The role of immigration in chronic hepatitis B and C in Asturias: origin and characteristics of the patients. An observational, cross-sectional study.

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OBJECTIVE: to understand the burden of immigration in chronic hepatitis B (CHB) and C (CHC) in our setting and the characteristics of immigrants with each infection. MATERIALS AND METHODS: an observational, descriptive, and cross-sectional study was performed that included all patients attended for CHB (n = 758) and CHC (n = 1,673) between January 2014 and December 2023. Demographic, epidemiological, and clinical variables were analyzed. RESULTS: the proportion of immigrants was higher in CHB than in CHC (38.8 % vs 5.6 %; p < 0.001), as well as among incident cases compared to prevalent ones, both in CHB (60.7 % vs 23.1 %; p < 0.001) and CHC (7.8 % vs 2.6 %; p < 0.001). The geographic area with the highest proportion of CHB was Sub-Saharan Africa (33.3 %), and for CHC it was Eastern Europe (40.4 %). The main known mechanism of infection was vertical-familial transmission (28.2 %) in CHB and injected drug use (21.3 %) in CHC. Compared with those with CHB, immigrants with CHC were older (51.6 vs 34 years; p < 0.001), consumed alcohol more frequently (16 % vs 3.7 %; p < 0.001), and had a higher body mass index (BMI) (26.7 vs 24.5 kg/m²; p = 0.03) and greater liver stiffness (7.9 vs 5.2 kilopascals [kPa]; p < 0.001) evaluated by transient elastography. CONCLUSIONS: immigration plays a growing role in hepatitis B and C in our setting, making systematic screening in this population necessary. Although the impact of immigration is much greater in CHB than in CHC, immigrants with CHC present have a more advanced stage of liver fibrosis.

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