Burden of HIV and hepatitis B and C viruses in incoming Venezuelan migrants at the Colombian border: a laboratory-based cross-sectional study, 2021-2023.

OBJECTIVES

The socioeconomic crisis in Venezuela has urged many to seek refuge elsewhere, primarily in Colombia. The vulnerability to and epidemiology of blood-borne viruses causing chronic infections such as HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) in incoming migrants at the Colombian border remain uncertain, which we aimed to elucidate.

METHODS

We conducted a cross-sectional study in 2469 adult Venezuelan migrants during 2021 (n= 1582) and 2023 (n= 887) encountered at governmental and nongovernmental organizations providing food and social services in Bucaramanga and Cúcuta, Colombia, close to the Venezuelan border. Demographic data and blood samples were collected and analysed by molecular, serological and bioinformatic tools.

RESULTS

The age- and sex-weighted HIV prevalence was 1.2% (95% CI: 0.6-1.7; 16/1650) and was significantly higher in men than in women (2.0% [95% CI: 0.8-3.2; 11/501] vs. 0.4% [95% CI: 0.0-0.7; 5/1149], p 0.002). Median HIV viral load was 3.9 log10 IU/mL (range: 2.2-5.1 log10 IU/mL). HIV infections were almost exclusively detected in migrants without health insurance. Viral genomes clustered with phylogenetically diverse HIV-1 group M subtype B strains from Colombia and Venezuela, refuting regional point-source acquisition. In silico susceptibility to antiviral drugs suggested lack of treatment access. The adjusted HBV prevalence in migrants was low (0.8%, 95% CI: 0.4-1.2; 12/1647), with median viral loads of 3.3 log10 IU/mL (range: 2.5-3.6 log10 IU/mL). The HCV estimate was also low (0.5%, 95% CI: 0.2-0.8; 10/2406) with median viral loads of 5.3 log10 IU/mL (range: 4.9-6.0 log10 IU/mL). Both HBV and HCV rates were comparable to Colombian population-level estimates, whereas HIV rates in migrants were 2x higher. No coinfections of HIV, HBV, or HCV were found. High levels of HIV but not HCV suggested predominantly sexual transmission rather than illicit drug use or contaminated blood transfusions.

CONCLUSIONS

Our data revealed a high burden of HIV, but not HBV and HCV in incoming Venezuelan migrants. Implementation of testing, educational, and prophylactic programmes in this highly vulnerable population at the border region is imperative.