Liver Unit, Gastroenterology Department, Consorci Sanitari de Terrassa, Terrassa, Spain.

Blai Dalmau (B)

Liver Unit, Gastroenterology Department, Parc Taulí University Hospital, Institut d'Investigacio i Innovació Parc Taulí I3PT, Autonomous University of Barcelona, Sabadell, Spain.

Rocío Temiño (R)

Liver Unit, Gastroenterology Department, University Hospital Mútua Terrassa, Barcelona, Spain.

Joan Carlos Quer (JC)

Gastroenterology Department, University Hospital Joan XXIII, Tarragona, Spain.

Jordi Sanchez-Delgado (J)

Liver Unit, Gastroenterology Department, Parc Taulí University Hospital, Institut d'Investigacio i Innovació Parc Taulí I3PT, Autonomous University of Barcelona, Sabadell, Spain.

Jordi Ortiz (J)

Liver Unit, Gastroenterology Department, Consorci Sanitari de Terrassa, Terrassa, Spain.

Mercedes Vergara (M)

Liver Unit, Gastroenterology Department, Parc Taulí University Hospital, Institut d'Investigacio i Innovació Parc Taulí I3PT, Autonomous University of Barcelona, Sabadell, Spain.

Classifications MeSH