Year 2025 / Volume 117 / Number 12
Original
The role of immigration in chronic hepatitis B and C in Asturias - Origin and characteristics of the patients. An observational, cross-sectional study

745-751

DOI: 10.17235/reed.2025.11373/2025

Ángela Suárez-Noya, Carmen Álvarez-Navascués, Mercedes Rodríguez, Valle Cadahía-Rodrigo, Lissa Franco, Andrés Castaño-García, Susana Rojo-Alba, María Varela, María Luisa González-Diéguez, Manuel Rodríguez,

Abstract
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.
Lay Summary
In this study, the influence of immigration on chronic hepatitis B and C cases was analyzed, which included 758 individuals with hepatitis B and 1,673 with hepatitis C attended between 2014 and 2023 at the Hospital Universitario Central de Asturias. The results show that the proportion of immigrants was higher in hepatitis B (38.8 %) than in hepatitis C (5.6 %), and also among new cases diagnosed during the study period compared to previously known cases with both infections. Regarding the origin of immigrants, one-third of hepatitis B cases came from Sub-Saharan Africa, while in hepatitis C, cases from Eastern Europe predominated. In hepatitis B, the main mechanism of infection acquisition was vertical-familial, whereas in hepatitis C, it was injected drug use. Immigrants with hepatitis C were older, had higher alcohol consumption and a higher body mass index, and exhibited more liver damage, measured by elastography. These results highlight the important role of immigration in chronic infections by both viruses, especially in hepatitis B, with direct implications for clinical practice, particularly in Primary Care, Infectious Diseases units, and Hepatology. They emphasize the need for systematic testing to detect these infections in immigrants, regardless of the presence of symptoms or known medical history, as many may not know they are infected. Additionally, in the case of hepatitis C, where identified cases present greater liver damage and risk factors such as alcohol consumption or a higher body mass index, professionals should pay more attention to signs of disease progression in these patients. In both cases, timely detection through accessible serological tests, along with early referral to specialized units, allows for effective treatment and prevention of severe complications such as cirrhosis or liver cancer.
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Suárez-Noya Á, Álvarez-Navascués C, Rodríguez M, Cadahía-Rodrigo V, Franco L, Castaño-García A, et all. The role of immigration in chronic hepatitis B and C in Asturias - Origin and characteristics of the patients. An observational, cross-sectional study. 11373/2025


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Publication history

Received: 28/05/2025

Accepted: 22/06/2025

Online First: 30/07/2025

Published: 12/12/2025

Article Online First time: 63 days

Article editing time: 198 days


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